Attention to local health burden and the global disparity of health research.

Most studies on global health inequality consider unequal health care and socio-economic conditions but neglect inequality in the production of health knowledge relevant to addressing disease burden. We demonstrate this inequality and identify likely causes. Using disability-adjusted life years (DAL...

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Autores principales:	James A Evans, Jae-Mahn Shim, John P A Ioannidis
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/accf042b7b7049e9b7c756cfe83826c6
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spelling	oai:doaj.org-article:accf042b7b7049e9b7c756cfe83826c62021-11-18T08:25:25ZAttention to local health burden and the global disparity of health research.1932-620310.1371/journal.pone.0090147https://doaj.org/article/accf042b7b7049e9b7c756cfe83826c62014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24691431/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203Most studies on global health inequality consider unequal health care and socio-economic conditions but neglect inequality in the production of health knowledge relevant to addressing disease burden. We demonstrate this inequality and identify likely causes. Using disability-adjusted life years (DALYs) for 111 prominent medical conditions, assessed globally and nationally by the World Health Organization, we linked DALYs with MEDLINE articles for each condition to assess the influence of DALY-based global disease burden, compared to the global market for treatment, on the production of relevant MEDLINE articles, systematic reviews, clinical trials and research using animal models vs. humans. We then explored how DALYs, wealth, and the production of research within countries correlate with this global pattern. We show that global DALYs for each condition had a small, significant negative relationship with the production of each type of MEDLINE articles for that condition. Local processes of health research appear to be behind this. Clinical trials and animal studies but not systematic reviews produced within countries were strongly guided by local DALYs. More and less developed countries had very different disease profiles and rich countries publish much more than poor countries. Accordingly, conditions common to developed countries garnered more clinical research than those common to less developed countries. Many of the health needs in less developed countries do not attract attention among developed country researchers who produce the vast majority of global health knowledge--including clinical trials--in response to their own local needs. This raises concern about the amount of knowledge relevant to poor populations deficient in their own research infrastructure. We recommend measures to address this critical dimension of global health inequality.James A EvansJae-Mahn ShimJohn P A IoannidisPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 4, p e90147 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q James A Evans Jae-Mahn Shim John P A Ioannidis Attention to local health burden and the global disparity of health research.
description	Most studies on global health inequality consider unequal health care and socio-economic conditions but neglect inequality in the production of health knowledge relevant to addressing disease burden. We demonstrate this inequality and identify likely causes. Using disability-adjusted life years (DALYs) for 111 prominent medical conditions, assessed globally and nationally by the World Health Organization, we linked DALYs with MEDLINE articles for each condition to assess the influence of DALY-based global disease burden, compared to the global market for treatment, on the production of relevant MEDLINE articles, systematic reviews, clinical trials and research using animal models vs. humans. We then explored how DALYs, wealth, and the production of research within countries correlate with this global pattern. We show that global DALYs for each condition had a small, significant negative relationship with the production of each type of MEDLINE articles for that condition. Local processes of health research appear to be behind this. Clinical trials and animal studies but not systematic reviews produced within countries were strongly guided by local DALYs. More and less developed countries had very different disease profiles and rich countries publish much more than poor countries. Accordingly, conditions common to developed countries garnered more clinical research than those common to less developed countries. Many of the health needs in less developed countries do not attract attention among developed country researchers who produce the vast majority of global health knowledge--including clinical trials--in response to their own local needs. This raises concern about the amount of knowledge relevant to poor populations deficient in their own research infrastructure. We recommend measures to address this critical dimension of global health inequality.
format	article
author	James A Evans Jae-Mahn Shim John P A Ioannidis
author_facet	James A Evans Jae-Mahn Shim John P A Ioannidis
author_sort	James A Evans
title	Attention to local health burden and the global disparity of health research.
title_short	Attention to local health burden and the global disparity of health research.
title_full	Attention to local health burden and the global disparity of health research.
title_fullStr	Attention to local health burden and the global disparity of health research.
title_full_unstemmed	Attention to local health burden and the global disparity of health research.
title_sort	attention to local health burden and the global disparity of health research.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/accf042b7b7049e9b7c756cfe83826c6
work_keys_str_mv	AT jamesaevans attentiontolocalhealthburdenandtheglobaldisparityofhealthresearch AT jaemahnshim attentiontolocalhealthburdenandtheglobaldisparityofhealthresearch AT johnpaioannidis attentiontolocalhealthburdenandtheglobaldisparityofhealthresearch
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Attention to local health burden and the global disparity of health research.

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