Inequalities in Human Resources for Health Linked to Mortality

Negative association seen between total human resources for health level and all-cause mortality

By Elana Gotkine HealthDay Reporter

MONDAY, May 15, 2023 (HealthDay News) — Inequalities in human resources for health (HRH; a range of occupations designed to promote or improve human health) are associated with all-cause and cause-specific mortality globally, according to a study published online May 10 in The BMJ.

Wenxin Yan, from the Peking University School of Public Health in Beijing, and colleagues examined inequalities in HRH in relation to all-cause and cause-specific mortality in 1990 to 2019 in an observational study conducted in 172 countries and territories.

The researchers found that globally, the total HRH density increased from 1990 to 2019, from 56.0 to 142.5 per 10,000 population, while age-standardized all-cause mortality decreased from 995.5 to 743.8 per 100,000 population. The Lorenz curve lay below the equality line, and the concentration index (CCI) was 0.43, suggesting that the health workforce was more concentrated with high ranking on the human development index. Between 1990 and 2001, the CCI for HRH was stable at about 0.42 to 0.43, and continued to decline from 0.43 to 0.38 from 2001 to 2019. A negative association was found between total HRH level and all-cause mortality, with incidence risk ratios (95 percent confidence intervals) of 1.15 (1.00 to 1.32), 1.14 (1.01 to 1.29), and 1.18 (1.08 to 1.28) for low, middle, and high, respectively, compared with the highest levels of HRH. The negative association between total HRH density and mortality was stronger for specific types of mortality, including neglected tropical diseases and malaria, enteric infections, maternal and neonatal disorders, and diabetes and kidney diseases.

“Our findings reinforce the importance of political commitment being strengthened to develop equity oriented policies for health workforces by expanding the financing of health and implementing targeted interventions to reduce deaths as a result of inadequate HRH to achieve the timely goal of universal health coverage by 2030,” the authors write.

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