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The progressive increase in the number of deaths caused by Alzheimer's disease (AD) in Brazil and around the world between 2010 and 2020 raises questions in scientific society. At the same time, there is also an increase in life expectancy at birth (LEB). Thus, the aim of this study was, for the first time, to compare the increase in AD mortality rate (ADMR) in Brazilian regions over the years 2010 to 2020 with the increase in LEB, and investigate the possible correlation between these demographic transition phenomena and pesticide sales and exposure during this period. Data were extracted from the Brazilian Institute of Geography and Statistics (IBGE), from the Department of Informatics and Technology of the Brazilian Ministry of Health (DATASUS) and from the Brazilian Institute of the Environment and Renewable Natural Resources (IBAMA). There was a significant increase in life expectancy at birth and in ADMR over the years between 2010 and 2020 in all Brazilian regions, with the female population in the South region being the most affected. In conclusion, there is a strong positive correlation between the increase in ADMR and LEB; ADMR and Human Development Index (HDI) and ADMR and pesticide sales and exposure in Brazil over the years studied.

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The Human Development Index (HDI) is a proxy for the social and economic level of countries, which is related to the health and well-being of older adults. This study aimed to examine the moderating effect of the HDI on the relationship between frailty and health-related quality of life among European older adults. Participants were 23,972 older adults (53.2% female, M = 74.2 years old, SD = 6.75 years old) from 24 European countries, joining wave 8 (2020) of the Survey of Health, Aging, and Retirement in Europe (SHARE). Multilevel modeling was used to analyze nested data. Significant differences in health-related quality of life among the several European Union countries were observed (intraclass correlation coefficient [ICC] = 0.18, LRT (1) = 5568.07, p < .001). The HDI has been shown to moderate the relationship between frailty and health-related quality of life among older adults, buffering the impact of frailty on the health-related quality of life. Since healthy aging is a priority for the European Union, policies mitigating the impact of HDI on the relationship between frailty and health-related quality of life should be implemented.

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Congenital birth defects (CBD) play a significant role in causing child mortality globally. The incidence and mortality of CBD vary widely across countries, and the underlying causes for this divergence remain incompletely comprehended. We conducted an analysis to investigate the relationship between the incidence and mortality of CBD in 189 countries and their Human Development Index (HDI). In this study, CBD data from 189 countries was used from the Global Burden of Diseases Study (GBD) 2019, and HDI data was collected for the same countries. Later, the relationship between CBD and HDI was analyzed, and the impact of gross national income (GNI) per capita, expected years of schooling, mean years of schooling and life expectancy at birth was quantified using principal component regression. The age-standardized incidence rate (ASIR) varied between 66.57 to 202.24 per 100,000, with a 95% uncertainty interval (UI) of 57.20-77.51 and 165.87-241.48 respectively. The age-standardized mortality rate (ASMR) also showed a rang from 1.38 to 26.53 (14.03-39.90) per 100,000, with the 95%UI of 0.91-2.09 and 14.03-39.90 respectively. Both the incidence and mortality rates of CBD decreased with the increased HDI (incidence: r = -0.38, p < 0.001, mortality: r = -0.77, p < 0.001). Our investigation revealed significant variations in the incidence and mortality of CBD among countries with different development levels. In conclusion, the global incidence and mortality of CBD vary significantly among countries, possibly due to differences in the accessibility of health services.

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The purpose of this study is to examine the impact of national savings on economic development, as measured by the Human Development Index (HDI), Inequality-adjusted HDI (iHDI), and Multidimensional Poverty Index (MPI), in ten of the poorest countries in Sub-Saharan Africa. The study employs a sequential Generalized Method of Moments (GMM) analysis to address potential endogeneity issues and account for the dynamic nature of the relationships, covering the period from 2009 to 2019. The findings reveal a complex relationship between national savings and the selected development indicators. While national savings exhibit positive impacts on HDI and iHDI, the results are not consistently statistically significant across all the sequential models. However, the analysis suggests that national savings have a positive influence on reducing multidimensional poverty, as measured by MPI, particularly when effectively channeled into productive investments. The study also highlights the significant positive impact of government expenditure and foreign direct investment (FDI) on human development, underscoring the importance of strategic public investments and foreign capital. The results suggest that while national savings are crucial, their effective utilization is essential for enhancing human development indices. Strategic investments in public goods and foreign capital are also important. The mixed effects of inflation and official development assistance (ODA) emphasize the need for stable economic policies and effective utilization of foreign aid. The modest positive impact of institutional quality suggests that improvements in governance and institutional frameworks can contribute to human development. The findings underscore the need for policies promoting financial inclusion, efficient public expenditure, foreign direct investment, and stable macroeconomic conditions to leverage national savings for economic development. The study's findings provide valuable insights for policymakers in Sub-Saharan Africa, highlighting the need for comprehensive strategies that leverage national savings, public expenditure, and foreign investment to drive sustainable economic development and poverty reduction.

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BACKGROUND: This study aimed to compare the overall prevalence, stratified by sex and age group of global physical activity (GPA), active commuting to school (ACS), and sedentary behavior (SB) among adolescents from ten Latin American countries, and to assess the correlation of Development Index with the indicators. METHODS: This research is grounded on data from the Global School-Based Student Health Survey (2009-2015) and the 2015 Brazilian National School Health Survey. The prevalence and 95% confidence intervals for GPA (≥5 d/wk), ACS (≥1 d/wk), and SB (>2 h/d) were calculated using the chi-square test to compare the sexes (male; female) and age group (≤13 y; 14 y; 15 y; ≥16 y). We also performed Pearson correlation analysis with the Human Development Index. RESULTS: The prevalence of indicators ranged from 16.1% to 28.2% for GPA, from 56.7% to 71.2% for ACS, and from 20.7% to 62.6% for SB. Boys generally had a higher prevalence of GPA and ACS, and girls had a higher prevalence of SB. The prevalence of the indicators by age group varied between countries, with significant differences observed in some, depending on each indicator. A positive correlation was observed between Human Development Index, GPA, and SB. CONCLUSION: Health promotion policies must include guidelines that encourage and promote a more active and less sedentary lifestyle among young people in Latin America, considering specific groups, the local socioeconomic context, and differences between countries.

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This study was designed to assess the connection between human capital development and the employment of women in China from 1990 to 2020. Data was collected from the World Development Indicators, after which it was subjected to Dynamic Ordinary Least Squares and Granger causality econometric analysis. The results from the study showed that human capital development and women employment had a negative but insignificant relationship. Similarly, a unidirectional relationship existed between female employment and government capital expenditure in China, while a bidirectional association ran between women employment and government expenditure on education in the country. Therefore, it is concluded that human capital development and government expenditure on education are the strong motivating factors that drive GDP growth rate and women employment in China. Consequently, we recommend that policymakers in China should consider massive investment in human capital development in order to enhance women employment in the country. Additionally, policymakers should embark on policies and programmes that foster the expansion of China`s GDP growth rate as a measure to increase employment opportunities for women.

Cette étude a été conçue pour évaluer le lien entre le développement du capital humain et l'emploi des femmes en Chine de 1990 à 2020. Les données ont été collectées à partir des indicateurs de développement mondial, après quoi elles ont été soumises à une analyse économétrique des moindres carrés ordinaires dynamiques et de la causalité de Granger. Les résultats de l'étude ont montré que le développement du capital humain et l'emploi des femmes entretenaient une relation négative mais insignifiante. De même, il existait une relation unidirectionnelle entre l'emploi des femmes et les dépenses publiques en capital en Chine, tandis qu'une association bidirectionnelle existait entre l'emploi des femmes et les dépenses publiques d'éducation dans le pays. Par conséquent, nous concluons que le développement du capital humain et les dépenses publiques consacrées à l'éducation sont les principaux facteurs de motivation qui déterminent le taux de croissance du PIB et l'emploi des femmes en Chine. Par conséquent, nous recommandons aux décideurs politiques chinois d'envisager des investissements massifs dans le développement du capital humain afin d'améliorer l'emploi des femmes dans le pays. En outre, les décideurs politiques devraient se lancer dans des politiques et des programmes qui favorisent l'expansion du taux de croissance du PIB chinois afin d'augmenter les opportunités d'emploi pour les femmes.

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This study aims to evaluate the temporal trend in the quality of cause-of-death data and garbage code profiles and to determine its association with socio-economic status in Serbia. A longitudinal study was assessed using data from mortality registers from 2005 to 2019. Computer application Analysis of Causes of National Deaths for Action (ANACONDA) calculates the distribution of garbage codes by severity and composite quality indicator: Vital Statistics Performance Index for Quality (VSPI(Q)). A relationship between VSPI(Q) and country development was estimated by analysing two socio-economic indicators: the Socio-demographic Index and the Human Development Index (HDI). Serbia indicates progress in strengthening cause-of-death statistics. The steady upward trend of the VSPI(Q) index has risen from 55.6 (medium quality) to 70.2 (high quality) over the examined years. Significant reduction of 'Insufficiently specified causes with limited impact' (Level 4) and an increase in the trend of 'High-impact garbage codes' (Levels 1 to 3) were evident. Decreased deaths of no policy value (annual percentage change of -1.41%) have manifested since 2014. A strong positive association between VSPI(Q) and socio-economic indicators was assessed, where the HDI has shown a stronger association with VSPI(Q). Improved socio-economic conditions on the national level are followed by enhanced cause-of-death data quality. Upcoming actions to improve quality should be directed at high-impact garbage codes. The study underlines the need to prioritise the education and training of physicians with a crucial role in death certification to overcome many cause-of-death quality issues identified in this assessment.

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Plastic pollution has emerged as a global environmental concern, impacting both terrestrial and marine ecosystems. However, understanding of plastic sources and transport mechanism at the catchment scale remains limited. This study introduces a multi-source plastic yield and transport model, which integrates catchment economic activities, climate data, and hydrological processes. Model parameters were calibrated using a combination of field observations, existing literature, and statistical random sampling techniques. The model demonstrated robust performance in simulating both plastic yield and transport from 2010 to 2020 in the upper and middle Mulan River Catchment, located in southeast China. The annual average yield coefficients were found to closely align with existing estimations, and the riverine outflow exhibited a high correlation coefficient of 0.97, with biases ranging from -63.0 % to -21.4 % across all monitoring stations. The analysis reveals that, on average, 12.5 ± 2.5 % of the total plastic yield is transported to rivers annually, with solid waste identified as the primary source, accounting for 37.8 ± 20.7 % of the total load to rivers, followed by agricultural film (26.4 ± 9.8 %), impermeable surfaces (21.5 ± 10.3 %), urban and rural sewage (10.4 ± 5.0 % and 3.0 ± 1.5 %, respectively), and industrial wastewater (0.9 ± 0.7 %). The annual average outflow was estimated to between 9.3 and 43.0 ton/year (median: 23.1) at a 95 % confidence level. This study not only provides insights into the primary sources and transport pathways of plastic pollution at the catchment scale, but also offers a valuable tool for informing effective plastic pollution mitigation strategies.

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Background: As the vital and scarce resource of the health system, physicians are responsible for treating patients and saving lives and the equitable distribution of physicians among the whole population is a prerequisite to achieving health for all. We aimed to investigate inequality in physician distribution in the world using the Gini coefficient. Methods: This descriptive-analytical study was conducted in 2021. The number of physicians and the population of countries were obtained from the WHO and United Nations (UN) databases. The Gini coefficient was calculated in three different modes and the distribution of physicians among countries in various Human Development Index (HDI) groups was determined using the physician ratio per 10,000 population. Results: There were generally more than 13 million doctors in the world. About 43% of the world's physicians were available to 20% of the world's population in very high HDI countries, and 12% of the population had access to about 1% of physicians in low HDI countries. An average of 19.5 physicians are distributed per 10,000 population worldwide. The Gini coefficient between the four groups of HDI countries was 0.55, and that of all countries in the world was 0.640. Conclusion: There was a shortage and inequality in the distribution of physicians worldwide. Governments should eliminate inequality in the distribution of the medical workforce, in particular physicians, by redoubling their efforts and accurate planning.

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OBJECTIVES: To test the prevailing dogma that Streptococcus pyogenes emm-types that cause pharyngitis are the same as those associated with the carriage, using a global dataset. METHODS: Drawing on our systematic review of the global distribution of S. pyogenes emm-types and emm-clusters from 1990 to 2023, we compared the distribution and diversity of strains associated with pharyngitis and pharyngeal carriage, in the context of local United Nations Development Programme Human Development Index (HDI) values. RESULTS: We included 20 222 isolates from 71 studies done in 34 countries, with the vast majority of carriage strain data from studies in 'Low HDI' settings (550/1293; 43%). There was higher emm-type diversity for carriage than pharyngitis strains (Simpson Reciprocal Index of diversity 28.9 vs. 11.4). Compared with pharyngitis strains, carriage emm-types were disproportionately from emm-clusters E and D, usually described as 'generalist' or 'skin' strains. DISCUSSION: A limited number of studies have compared S. pyogenes strains from cases of pharyngitis compared with carriage. Our understanding of strains associated with carriage is the poorest for high-income settings. In low and medium HDI countries, we found greater strain associated with pharyngeal carriage than pharyngitis. Improving our understanding of S. pyogenes carriage epidemiology in the pre-vaccine era will help to decipher the direct and potential indirect effects of vaccines.

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BACKGROUND: Little information is available regarding global H. pylori recurrence, recrudescence, and re-infection in pediatric patients after successful eradication, nor are their influencing factors clear. We conducted a systematic review and meta-analysis to determine global H. pylori recurrence status and its influencing factors in children and adolescents to improve infection management and disease prevention. METHODS: Published studies on H. pylori recurrence in children and adolescents were collected from major public databases until January 2023. H. pylori recurrences were determined using randomized-effect and fixed-effect models. Stratified analysis was performed based on various regions, countries, publication time, human development indexes (HDIs), and ages. RESULTS: A total of 3310 relevant articles were screened, and 30 articles (1915 participants) were finally enrolled for analysis. The overall H. pylori recurrence rate was 19%, and the annual recurrence rate was 13%. In stratified analysis, H. pylori annual recurrence rate in Asian children was higher than that in Europe (17% vs. 6%) and higher in developing countries than in developed countries (18% vs. 5%). In children aged ≤ 5 years, ≤ 10 years, and 11-18 years, the H. pylori recurrence rates were 30%, 14%, and 8%, respectively. H. pylori recrudescence and re-infection rates were 6% and 10%, respectively, and its recurrence was inversely correlated with HDI. CONCLUSIONS: These results provide insights into global H. pylori recurrence, annual recurrence, recrudescence, and re-infection status in pediatric population. The stratified analysis revealed the pattern and seriousness of infection, which requires further efforts to improve patient care.

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COVID-19 vaccination is vital in reducing illness, hospitalization, and mortality in the face of this global pandemic. However, COVID-19 vaccination rates worldwide remain below WHO public health targets, and persistent structural inequities reduce vaccine uptake likelihood among populations of low socioeconomic status. We conducted a cross-sectional study based on publicly available data from the Our World in Data project. We included all 124 countries with available open epidemic data and a population of more than 5 million. We used a Cox Regression Model, with population, population density, median age, human development index, GDP per capita, gender inequality index, healthcare access and quality index, hospital beds per thousand people, completion rate of primary education, infection cases of COVID-19 by the end of 2022, and death rate due to COVID-19 by the end of 2022 as predictors for model hazard rates of completion of 50% population vaccination. According to our study, countries with higher populations, higher population density, higher human development index, lower gender inequality index, and lower hospital beds per 1000 people had a higher hazard rate, which means they were more likely to achieve 50% population vaccination faster. By utilizing the time to achieve vaccination rate goals as our primary endpoint, we evaluated inequity from a dual perspective, considering both the differences in vaccination rates and the duration required to attain them. Consequently, this study employed survival analysis approaches to gain a comprehensive understanding of vaccine drivers and population-level trends nationally and inform all communities from a statistical perspective to prepare for health emergencies. Development-level standing modified the effects of equal access to COVID-19 vaccination on cumulative cases and mortality, for which countries of low or medium human development tended to fare worse in outcomes than high human development countries. As COVID-19 vaccination efforts evolve, healthcare professionals, scholars, and policymakers need to identify the structural impediments to equitable vaccination awareness, access, and uptake so that future vaccination campaigns are not impeded by these barriers to immunization. Recognizing the complex nature of this significant barrier, it is evident that no single statistical analysis method can comprehensively address all intricacies.

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The aim of this study was to investigate relationships between changes in training practices and human development index (HDI) levels, and identify strategies employed by athletes who consistently maintained their training quantity during the first 100 days of the COVID-19 pandemic. A total of 10,074 athletes (5290 amateur and 4787 professional athletes from 121 countries) completed an online survey between 17 May to 5 July 2020. We explored their training practices, including specific questions on training frequency, duration and quantity before and during lockdown (March-June 2020), stratified according to the human development index (HDI): low-medium, high, or very high HDI. During the COVID-19 lockdown, athletes in low-medium HDI countries focused on innovative training. Nevertheless, women and amateur athletes experienced a substantial reduction in training activity. Performance-driven athletes and athletes from higher HDI indexed countries, were likely to have more opportunities to diversify training activities during lockdowns, facilitated by the flexibility to perform training away from home. Factors such as lockdown rules, socioeconomic environment, and training education limited training diversification and approaches, particularly in low-medium and high HDI countries. Athletes (amateurs and professionals) who maintained the quantity of training during lockdown appeared to prioritize basic cardiovascular and strength training, irrespective of HDI level. Modifying training and fitness programs may help mitigate the decrease in training activities during lockdowns. Customized training prescriptions based on gender, performance, and HDI level will assist individuals to effectively perform and maintain training activities during lockdowns, or other challenging (lockdown-like) situations.

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BACKGROUND: Numerous studies on the association between the human development index (HDI) and road traffic death rate (RTDR) merely focus on developed countries, not reflecting the relationship between the HDI components and RTDR in a time-trend analysis. Accordingly, this study analyzes the trends of RTDR and their association with the HDI and its components from 2000 to 2019. METHODS: The RTDR data of 154 countries were imported into the unconditional latent growth model (LGM) to assess the RTDR trends. The impact of the HDI and its components (viz., education, income, and life expectancy [LE viz]) on the trajectory of RTDR was also evaluated using the conditional LGM. RESULTS: The results of the unconditional LGM indicated an overall decreasing trend in RTDR. The conditional LGM results revealed the negative effect of the HDI and its components on the model parameters. The findings of random forests indicated that education and LE were the most crucial variables. CONCLUSION: Overall, this study emphasizes the significance of HDI and its components, particularly education and LE, in lowering the number of traffic fatalities. In this sense, improving formal education and LE could be one of the main policies that policymakers could consider to reduce RTDR.

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The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI.

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INTRODUCTION: General anaesthesia for emergent caesarean section, though uncommon, is vital in expediting deliveries. Studies indicate higher complication risks among pregnant migrant women. This research investigates if migrant women in Iceland are more likely to undergo general anaesthesia for emergent caesarean section compared to their Icelandic counterparts. MATERIALS AND METHODS: This population-based cohort study analysed 4,415 emergency caesarean sections in Iceland between 2007 and 2018, sourced from the National Birth Registry. Participants were categorized by citizenship, with migrants further stratified by their country's Human Development Index (HDI). NCSP-IS and ICD-10 codes indexed diseases, interventions, and complications. The impact of variables was assessed through multiple logistic regression analysis. RESULTS: Migrant women received general anaesthesia in 16.1% of cases, slightly surpassing Icelandic women's 14.6%. Adjusting for risk factors showed no increased risk for migrant women. However, they had a higher likelihood of urgent caesarean sections (OR 1.45, 95% CI 1.08-1.94, p=0.015), a known risk factor for general anaesthesia, despite fewer comorbidities. Adjusting for confounders revealed reduced odds with a history of previous caesarean section (aOR 0.73, 95% CI 0.59-0.89, p=0.003) and placement of epidural anaesthesia in the delivery room (aOR 0.49, 95% CI 0.40-0.60, p< 0.001). CONCLUSIONS: Migrant women in Iceland do not face increased risks of general anaesthesia for emergent caesarean sections. However, their elevated risk of urgent caesarean sections suggests potential challenges, including language barriers or inadequate antenatal care. Early information dissemination and targeted interventions may mitigate these risks in this vulnerable community.

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BACKGROUND: The COVID-19 pandemic led to numerous challenges for child protection professionals (CPPs). However, limited research has investigated the interwoven concepts of coping, resilience, and mental distress among CPPs during COVID-19 on a global scale. OBJECTIVES: This study aimed to explore CPPs' practice, resilience, and mental distress during COVID-19, the relationship between their resilience and mental distress, the global stability of the Multi-System Model of Resilience (MSMR), and how CPPs' resilience varied according to the Human Development Index (HDI). METHODS: Data were collected from 420 CPPs in 57 countries across five continents between July and September 2021. Participants completed an online questionnaire on demographics, resilience, mental distress, coping, and perceptions of child protection during the pandemic in their native languages. The analyses compared the countries grouped according to HDI using means comparisons, correlations, and multiple linear regressions. A two-path analysis was also performed to identify variables associated with behavioral resilience engagement and mental distress. RESULTS: The findings indicated that CPPs' perceptions of COVID-19's impact on child maltreatment varied in correlation with their country's HDI. There were also significant HDI-based differences regarding the perceived opportunity to engage in resilient behavior and its helpfulness. Years of professional experience, internal resilience, and external resilience were shown to be significant predictors of mental distress among CPPs during the pandemic, and resilience mediated how years of experience predicted mental distress. CONCLUSIONS: This study emphasized the importance of experience and internal resilience for CPPs' psychological well-being. It also provides empirical evidence to support the MSMR theory on a global scale. Additionally, it demonstrates how the perceived changes in child maltreatment during COVID-19 may be associated with regional HDI. Lastly, the opportunities CPPs had to engage in resilient behavior and how much this helped them was associated with regional HDI, but not in the way originally predicted. Study results also hold implications for how practice and policy may be altered to help CPPs cope better during times of crisis and generally.

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OBJECTIVE: To perform a meta-analysis and comparison between high-income, and low- and middle-income countries postpartum depression symptoms prevalences. METHODS: PubMed, Embase, Virtual Health Library, Scopus, Web of Science, PsycINFO and CINAHL databases were searched until October 2022 for studies that collected data from pandemic. The metaprop command was used in the Stata statistical software v.12.0 to run a random-effects meta-analysis. RESULTS: A total of 15 studies with 4,788 postpartum women were included. The overall prevalence of postpartum depression symptoms was 31% (95% CI: 21.85-40.99). The pooled prevalence of postpartum depression symptoms among women from high-income countries [30.5% (95% CI: 16.95-46.02)] did not differ significantly from that among women from low- and middle-income countries [31.5% (95% CI: 19.26-45.15)]. However, studies that analyzed women up to one month after childbirth had a lower prevalence of postpartum depression symptoms [17.5% (95% CI: 9.85-26.62)] compared to those that observed them up to one year after childbirth [38.3% (95% CI: 33.96-42.83)]. CONCLUSIONS: The prevalence of postpartum depression symptoms was high regardless of the country's human development index and it must be regularly tracked around the world to assess, discuss, and recommend more assertive steps that may be implemented based on the particular characteristics of each country.

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OBJECTIVES: South Asia (SA) and Southeast Asia (SEA) are geographically close; however, discrepancies in oral cancer (OC) epidemiology exist between the two regions. Socioeconomic disparities may influence the OC burden. The aim of this study was to assess the epidemiology of OC and its relationship with the Inequality Adjusted Human Development Index (IHDI) and its components in SA and SEA. METHODS: Cancer data for this ecological study was obtained from GLOBOCAN 2020, while the IHDI was obtained from the Human Development Report 2020. Based on data availability, 14 SA and SEA countries were chosen. Poisson log-weighted regression models were employed to examine IHDI and its components in relation to incidence and mortality. Univariate linear regression models were utilized to determine the association between the mortality-to-incidence ratio (MIR) and the IHDI. RESULTS: Mortality and MIR of OC were negatively correlated with all sub-indices of the IHDI, including education, health and income. However, incidence and mortality of OC were influenced by region and sex. CONCLUSIONS: Higher IHDI countries tended to have lower MIR. SA and males showed higher incidence and mortality. Reducing intra-country inequalities in development may be a pragmatic approach to enhancing the OC burden and prognosis.

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BACKGROUND: We aimed to investigate global variations in incidence and mortality and their associations to possible risk factors for prompt cancer prevention and control. METHODS: Estimates of incidence and mortality rates for six types of head and neck cancer were extracted from the GLOBOCAN 2020 database. Summary exposure values for level-two risk factors were obtained from the Global Burden of Disease. Regression models adjusting for the human development index (HDI) were constructed to analyze correlations between age-standardized rates and risk factors. RESULTS: The incidence rates of multiple types of head and neck cancer were positively associated with HDI tiers. In addition to tobacco use and alcohol consumption, high systolic blood pressure was associated with the incidence and mortality of cancers of the salivary glands, oropharynx, hypopharynx, and larynx. Dietary risks were linked to cancers of the oropharynx, nasopharynx, and hypopharynx. CONCLUSIONS: This comprehensive analysis provides valuable insights into possible risk factors for head and neck cancer.

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