Sociodemographic inequalities in premature mortality
A cause-specific decomposition of the global years of life lost (YLL) gap, 1990–2023
Bibliographic Data
| ID | 24214180 |
|---|---|
| Authors | Dev Desai (Department of Psychiatry, Dr . D. Y. Patil Medical College Hospital And Research Centre, Dr. D. Y. Patil Vidyapeeth(Deemed to be University), Pimpri) |
| Year | 2026 |
| Pages | 1-7 |
| Publication date | 2026-09-23 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Sociological Spectrum (JOURNAL) |
| Journal identifiers | ISSN: 0273-2173 • E-ISSN: 1521-0707 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/02732173.2026.2728985 |
| OpenAlex | W7214103383 |
| Language | EN |
| References cited | 9 |
Background Traditional epidemiological metrics rely on age-standardized mortality rates, which weight deaths equally and obscure the concentration of premature mortality among younger populations. Years of Life Lost (YLL) metrics assign greater weight to early-life mortality, providing a robust proxy for the opportunity cost of lost human capital. This study decomposes structural health inequalities by identifying the specific disease burdens driving the global YLL gap between the highest and lowest economic tiers over a 33-year horizon.Methods Utilizing data from the Global Burden of Disease (GBD) 2023 study, we analyzed age-standardized YLL rates per 100,000 across Socio-Demographic Index (SDI) quintiles. Inequality was quantified using the Inequality Ratio (IR), defined as the age-standardized YLL rate in Low-SDI regions divided by the corresponding rate in High-SDI regions. This metric was selected over gradient-based indices to provide a direct, policy-actionable multiplier of absolute disparity. Absolute YLLs were categorized by primary preventative intervention using strict classifications predefined in the GBD 2023 supplementary framework (Table S4).Results Global premature mortality declined significantly between 1990 and 2019, led by massive reductions in communicable diseases (e.g., a 44.56% decline in the Neonatal Disorders YLL rate). Profound structural inequality, however, persists. Communicable, maternal, neonatal, and nutritional diseases act as primary “gap-drivers,” exhibiting extreme Inequality Ratios that confirm these burdens fall disproportionately on Low-SDI populations. The 2019–2021 pandemic epoch interrupted this inequality compression. The age-standardized YLL rate for Lower Respiratory Infections surged by 19.25% between 2021 and 2023. By 2023, 59.8 million absolute YLLs remained strictly categorized as “Vaccine Preventable,” down from 178.4 million in 1990 but representing a persistent failure in health equity.Conclusions While global YLL rates have compressed, the disparity between Low- and High-SDI regions remains driven by a concentrated subset of highly preventable diseases. The persistence of extreme Inequality Ratios for communicable conditions and vaccine-preventable mortality indicates that targeted resource allocation toward these specific gap-drivers is necessary to break the human capital trap in transitional economies.
COVID-19 pandemic · health disparities · Health equity · Human capital · Lower respiratory tract infection · neonatal diseases · premature mortality · socio-demographic index · sociodemographic disparities · Vaccine-preventable diseases · years of life lost · Global Health and Epidemiology · Health disparities and outcomes · Infectious Diseases · Insurance, Mortality, Demography, Risk Management
The Epidemiologic Transition
Measuring the Global Burden of Disease
Biodemography of human ageing
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the Covid-19 pandemic
Global health 2035
The Effect of Health on Economic Growth
| Highly cited | No |
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