Gender Inequality in Global Burden of Uncorrected Refractive Error

PURPOSE: To explore gender inequality in global burden of uncorrected refractive error (URE) by year, age, and socioeconomic status using disability-adjusted life years (DALYs). DESIGN: International, comparative burden-of-disease study. METHODS: Global, regional, and national gender specific DALY numbers; crude DALY rates; and age standardized DALY rates caused by URE, by year and age, were extracted from the Global Burden of Disease Study 2015. Human development index (HDI) in 2015 as an indicator of national socioeconomic status was extracted from the Human Development Report. Pearson correlation and linear regression analyses were conducted to investigate the association between socioeconomic status and gender inequality. RESULTS: Gender inequality in global URE burden has persisted since 1990, through 2015, with little improvement over the decades. Age-standardized DALY rates were 189.8 among male subjects vs 223.0 among female subjects in 1990 and 188.4 vs 225.2 in 2015. Female subjects had higher burden than male subjects of the same age, and gender inequality increased with age. Female minus -male difference in age-standardized DALY rates (r = -0.562, P <.001; standardized beta = -0.562, P <.001) and female-to-male age-standardized DALY rate ratios (r = 0.258, P <.001; standardized beta= 0.258, P <.001) were negatively related to HDI. CONCLUSIONS: Gender inequality in global URE burden has persisted over the past few decades, with female individuals bearing more burden than male individuals. Older age and lower socioeconomic status are related to greater gender inequality. These findings highlight the importance of making gender-sensitive health policy to manage global vision loss caused by URE. (C) 2018 Elsevier Inc. All rights reserved.