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Abstract Details
The global fatty liver disease Sustainable Development Goal country score for 195 countries and territories
1Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.
2EASL International Liver Foundation, Geneva, Switzerland.
3Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
4CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, New York, USA.
5Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.
6Organ Transplant Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
7I. Department of Medicine, Metabolic Liver Research Program, University Medical Center, Mainz, Germany.
8Respiratory Department, Hospital Universitario de la Princesa; School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
9Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
10School of Public Health, University of Haifa, Haifa, Israel.
11Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv, Israel.
12Department of Health Metrics Sciences, Department of Family Medicine, University of Washington, Seattle, Washington, USA.
Abstract
Background and aims: Fatty liver disease is highly prevalent, resulting in overarching wellbeing and economic costs. Addressing it requires comprehensive and coordinated multisectoral action. We developed a fatty liver disease Sustainable Development Goal (SDG) country score to provide insights into country-level preparedness to address fatty liver disease through a whole-of-society lens.
Approach and results: We developed 2 fatty liver disease-SDG score sets. The first included 6 indicators (child wasting, child overweight, noncommunicable disease mortality, a universal health coverage service coverage index, health worker density, and education attainment), covering 195 countries and territories between 1990 and 2017. The second included the aforementioned indicators plus an urban green space indicator, covering 60 countries and territories for which 2017 data were available. To develop the fatty liver disease-SDG score, indicators were categorized as "positive" or "negative" and scaled from 0 to 100. Higher scores indicate better preparedness levels. Fatty liver disease-SDG scores varied between countries and territories (n = 195), from 14.6 (95% uncertainty interval: 8.9 to 19.4) in Niger to 93.5 (91.6 to 95.3) in Japan; 18 countries and territories scored > 85. Regionally, the high-income super-region had the highest score at 88.8 (87.3 to 90.1) in 2017, whereas south Asia had the lowest score at 44.1 (42.4 to 45.8). Between 1990 and 2017, the fatty liver disease-SDG score increased in all super-regions, with the greatest increase in south Asia, but decreased in 8 countries and territories.
Conclusions: The fatty liver disease-SDG score provides a strategic advocacy tool at the national and global levels for the liver health field and noncommunicable disease advocates, highlighting the multisectoral collaborations needed to address fatty liver disease, and noncommunicable diseases overall.