Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries, 1990–2010: a longitudinal analysis

Overview of attention for article published in The Lancet, May 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#11 of 21,974)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Mentioned by

news
216 news outlets
blogs
3 blogs
twitter
475 tweeters
facebook
20 Facebook pages
googleplus
4 Google+ users
reddit
2 Redditors

Readers on

mendeley
74 Mendeley
citeulike
1 CiteULike
Title
Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries, 1990–2010: a longitudinal analysis
Published in
The Lancet, May 2016
DOI 10.1016/s0140-6736(16)00577-8
Pubmed ID
Authors

Mahiben Maruthappu, Johnathan Watkins, Aisyah Mohd Noor, Callum Williams, Raghib Ali, Richard Sullivan, Thomas Zeltner, Rifat Atun, Maruthappu, Mahiben, Watkins, Johnathan, Noor, Aisyah Mohd, Williams, Callum, Ali, Raghib, Sullivan, Richard, Zeltner, Thomas, Atun, Rifat

Abstract

The global economic crisis has been associated with increased unemployment and reduced public-sector expenditure on health care (PEH). We estimated the effects of changes in unemployment and PEH on cancer mortality, and identified how universal health coverage (UHC) affected these relationships. For this longitudinal analysis, we obtained data from the World Bank and WHO (1990-2010). We aggregated mortality data for breast cancer in women, prostate cancer in men, and colorectal cancers in men and women, which are associated with survival rates that exceed 50%, into a treatable cancer class. We likewise aggregated data for lung and pancreatic cancers, which have 5 year survival rates of less than 10%, into an untreatable cancer class. We used multivariable regression analysis, controlling for country-specific demographics and infrastructure, with time-lag analyses and robustness checks to investigate the relationship between unemployment, PEH, and cancer mortality, with and without UHC. We used trend analysis to project mortality rates, on the basis of trends before the sharp unemployment rise that occurred in many countries from 2008 to 2010, and compared them with observed rates. Data were available for 75 countries, representing 2·106 billion people, for the unemployment analysis and for 79 countries, representing 2·156 billion people, for the PEH analysis. Unemployment rises were significantly associated with an increase in all-cancer mortality and all specific cancers except lung cancer in women. By contrast, untreatable cancer mortality was not significantly linked with changes in unemployment. Lag analyses showed significant associations remained 5 years after unemployment increases for the treatable cancer class. Rerunning analyses, while accounting for UHC status, removed the significant associations. All-cancer, treatable cancer, and specific cancer mortalities significantly decreased as PEH increased. Time-series analysis provided an estimate of more than 40 000 excess deaths due to a subset of treatable cancers from 2008 to 2010, on the basis of 2000-07 trends. Most of these deaths were in non-UHC countries. Unemployment increases are associated with rises in cancer mortality; UHC seems to protect against this effect. PEH increases are associated with reduced cancer mortality. Access to health care could underlie these associations. We estimate that the 2008-10 economic crisis was associated with about 260 000 excess cancer-related deaths in the Organisation for Economic Co-operation and Development alone. None.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 74 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Spain 1 1%
Portugal 1 1%
Switzerland 1 1%
United Kingdom 1 1%
Rwanda 1 1%
Japan 1 1%
Korea, Republic of 1 1%
Unknown 67 91%

Demographic breakdown

Readers by professional status Count As %
Researcher 16 22%
Other 14 19%
Student > Ph. D. Student 13 18%
Student > Master 10 14%
Professor 7 9%
Other 14 19%
Readers by discipline Count As %
Medicine and Dentistry 35 47%
Social Sciences 10 14%
Nursing and Health Professions 7 9%
Agricultural and Biological Sciences 4 5%
Economics, Econometrics and Finance 4 5%
Other 14 19%

Attention Score in Context

This research output has an Altmetric Attention Score of 2071. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 March 2017.
All research outputs
#205
of 7,420,700 outputs
Outputs from The Lancet
#11
of 21,974 outputs
Outputs of similar age
#17
of 264,651 outputs
Outputs of similar age from The Lancet
#2
of 594 outputs
Altmetric has tracked 7,420,700 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 21,974 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 25.5. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 264,651 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 594 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.