Download This Paper
Preprints with The Lancet is a collaboration between The Lancet Group of journals and SSRN to facilitate the open sharing of preprints for early engagement, community comment, and collaboration. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early-stage research papers that have not been peer-reviewed. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. The findings should not be used for clinical or public health decision-making or presented without highlighting these facts. For more information, please see the FAQs.
We Need More Sex-Disaggregated Data: Unveiling the Data Gap and Showing the Benefit of Sex-Disaggregated Data Along the Health Pathways for Hypertension, Diabetes, HIV and Aids
28 Pages Posted: 25 Jul 2024
More...Abstract
Background: Health data disaggregated by sex or gender identity is vital for identifying the distribution of illness, and assessing risk exposures, service access and utilisation. Disaggregating data along a health pathway, i.e., the measurable continuum from risk factor exposure to final health outcome (death), and including disease prevalence and a three-step care cascade (diagnosis, treatment, and control), has the potential to provide a rich source of information on sex- and gender-based health inequities and identify opportunities for more tailored interventions to reduce those inequities.
Methods: We collected sex- and age-disaggregated data along the health pathway. We searched for papers using global datasets on the sex-disaggregated care cascade for eight major conditions and identified cascade data for only three conditions: hypertension, diabetes, and HIV and AIDS. For each disease, we collected risk factor prevalence, disease prevalence, cascade progression, and death rates, and we assessed the sex difference for all steps along the pathway.
Findings: Data on risk factors, prevalence and mortality are found for all three conditions across 200 countries. Global sex-disaggregated care cascades were found only for hypertension, diabetes, and HIV and AIDS, covering 200, 39, and 73 countries, respectively. Significant sex differences were found in each step along the pathways for many countries. Compared to females, males exhibited higher disease prevalence and death rates and lower rates of health care seeking, diagnosis and treatment adherence in many countries. Smoking prevalence was higher among males in most countries, whereas prevalence of obesity and unsafe sex were higher in females in most countries.
Interpretation: Findings underscore the importance of sex-disaggregated data in understanding health inequities and guiding gender-responsive interventions. Despite limitations in data availability and completeness, this study elucidates the need for more comprehensive and harmonised datasets for these and other conditions to monitor sex differences and implement sex-/gender-responsive interventions along the health pathway.
Funding: This work was supported by the Bill & Melinda Gates Foundation (grant INV-030827).
Declaration of Interest: The authors declare no conflicts of interest.
Ethical Approval: The authors confirm that the ethical policies of the journal, as noted on the journal’s author guidelines page, have been adhered to.
Keywords: sex differences, gender differences, health pathway, care cascade, data gap
Suggested Citation: Suggested Citation