Analysis of Global Inequalities in Inflammatory Bowel Disease

ABSTRACT Background This study aims to rigorously assess socioeconomic and geographic inequalities in IBD burden globally. Methods Using data from the Global Burden of Disease (GBD) 2021 study, this research applies seven advanced summary measures of health inequality to assess regional disparities in inflammatory bowel disease (IBD) across four key indicators: age‐standardized prevalence (ASPR), incidence (ASIR), mortality (ASMR), and disability‐adjusted life years (AS‐DALYs) in both 1990 and 2021. A total of 204 countries and territories were categorized into 5 Socio‐demographic Index (SDI) levels and 21 GBD regions, with ordered inequality metrics applied to SDI‐based groupings, and non‐ordered metrics to GBD regional groupings. Results Stratified by SDI, high‐SDI countries had substantially higher age‐standardized prevalence, incidence, mortality, and DALYs in 1990—by 57.09 (95% CI: 48.25–66.95), 3.60 (2.91–4.38), 0.19 (0.04–0.35), and 11.53 (5.99–17.35) per 100,000 respectively—corresponding to 5.59‐, 3.05‐, 1.44‐, and 1.80‐fold differences compared to low‐SDI countries. These gaps narrowed modestly by 2021, but high‐SDI regions continued to bear disproportionate burden, as reflected by persistently positive concentration indices. Across GBD regions, East Asia, Australasia, and Western Europe had significantly higher ASIR and ASMR than the global average. When accounting for population weights, Central Europe also emerged as a high‐burden region. For ASMR and AS‐DALYs, disparities were most pronounced in Central and Western Europe, Pacific island countries, and sub‐Saharan Africa after population weighting. Conclusion With higher disease burdens systematically concentrated in developed regions and geographic inequalities intensifying, there is an urgent need to bridge inequities in IBD across the regions of different development levels.