Global, regional, and national impact of epidemic disasters on health workforce equality between 1990 and 2019: An ecological and modeling study

Background: Global distribution of human resources for health (HRH) is highly unequal and less resourced regions may particularly be vulnerable to disastrous emergencies. We examined HRH losses attributable to epidemics of infectious diseases, both globally and geographically. Methods and findings: First, using 30-year ecological data from the 1990 to 2019 records at international Emergency Events Database and HRH density statistics from the Global Burden of Disease study, we extracted estimates of annual country-specific epidemic events and cadre-specific HRH density data across 194 countries and territories. The association between the number of epidemics and HRH density (number of HRH per 10,000 population) was established using the Generalized Estimating Equation model, adjusted for geographic and socioeconomic status. Second, based on the country- and year-specific number of epidemics, HRH density, and epidemic-HRH density associations, we further estimated the annual average absolute number of HRH losses and the average relative number of HRH losses per 10,000 HRHs that can be attributed to epidemic events, globally, by region, and by country. Conclusions: Epidemics of infectious diseases are associated with HRH losses globally, particularly in low- and middle-income countries, further aggravating the global inequity in the health workforce. Why was this study done?: What did the researchers do and find?: What do these findings mean?: Manman Chen, Wanzhou Wang and colleagues examined how infectious disease epidemics were associated with changes in the health workforce across 194 countries and territories from 1990 to 2019. Their findings suggest that epidemic events were linked to health workforce losses worldwide, with the largest relative impacts observed in low- and middle-income countries.