Inequalities in Global Health Inequalities Research (1966-2015)

2018 edition

Lucinda Cash-Gibson

Background: Increasing evidence shows that health inequalities exist between and
within countries, and emphasis has been placed on strengthening the production and
use of the global health inequalities research, so as to improve capacities to act. Yet, a
comprehensive overview of this evidence base is still needed, to determine what is
known about the global and historical scientific production on health inequalities to
date, how is it distributed in terms of country income groups and world regions, how
has it changed over time, and what international collaboration dynamics exist.
Methods: A comprehensive bibliometric analysis of the global scientific production on
health inequalities, from 1966 to 2015, was conducted using Scopus database. The
historical and global evolution of the study of health inequalities was considered, and
through joinpoint regression analysis and visualisation network maps, the preceding
questions were examined.
Findings: 159 countries (via authorship affiliation) contributed to this scientific
production, three times as many countries than previously found. Scientific output on
health inequalities has exponentially grown over the last five decades, with several
marked shift points, and a visible country-income group affiliation gradient in the
initiation and consistent publication frequency. Higher income countries, especially
Anglo-Saxon and European countries, disproportionately dominate first and coauthorship, and are at the core of the global collaborative research networks, with the
Global South on the periphery. However, several country anomalies exist that suggest
that the causes of these research inequalities, and potential underlying dependencies,
run deeper than simply differences in country income and language.
Conclusions: Whilst the global evidence base has expanded, Global North-South
research gaps exist, persist and, in some cases, are widening. Greater understanding
of the structural determinants of these research inequalities and national research
capacities is needed, to further strengthen the evidence base, and support the long
term agenda for global health equity.