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Higher levels of human development are associated with better universal health coverage worldwide, and disparities in coverage between income groups are generally larger than disparities between world regions. Those are two of the conclusions of a new study published this week in the journal PLOS Global Public Health by Akira Hayasaka of Yokohama City University, Japan, Yasuhiro Nakanishi of the National Institute of Public Health, Japan, and colleagues.

Universal health coverage (UHC) is a core target of the Sustainable Development Goals, tracked using the UHC Service Coverage Index (SCI), a composite score built from four domains: reproductive, maternal, newborn and child health; infectious diseases; noncommunicable diseases; and service capacity and access.

UHC and human development are closely linked because of how greater access to health care leads to better health outcomes in general (due to preventive care, screenings, vaccinations, etc.). However, how this relationship varies across coverage domains, income groups and world regions over time has not been systematically examined.

In the new study, researchers conducted a retrospective, country-level longitudinal analysis using seven different years of publicly available World Health Organization and United Nations data spanning 2000–2021. The dataset allowed them to compare the UHC Service Coverage Index and its four sub-indices with the Human Development Index (HDI) and its components across World Bank income groups and WHO regions.

After adjusting for other variables, low-income countries had significantly lower UHC coverage than high-income countries (21% lower overall), with the largest gaps in the infectious disease domain (31% lower).

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