Does health-related poverty publication panorama replicate international wants within the gentle of the present poverty rebound? | Globalization and Well being
A total of 5527 publications (n) could be found by applying the search terms. Of these, most (56.32%) were original articles. Editorial material and meeting abstracts were published in about 13% of all publication types. Book reviews or chapters, letters, proceedings papers, reviews, and news items were published in only single digit numbers. Other document types were only sporadically present.
The first article on P&H listed in the WoS was published in 1901. After the early years of P&H research, there was an annual publication output of less than ten articles until 1965. It was not until the mid-1960s that the number increased to double digits but then with a steady slope and a first peak in 1970 with n = 42 articles. In 2000, the number of P&H-related articles rose to a three-digit number for the first time. A first major peak in article counts was reached in 2007 (n = 289). This was followed by a lower performance period that ended in 2011 and led to another apparent peak in 2016 (n = 301). The year with the most articles published to date was 2020 with n = 311. In general, the development of citations received per year increased similarly to the number of articles published, with the exception of the years after 2010, when a clearly visible decrease could be observed. In terms of citations, there are some clear peak years. The years 1970 (c = 381), 1991 (c = 1409), 1997 (c = 3092), 2003 (c = 4331), and 2007, as the year with the most citations up to the time of the evaluation, (c = 4829) are striking. After that, the years 2010 (c = 4575 and 2014 (c = 3052) show peaks, but at lower levels. The sharp decline in citation numbers in recent years is due to the cited-half-life of citation numbers, which shows that publications need a certain amount of time to reach maximum citation numbers.Thus, this is a methodological phenomenon that is not due to declining interest in P&H research.
The years with the highest citation rates were 1997 (cr = 43.55) and 2003 (cr = 44.65), years with citation peaks but no exceptionally high publication output (Fig. 1).
Development of the number of articles, the number of citations, and the citation rate (display: × 5) from 1965 to 2020
The most frequently cited articles are listed in Table 1.
Table 1 Ten most-cited publications
The analysis of the thematic associations of the P&H research measured in the occurrence of keywords revealed four main clusters dealing with industrial and developing regions, children-related issues, and impact on income and health-care costs. Here, the USA as study area and the effects on children, adolescents, and families were quantitatively dominant (Fig. 2).
Cluster Analysis of the co-occurrence of keywords (threshold at least 35 occurrences), red cluster: Industrial countries (USA) and related burdens of poverty, green cluster: children and families and related burdens of poverty, blue: determinants and health care, yellow cluster: developing countries (Africa) and related burdens of poverty
The sub-analysis of poverty-related diseases showed that AIDS was the most considered topic, to which n = 269 publications could be assigned. Tuberculosis was addressed in n=99 publications and malaria in n=59. Reference to children was evident in n=1573 publications. Regionally, the USA was the most frequently mentioned study area with n = 532 publications. African countries were addressed in n = 417 publications.
Out of all items, n = 4610 publication (83.40%) could be attributed to a country of origin by reading the collected metadata and thus included in the geographic analyses.
The country with the most publications on P&H was the USA with n = 2512 articles. The UK (n = 611) followed in second place with only about a quarter of the US-American articles. The next three ranks were occupied by Canada (n = 295), Australia (n = 164), and China (n = 155) as the first non-high-income country in the evaluation. South-Africa, i.e. an upper-middle-income country, followed in next place (n = 136). Brazil and Mexico, both emerging countries, ranked 9th and 10th (Fig. 3A). The African countries Nigeria and Kenya, as the most publishing lower-middle-income countries, ranked 19th and 21st, followed by the Asian lower-middle-economy Bangladesh in 22nd place.
Geographical distribution of publication output on Poverty and Health (P&H). A number of articles per country. B Development of the relative proportion of the most publishing countries on the publication output on R&H in 4-year intervals from 1981 to 2020
Analysis of the citations received at countries’ level revealed a similar picture of US-American dominance (c = 53.786), followed by the UK (c = 13.912). In contrast to the publication numbers, South Africa followed in 4th place (c = 3476) behind Canada (c = 4869). India reached 5th place (c=2749). Switzerland, with only n = 62 articles on P&H, ranked 7th with its citation numbers (c = 2031) (Fig. 4A).
Citation parameters. A number of citations per country. B Citation rate per country (threshold > 30 articles)
Switzerland’s performance on P&H was underlined by the analysis of citation rates (cr), which included 26 countries (analysis threshold = at least 30 articles on P&H per country). Here, it achieved a citation rate of cr = 32.76, ranking first. Bangladesh was also outstanding in terms of citation rate and achieving second place with cr = 31.68, followed by South Africa (cr = 25.56), the UK (cr = 22.77), and Kenya (cr = 22.48) (Fig. 4B). WHO was the most published institution based in Switzerland. Thus, the most cited study that was carried out in Asian countries, which also includes the co-authorship of Bangladesh, notes that out-of-the-pocket payments can exacerbate poverty . The second most cited article is a systematic review that shows no conclusive effect of mental health interventions. It was first written by South Africa’s University of Cape Town in collaboration with WHO and others .
It was possible to identify n = 751 collaboration articles (16.29% of the geographically assignable articles). Of these, n = 546 articles were binational work, n = 126 articles were trinational, and the remainder were multinational collaborations. The most collaborations occurred between the USA and the UK (n = 78), followed by the USA and Canada (n = 41), the UK and Australia, tied with the UK and South Africa, as the first collaboration with a non-native English country (both n = 31). The developing country involved in the most collaborations was Kenya with n = 19 collaborations with the UK and n = 14 collaborations with the USA. Tanzania followed with n = 12 collaborations with the USA and Bangladesh with n = 11 US-American collaborations. Other low- or lower-middle economies integrated into the international network were Sudan, Nigeria, Ghana, Burkina Faso, Uganda and Malawi. On the bilateral side, Zimbabwe and Ethiopia (UK collaborations), Zambia, Indonesia, Haiti (US-American collaborations), Nicaragua (Swedish collaborations), and Cameroon (Dutch collaborations) collaborated (Fig. 5).
International network (display threshold at least 4 collaboration articles), numbers in brackets (number of publications / number of collaboration articles)
At the national level, US-American institutions (mostly universities) were widely networked. At the international level, the University of London (UK) and the University of Cape Town (South Africa) reached n = 10 collaboration articles. These most frequently collaborating institutions also the ones that published the most.
The GDP in 1000 bn US dollars and the total population of the publishing countries were related to the numbers of articles to provide deeper insight into national research efforts on P&H. Table 2 ranks the countries according to the two indices in order of the GDP-related parameter.
Table 2 Socio-economic ranking of the countries with at least 30 articles on P&H, n number of articles, GDP gross domestic product in purchase power parity (PPP) in current international $, RGDP number of articles / GDP in 1000 bn PPP, RPOP number of articles / population in mill . HI high-income country, UMI upper-middle-income country, LMI lower-middle-income country ranked by RGDP
New Zealand ranked first, followed by the UK, South Africa, Kenya, and Canada. The order changed in terms of populations: UK, New Zealand, Canada, USA and Switzerland. The correlations between the number of publications and the GDP in 1000 bn US dollars is highly significant (Pearson p < 0.0001). The correlation between the number of publications and the populations was also significant (Pearson p = 0.001).
National poverty burden
The inclusion of poverty-related indicators also changes the ranking of countries. The multiplication of the GHI as a factor with the publication numbers (GHI(n)), shows India at the top with GHI(n) = 3856.4, followed by the USA (GHI(n) = 2512), which corresponds to the absolute publication number (all high-income countries were assigned GHI = 1 to include them in the analysis). On rank 3, South Africa was ranked (GHI(n) = 1972), followed by Nigeria (GHI(n) = 1337.3), and China (GHI(n) = 1178) (Table 3).
Table 3 Ranking of the 20 countries with the highest GH-normalized publication numbers, GHI Global Hunger Index,  n number of articles, high-income countries were assigned GHI 1
Meaningful correlation analyzes were conducted between the number of articles of developing countries and the population living in multidimensional poverty according to the MPI . A significant negative correlation (Pearson p = 0.054) was found. Figure 6A shows the linear regression of the two variables. The analysis of the residuals of the 20 most publishing developing countries listed China, Sri Lanka, Brazil, and Mongolia as countries with the highest deviation from the regression line in favor of the number of articles. While El Salvador, Tunisia and Jordan showed the highest deviation in the negative directions, albeit to a lesser extent. (Figure 6B).
Association between number of articles and population living in multidimensional poverty (Multidimensional Poverty Index)  of developing countries. A linear regression. B Residuals of 20 most publishing developing countries. Yellow: negative residuals, blue: positive residual
A total of 2048 articles (37.05%) received 3472 grants. There were a variety of funders, ranging from governments, universities, hospitals, independent research institutions, non-profit organizations and foundations to private companies and banks. Also, international associations, societies and inter-governmental organizations participated in research funding on P&H (Table 4).
Table 4 Donors of P&H research
Governments of 51 countries (including regional and local governments) granted funds for research on P&H (Table 5).
Table 5 Most funding governments, %Grants Grants/Articles × 100
A total of 2379 grants (g) were awarded by governments including international collaborations (g = 19). The USA was by far the largest funder of P&H research with 1665 grants (g). Of these, most grants (g = 1382) were awarded by the National Institute of Health (55.02%), with 1249 attributable to the respective institute. The National Institute of Child Health & Human Development (NICHD) funded g=213 times, followed by the National Institute of Mental Health (NIMH) (g=175) and the National Institute on Drug Abuse (NIDA).
The most funding foundations were The Wellcome Trust (UK), giving g = 88 grants, that were partly awarded together with programs from the European Union (EU), the Robert Wood Johnson Foundation (USA, g = 35), and the Melinda and Bill Gates Foundation (US, g=27).