Chapter 2: Burden by Level of Development Relationship between the HDI and burden of digestive diseases and cancers The overall range of the HDI is from 0-1 with higher values indicating higher levels of human development. The HDI amongst the 35 European countries ranged from 0.774 in North Macedonia, to 0.957 in Norway, in 2019. On average, countries within Southeastern, Central and Eastern, and Southern Europe tended to have lower HDI values compared to countries within Western Europe and the Nordic region. In general, countries with higher levels of human development (based on the HDI) appeared to have lower age-standardised DALY rates for the majority of digestive diseases and cancers (Figure 141 to Figure 144). The direction of the relationship appeared to be reversed for inflammatory bowel disease and oesophageal cancer. Figure 141. Relationship between age−standardised DALY rates for digestive diseases and human development, in 2019, for 35 European UEG member countr ies Cirrhosis and other chronic liver diseases due to alcohol use 100 200 300 400 500 0.80 0.85 0.90 0.95 Cirrhosis and other chronic liver diseases due to hepatitis C 100 150 200 250 50 0.80 0.85 Central and Eastern Europe 0.90 0.95 Southeastern Europe 0.80 Human Development Index Southern Europe Western Europe Source: authors' compilation using UNDP and GBD 2019 data. Displa ying linear trend and 95% confidence inter vals. Nordic 0.85 0.90 0.95 100 150 200 50 0.80 0.85 0.90 0.95 Cirrhosis and other chronic liver diseases due to NAFLD Cirrhosis and other chronic liver diseases due to hepatitis B 90 60 30 White Book 2: Part 1 152 Age−standardised DALYs per 100,000