Trends and cross-country inequalities in global burn burden: A population-based study from 1990 to 2021

Background Burns represent a substantial global health burden, causing significant mortality, disability, and socioeconomic consequences. This study evaluates the global temporal trends, and inequalities in burns burden from 1990 to 2021 and projects trajectories to 2036. Methods Data on burn incidence, prevalence, and years lived with disability (YLDs), along with their age-standardized rates (ASIR, ASPR, ASYLDs), were extracted from the Global Burden of Disease 2021 database. Temporal trends were assessed using estimated annual percentage changes (EAPCs). Socioeconomic disparities were evaluated using the Slope Index of Inequality (SII) and the Concentration Index. Future trends were projected using a Bayesian Age-Period-Cohort (BAPC) model. Results In 2021, there were approximately 15,345,321 burn injuries globally, with ASIR, ASPR and ASYLDs of 199.72, 2974.10 and 81.71 per 100,000 population, respectively. Annual reductions (EAPC) were 1.20%, 1.22% and 1.83% from 1990 to 2021. Lower airway burns showed minimal improvement in incidence (EAPC = − 1.01%). Males exhibited higher rates than females. Children and adolescents (5–19 years) experienced the highest ASIR, while adults aged 40–44 exhibited the highest ASYLDs. Caribbean and Central Europe reporting the highest ASIRs. Haiti’s ASYLDs (542.66 per 100,000) were 106% higher than Afghanistan’s, which ranked second. Afghanistan and Yemen experienced rising incidence (EAPC = 1.64% and 1.07%, respectively). Low SDI regions had 31% slower reductions than high SDI regions. Absolute inequalities narrowed, but YLDs remained concentrated in low SDI regions. Projections to 2036 show continued decline, with incidence falling fastest (–13.6%). Males consistently had 20–25% higher rates. Conclusion This global burden has declined significantly, and absolute disparities have narrowed. Projections to 2036 suggest continued reductions; however, substantial disparities persist across demographic and socioeconomic groups. Targeted interventions should integrate prevention, improved access to acute care, and rehabilitation services to mitigate preventable disability and advance global health equity.