Social determinants of tuberculosis in Europe: A prospective ecological study.


Ploubidis, GB; Palmer, MJ; Blackmore, C; Lim, TA; Manissero, D; Sandgren, A; Semenza, JC; (2012) Social determinants of tuberculosis in Europe: A prospective ecological study. The European respiratory journal, 40 (4). pp. 925-30. ISSN 0903-1936 DOI: https://doi.org/10.1183/09031936.00184011

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Abstract

: Tuberculosis (TB) is considered to be a disease of poverty, since its incidence is exacerbated by socioeconomic factors, inconsistent or partial treatment practices, and immigration from endemic countries. A prospective country level study, using a comprehensive dataset of TB incidence and prevalence taken from countries within the World Health Organization (WHO) European region, was conducted. We employed quintile regression to investigate the prospective association between baseline (measured in 2000) and a nation's wealth, level of egalitarianism, migration rate, health-related lifestyle and social capital with TB incidence and prevalence over a 10-yr period (2000-2009). We found that ∼50% of TB variation is accounted for by a nation's wealth and level of egalitarianism. We observed a negative prospective association between logged gross domestic product and TB rates, and a positive prospective association between income inequality and TB. National income levels per capita and income inequality are important predictors for TB incidence and prevalence in the WHO European region. They account for 50% of country-level variation, indicating the importance of a combined absolute and relative socioeconomic disadvantage in the development of TB. These findings also provide a tool for forecasting potential fluctuations in the level of TB epidemics in the WHO European region, with respect to socioeconomic changes.<br/>

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Population Studies (1974-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
Research Centre: Population Studies Group
PubMed ID: 22267772
Web of Science ID: 309795500020
URI: http://researchonline.lshtm.ac.uk/id/eprint/55495

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