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Impact of socio-economic inequities on tuberculosis in a Southern European city: what is the effect of the recession?

Abstract:

Introduction

Economic crises affect the population’s health, especially among the most deprived. The increase in health inequalities in this recession may have influenced the incidence of tuberculosis (TB). We analyzed the effect of socioeconomic inequities and the recession on the incidence of TB.

Methods

We conducted a population-based incidence study of TB cases in Barcelona, Spain, who started treatment between 2003 and 2015. A multilevel interrupted time series analysis was done to analyze differences in incidence trends between the pre-recession (until 2008) and recession periods.

Results

We observed differences in TB incidence according to deprivation and immigration status. TB incidence among most deprived neighborhoods was 2.72 times higher than least deprived. Compared to natives, incidence was 9 times higher among those born in Africa, and 6 times higher among those born in Asia and Oceania. The previous decreasing trend in incidence (4%) was accentuated during the recession (7%).

Conclusions

The incidence of TB decreased during the recession, probably due to a reduction of new immigrants and the TB programme. However, incidence is highly unequal between districts with different levels of deprivation, and between foreign-born from different geographical regions. Social measures are important for reducing inequalities and TB incidence in Barcelona.

Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.5588/ijtld.18.0110

Authors


More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
NDORMS
Oxford college:
St Peter's College
Role:
Author


Publisher:
International Union against Tuberculosis and Lung Disease
Journal:
International Journal of Tuberculosis and Lung Disease More from this journal
Volume:
23
Issue:
1
Pages:
45-51
Publication date:
2018-12-20
Acceptance date:
2018-07-04
DOI:
EISSN:
1815-7920
ISSN:
1027-3719


Keywords:
Pubs id:
pubs:948537
UUID:
uuid:d67992ac-147d-48c4-8aef-ea8e3d4c8baa
Local pid:
pubs:948537
Source identifiers:
948537
Deposit date:
2018-11-30

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