1. Educational inequalities in tuberculosis mortality in sixteen European populations
- Author
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Ramune Kalediene, Barbara Artnik, Mall Leinsalu, Jan Hendrik Richardus, Johan P. Mackenbach, Anton E. Kunst, Bjørn Heine Strand, P Deboosere, J. L. Álvarez, Olle Lundberg, Gwenn Menvielle, Matthias Bopp, Pekka Martikainen, Amsterdam Public Health, Public and occupational health, Department of Public Health, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Department of Preventive Medicine & Public Health and Medical Immunology & Microbiology, Universidad Rey Juan Carlos [Madrid] (URJC), University of Amsterdam [Amsterdam] (UvA)-Academic Medical Centre (AMC), Department of Epidemiology and Biostatistics, National Institute for Health Development, Social and Preventive Medicine Institute, Universität Zürich [Zürich] = University of Zurich (UZH), Division of Epidemiology, Norwegian Institute of Public Health [Oslo] (NIPH)-Department of Genes and Environment, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre for Health Equity Studies (CHESS), Stockholm University-Karolinska Institutet [Stockholm], Department of Social Research Sociology, Department of Sociology, Vrije Universiteit Brussel (VUB)-Interface Demography (ID), Health Management Department, Faculty of Public Health-Lithuanian University of health Sciences, Public Health, Faculty of Medicine-Institute of Oncology-University Medical Centre Ljubljana [Ljubljana, Slovenia] (UMCL), Spanish Ministry of Education by means of an FPU grant (beca de Formación de Profesorado Universitario), Epidemiology, University of Zurich, Interface Demography, Sociology, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), and Schmaus, Annie
- Subjects
Gerontology ,Male ,demography ,MESH: Urban Health ,Time Factors ,Rural Health ,MESH: Risk Assessment ,MESH: Linear Models ,0302 clinical medicine ,Sex factors ,MESH: Risk Factors ,Risk Factors ,Medicine ,MESH: Tuberculosis ,030212 general & internal medicine ,MESH: Incidence ,10. No inequality ,Socioeconomic inequalities ,media_common ,MESH: Aged ,education ,MESH: Middle Aged ,Incidence (epidemiology) ,Incidence ,MESH: Sex Distribution ,1. No poverty ,Age Factors ,SDG 10 - Reduced Inequalities ,Middle Aged ,3. Good health ,Europe ,Infectious Diseases ,Educational Status ,Female ,0305 other medical science ,Risk assessment ,Rural population ,Pulmonary and Respiratory Medicine ,Adult ,Tuberculosis ,Inequality ,media_common.quotation_subject ,610 Medicine & health ,macromolecular substances ,Risk Assessment ,Vulnerable Populations ,Article ,03 medical and health sciences ,Age Distribution ,Sex Factors ,SDG 3 - Good Health and Well-being ,MESH: Sex Factors ,Humans ,Social inequality ,Sex Distribution ,MESH: Age Distribution ,Aged ,MESH: Age Factors ,030505 public health ,MESH: Humans ,social inequalities ,business.industry ,MESH: Time Factors ,Urban Health ,MESH: Adult ,10060 Epidemiology, Biostatistics and Prevention Institute (EBPI) ,2725 Infectious Diseases ,MESH: Rural Health ,medicine.disease ,mortality ,MESH: Male ,MESH: Vulnerable Populations ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,2740 Pulmonary and Respiratory Medicine ,Linear Models ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,MESH: Europe ,business ,MESH: Educational Status ,MESH: Female ,Demography - Abstract
International audience; OBJECTIVE: To describe the magnitude of socioeconomic inequalities in tuberculosis (TB) mortality by level of education in male, female, urban and rural populations in several European countries. DESIGN: Data were obtained from the Eurothine Project, covering 16 populations between 1990 and 2003. Age- and sex-standardised mortality rates, the relative index of inequality and the slope index of inequality were used to assess educational inequalities. RESULTS: The number of TB deaths reported was 8530, with a death rate of 3 per 100 000 per year, of which 73% were males. Educational inequalities in TB mortality were present in all European populations. Inequalities in TB mortality were greater than in total mortality. Relative and absolute inequalities were large in Eastern European and Baltic countries but relatively small in Southern European countries and in Norway, Finland and Sweden. Inequalities in mortality were observed among both men and women, and in both rural and urban populations. CONCLUSIONS: Socio-economic inequalities in TB mortality exist in all European countries. Firm political commitment is required to reduce inequalities in the social determinants of TB incidence. Targeted public health measures are called for to improve access to treatment of vulnerable groups and thereby reduce TB mortality.
- Published
- 2011
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