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Free Content Educational inequalities in tuberculosis mortality in sixteen European populations

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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.
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Keywords: EDUCATION; EUROPE; MORTALITY; SOCIAL INEQUALITIES; TUBERCULOSIS

Document Type: Research Article

Affiliations: 1: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Preventive Medicine and Public Health, Rey Juan Carlos University, Madrid, Spain 2: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands 3: Stockholm Centre on Health of Societies in Transition, Södertörn University, Huddinge, Sweden 4: Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland 5: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway 6: University of Versailles, St Quentin, France; Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden 7: Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden 8: Department of Sociology, University of Helsinki, Helsinki, Finland 9: Interface Demography, Centrum voor Sociologie–VUB, Brussels, Belgium 10: Department of Health Management, Kaunas University of Medicine, Kaunas, Lithuania 11: Department of Public Health, Faculty of Medicine, Ljubljana, Slovenia 12: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherland 13: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands

Publication date: 01 November 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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