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Ecological analysis of ethnic differences in relation between tuberculosis and poverty
J I Hawker1, S S Bakhshi, S Ali
1Public Health Laboratory Service Communicable Disease Surveillance Centre, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS. jhawker@cdscwmid.demon.co.uk
BMJ (Clinical Research Ed.)
|October 16, 1999
Summary
Tuberculosis rates are linked to deprivation in white populations, but not in South Asian populations. This suggests different causes and interventions are needed for each ethnic group to combat tuberculosis.
Area of Science:
- Public Health
- Epidemiology
- Sociology
Background:
- Socioeconomic factors, known as deprivation, are associated with tuberculosis (TB) incidence.
- The impact of deprivation on TB may vary across different ethnic groups.
Purpose of the Study:
- To investigate how ethnicity influences the relationship between tuberculosis and deprivation.
- To compare TB rates and deprivation indices across white and South Asian populations in Birmingham.
Main Methods:
- A retrospective ecological study was conducted in Birmingham, UK, from 1989 to 1993.
- Data included 1516 notified tuberculosis cases, comparing incidence in white and South Asian residents.
- Ethnic-specific indices of deprivation were analyzed alongside tuberculosis rates.
Main Results:
- Tuberculosis rates were significantly associated with deprivation indices and the proportion of South Asian residents in univariate analysis.
- Overcrowding independently predicted higher tuberculosis rates in the overall population and specifically in the white population.
- No significant association between deprivation and tuberculosis was found for the South Asian population in multivariable analyses.
Conclusions:
- Deprivation is a significant factor for tuberculosis in the white population but not in the South Asian population.
- These findings indicate that the underlying causes of tuberculosis and effective interventions likely differ between ethnic groups.
- Public health strategies for tuberculosis control should consider ethnic-specific socioeconomic determinants.