Inequalities in tuberculosis mortality: long-term trends in 11 European countries

Area of Science:

• Public Health
• Epidemiology
• Social Determinants of Health

Background:

• Tuberculosis (TB) mortality disproportionately affects individuals of lower socioeconomic status globally.
• Understanding trends in educational inequalities in TB mortality is crucial for targeted public health interventions.

Purpose of the Study:

• To analyze the trends and magnitude of educational inequalities in tuberculosis mortality across 11 European countries from 1980 to 2011.
• To identify countries with the largest and smallest educational disparities in TB mortality.

Main Methods:

• Utilized TB mortality data for individuals aged 35-79 years between 1980 and 2011.
• Calculated age-standardized mortality rates stratified by educational attainment.
• Employed relative and slope indices of inequality to quantify disparities.

Main Results:

• Educational inequalities in TB mortality were present in all studied European countries in the early 21st century.
• Lithuania exhibited the largest absolute inequalities, while Denmark had the smallest.
• Relative inequalities remained largely stable; absolute inequalities decreased in most nations but substantially increased in Lithuania and Estonia.

Conclusions:

• Despite progress in reducing absolute inequalities in TB mortality in many European countries, significant disparities persist.
• There is a continued need for intensified interventions to prevent TB and reduce case fatality among lower socioeconomic groups.
• Special attention and targeted strategies are recommended for the Baltic countries due to increasing absolute inequalities.