Temporal and spatial dynamics of hepatitis incidence in China based on the STWR model

To achieve the goal of "eliminating viral hepatitis as a public health threat by 2030" proposed by the World Health Organization, we explore the spatio-temporal dynamics of hepatitis incidence in China to provide reference for research, prevention, and control of hepatitis and other public health diseases. Local Indicators of Spatial Association (LISA) and Mann-Kendall (MK) trend tests were used to analyze the spatial-temporal variation of hepatitis incidence in China from 2012 to 2019. A spatio‑temporal weighted regression (STWR) model was constructed using provincial gross domestic product per capita, health expenditures, number of CDC personnel, number of healthcare institutions, and population density to assess spatio‑temporal heterogeneity in the associations with hepatitis incidence. From 2012 to 2019, statistically significant MK trends (p < 0.05) showed that HBV incidence decreased in 8 provinces and increased in 4 provinces; HCV incidence decreased in 7 provinces and increased in 17 provinces. Spatially, HBV exhibited a "high‑high" cluster with significant high-high clustering, whereas HCV showed "high‑low", "low‑high" and "low‑low" patterns. Crucially, the STWR model outperformed traditional OLS and spatial‑only GWR models, and indicated substantial spatio‑temporal non‑stationarity in the associations of all investigated drivers. The effectiveness of hepatitis control is intricately linked to, but not simply determined by, economic growth. Targeted public health investment synchronized with economic development, optimized CDC operations and healthcare resource allocation, and vigilant management of risks associated with population density and mobility are critical. The observed spatio‑temporal heterogeneity underscores the need for regionally tailored and dynamically adjusted intervention strategies, supported by robust cross‑regional collaboration, to achieve national hepatitis elimination goals.