Abstract
BackgroundTuberculosis (TB) is one of the major infectious diseases that seriously endanger people’s health. In Shandong province, the relationship between the level of economic development and TB incidence has not been studied. This study aims to provide more research basis for the government to prevent and control TB by exploring the impact of different economic factors on TB incidence.MethodsBy constructing threshold regression model (TRM), we described the extent to which different economic factors contribute to TB registered incidence and differences in TB registered incidence among seventeen cities with different levels of economic development in Shandong province, China, during 2006–2017. Data were retrieved from the China Information System for Disease Control and Prevention.ResultsPer capita medical expenditure (regression coefficient, -0.0314462; SD, 0.0079305; P > |t|, 0.000) and per capita savings (regression coefficient, 0.0001924; SD, 0.0000566; P > |t|, 0.001) passed the significance test at the level of 1%.They are the two economic indicators that have the greatest impact on TB registered incidence. Through the threshold test, we selected the per capita savings as the threshold variable. In the three stages of per capita savings (<9772.8086 China Yuan(CNY); 9772.8086–33,835.5391 CNY; >33,835.5391 CNY), rural per capita income always has a significant negative impact on the TB registered incidence (The regression coefficients are − 0.0015682, − 0.0028132 and − 0.0022253 respectively. P is 0.007,0.000 and 0.000 respectively.).In cities with good economies, TB registered incidence was 38.30% in 2006 and dropped to 25.10% by 2017. In cities with moderate economies, TB registered incidence peaked in 2008 at 43.10% and dropped to 27.1% by 2017.In poorer cities, TB registered incidence peaked in 2008 at 56.30% and dropped to 28.9% in 2017.ConclusionWe found that per capita savings and per capita medical expenditure are most closely related to the TB incidence. Therefore, relevant departments should formulate a more complete medical system and medical insurance policy to effectively solve the problem of “difficult and expensive medical treatment”. In order to further reduce the TB incidence, in addition to timely and accurate diagnosis and treatment, it is more important for governments to increase investment in medicine and health care.
Highlights
Tuberculosis (TB) is one of the major infectious diseases that seriously endanger people’s health
Background the target of the Millennium Development Goals to halve tuberculosis prevalence and mortality by 2015, compared to 1990 levels, has been achieved around the world, TB remains a major infectious disease that threatens global health [1].The World Health Organization (WHO) estimates that 10 million people worldwide suffer from TB and 1.6 million people die in 2017.The social and economic impacts are devastating [2, 3].The End TB Strategy which was adopted by the World Health Assembly in May, 2014, outlines an overall target of reducing global TB incidence and mortality by 90 and 95% respectively by the year of 2035 [4] .This strategy emphasizes the importance of social determinants for prevention and care of TB, including policies to alleviate poverty, and social protection programme
This study aims to examine the association between the registered incidence of TB and the level of economic development in Shandong Province with the data from seventeen cities in Shandong province from 2006 to 2017, and to find out which indicators in economic aspects contribute to TB prevention and control and to what extent, so as to provide a basis for the prevention and control of tuberculosis in Shandong Province
Summary
Tuberculosis (TB) is one of the major infectious diseases that seriously endanger people’s health. Castro found higher TB incidence associated with urbanization, population density, poor economic conditions, household crowding, worse health and healthcare indicators [5] The content of this strategy is supported by many research results [6, 7]. Despite a lot of research on TB abroad, only a few studies have investigated the relationship between the level of economic development and the incidence of TB, especially in China [9,10,11] It can be seen from foreign studies that increasing social protection and public health expenditure is closely related to reducing the incidence, mortality, and cure success rate of TB, but whether the results of foreign studies are applicable to China or Shandong Province is not yet known. This study aims to examine the association between the registered incidence of TB and the level of economic development in Shandong Province with the data from seventeen cities in Shandong province from 2006 to 2017, and to find out which indicators in economic aspects contribute to TB prevention and control and to what extent, so as to provide a basis for the prevention and control of tuberculosis in Shandong Province
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