Abstract
IntroductionMajor efforts have been made to improve the health care system in Hunan province, China. The aims of this study were to assess whether and to what extent these efforts have impacted on gender and regional disparities of Tuberculosis (TB) incidence in recent years, especially for less developed areas.MethodsWe obtained data from the 2005–2009 China Information System for Disease Control and Prevention (CISDCP)to conduct this study in Hunan province. Counties within the province were divided into four regions according to quartiles based on the 2007 per capita GDP. Index of Disparity (ID) and Relative Index of Inequality (RII) were used to measure the disparities of TB incidence in relation to gender and region. Bootstrap technique was used to increase the precision.ResultsThe average annual incidence of TB was 111.75 per 100,000 in males and 43.44 per 100 000 in females in Hunan. The gender disparity was stable, with ID from 42.34 in 2005 to 43.92 in 2009. For regional disparity, ID, RII (mean) and RII (ratio) decreased significantly from 2005 to 2009 in males (P < 0.05) but remained stable among the female population.ConclusionsAs interventions such as introduction of the New Rural Cooperative Scheme put in place to reduce health disparities in China, regional disparity in relation to incidence of TB decreased significantly, but the gender disparity remains in the Hunan province.
Highlights
Major efforts have been made to improve the health care system in Hunan province, China
The result of linear regression showed that gender disparity in TB incidence was stable: Index of Disparity (ID) = 42.34 in 2005 and 43.92 in 2009. (P = 0.171, Table 2)
The result of linear regression analysis showed that disparity of TB incidence in different SES regions decreased significantly among the male population: from ID = 7.55 in 2005 to ID = 6.01 in 2009 (P < 0.05), but remained stable among the female population as well as the entire population between 2005 and 2009(P > 0.05) (Figure 1)
Summary
Major efforts have been made to improve the health care system in Hunan province, China. The aims of this study were to assess whether and to what extent these efforts have impacted on gender and regional disparities of Tuberculosis (TB) incidence in recent years, especially for less developed areas. Health disparity in different subgroups has become a major public health problem in the world [1,2,3,4]. In 2001 the Netherlands National Center for Health Statistics issued a monograph with 11 guidelines for reporting health disparities [5]. Higher TB incidence has been reported among males compared with females [9]. The 2009 male to female ratio (MFR) of notified new sputum smear positive TB cases
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