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. 1995 Apr 15;310(6985):963–966. doi: 10.1136/bmj.310.6985.963

Socioeconomic deprivation and notification rates for tuberculosis in London during 1982-91.

P Mangtani 1, D J Jolley 1, J M Watson 1, L C Rodrigues 1
PMCID: PMC2549356  PMID: 7728030

Abstract

OBJECTIVES--To investigate the association between four sociodemographic measures (unemployment, overcrowding, low social class, and the proportion of migrants from areas of high prevalence of tuberculosis) and average level and rate of change of notification rates for tuberculosis. DESIGN--Ecological analysis of both the average and the rate of change of standardised annual notification rates for tuberculosis from 1982-91 and sociodemographic measures from the 1981 and 1991 censuses. SETTING--32 London boroughs. SUBJECTS AND DATA--Sociodemographic measures from the 1981 and 1991 censuses and tuberculosis notification rates for 1982-91. MAIN OUTCOME MEASURES--A measure of the association between average levels and rate of change in tuberculosis notification rates and four sociodemographic measures in 1981 and between the rate of change in tuberculosis notification rates between 1981 and 1991 and changes in sociodemographic measures between 1981 and 1991. RESULTS--The average level of notifications was correlated with overcrowding and the proportion of migrants but not with unemployment or social class. No significant association was found between the rate of change in notification rates and sociodemographic measures in 1981. An association was found between increases in unemployment and the rate of change in notification rates, but the effect was small. Changes in the levels of unemployment explained 23% of the variation between boroughs in the rate of change in their notification rates. CONCLUSION--The average tuberculosis notification rates were related to overcrowding and the proportion of migrants in 1981. Only increases in unemployment from 1981 to 1991, however, were significantly associated with the rate of change in notifications over the same period.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bradley B. L., Kerr K. M., Leitch A. G., Lamb D. Notification of tuberculosis: can the pathologist help? BMJ. 1988 Sep 3;297(6648):595–595. doi: 10.1136/bmj.297.6648.595. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Brudney K., Dobkin J. Resurgent tuberculosis in New York City. Human immunodeficiency virus, homelessness, and the decline of tuberculosis control programs. Am Rev Respir Dis. 1991 Oct;144(4):745–749. doi: 10.1164/ajrccm/144.4.745. [DOI] [PubMed] [Google Scholar]
  3. Carstairs V., Morris R. Deprivation and mortality: an alternative to social class? Community Med. 1989 Aug;11(3):210–219. doi: 10.1093/oxfordjournals.pubmed.a042469. [DOI] [PubMed] [Google Scholar]
  4. Centers for Disease Control (CDC) Tuberculosis, final data--United States, 1986. MMWR Morb Mortal Wkly Rep. 1988 Jan 1;36(50-51):817–820. [PubMed] [Google Scholar]
  5. Drucker E., Alcabes P., Bosworth W., Sckell B. Childhood tuberculosis in the Bronx, New York. Lancet. 1994 Jun 11;343(8911):1482–1485. doi: 10.1016/s0140-6736(94)92588-7. [DOI] [PubMed] [Google Scholar]
  6. Greenland S., Morgenstern H. Ecological bias, confounding, and effect modification. Int J Epidemiol. 1989 Mar;18(1):269–274. doi: 10.1093/ije/18.1.269. [DOI] [PubMed] [Google Scholar]
  7. McAdam J. M., Brickner P. W., Scharer L. L., Crocco J. A., Duff A. E. The spectrum of tuberculosis in a New York City men's shelter clinic (1982-1988) Chest. 1990 Apr;97(4):798–805. doi: 10.1378/chest.97.4.798. [DOI] [PubMed] [Google Scholar]
  8. Nolan C. M., Elarth A. M., Barr H., Saeed A. M., Risser D. R. An outbreak of tuberculosis in a shelter for homeless men. A description of its evolution and control. Am Rev Respir Dis. 1991 Feb;143(2):257–261. doi: 10.1164/ajrccm/143.2.257. [DOI] [PubMed] [Google Scholar]
  9. Patel K. R. Pulmonary tuberculosis in residents of lodging houses, night shelters and common hostels in Glasgow: a 5-year prospective survey. Br J Dis Chest. 1985 Jan;79(1):60–66. doi: 10.1016/0007-0971(85)90008-7. [DOI] [PubMed] [Google Scholar]
  10. Ramsden S. S., Baur S., el Kabir D. J. Tuberculosis among the central London single homeless. A four-year retrospective study. J R Coll Physicians Lond. 1988 Jan;22(1):16–17. [PMC free article] [PubMed] [Google Scholar]
  11. Raviglione M. C., Sudre P., Rieder H. L., Spinaci S., Kochi A. Secular trends of tuberculosis in western Europe. Bull World Health Organ. 1993;71(3-4):297–306. [PMC free article] [PubMed] [Google Scholar]
  12. Rieder H. L., Cauthen G. M., Kelly G. D., Bloch A. B., Snider D. E., Jr Tuberculosis in the United States. JAMA. 1989 Jul 21;262(3):385–389. [PubMed] [Google Scholar]
  13. Sheldon C. D., King K., Cock H., Wilkinson P., Barnes N. C. Notification of tuberculosis: how many cases are never reported? Thorax. 1992 Dec;47(12):1015–1018. doi: 10.1136/thx.47.12.1015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Spence D. P., Hotchkiss J., Williams C. S., Davies P. D. Tuberculosis and poverty. BMJ. 1993 Sep 25;307(6907):759–761. doi: 10.1136/bmj.307.6907.759. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Teale C., Cundall D. B., Pearson S. B. Outbreak of tuberculosis in a poor urban community. J Infect. 1991 Nov;23(3):327–329. doi: 10.1016/0163-4453(91)93224-z. [DOI] [PubMed] [Google Scholar]
  16. Watson J. M., Meredith S. K., Whitmore-Overton E., Bannister B., Darbyshire J. H. Tuberculosis and HIV: estimates of the overlap in England and Wales. Thorax. 1993 Mar;48(3):199–203. doi: 10.1136/thx.48.3.199. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Watson J. M. Tuberculosis in Britain today. BMJ. 1993 Jan 23;306(6872):221–222. doi: 10.1136/bmj.306.6872.221. [DOI] [PMC free article] [PubMed] [Google Scholar]

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