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Tuberculosis mortality in England and Wales during 1982-1992: its association with poverty, ethnicity and AIDS

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  • Elender, Frances
  • Bentham, Graham
  • Langford, Ian

Abstract

This paper seeks to establish the strength of association between contemporary tuberculosis (TB) in England and Wales and several potential aetiological factors. It presents an ecological analysis of standardised annual TB mortality rates for the 403 local authority districts between 1982 and 1992, disaggregated by age and sex. Social, demographic and ethnicity measures from the 1981 and 1991 censuses and standardised annual AIDS-related mortality rates for young men are used to calculate Poisson regression models. A strong association was found between all TB mortality groups and overcrowding at the household level. For women, no other measures improved the explanatory power of the models. In multiple regressions, both poverty and AIDS-related mortality explained additional variation in the model for younger men. The link between ethnicity and tuberculosis notifications was not reflected in this analysis of mortality. For all groups no evidence of a positive relationship with ethnicity was found, once overcrowding had been accounted for. The significance of household as opposed to district level crowding suggests that prolonged contact is required for disease transmission. Regression analysis indicates that it is the overcrowding and poverty among ethnic populations that is significant for their tuberculosis mortality. The fact that the relationship between AIDS and TB is confined to the group most typical of AIDS patients provides evidence that AIDS has little influence on the level of tuberculosis mortality in the wider population. Explanations for the observed relationship include preferential certification, migration for treatment and shortcomings in health care provision.

Suggested Citation

  • Elender, Frances & Bentham, Graham & Langford, Ian, 1998. "Tuberculosis mortality in England and Wales during 1982-1992: its association with poverty, ethnicity and AIDS," Social Science & Medicine, Elsevier, vol. 46(6), pages 673-681, March.
    • Handle: RePEc:eee:socmed:v:46:y:1998:i:6:p:673-681
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    Cited by:

    1. Espinoza-Delgado, José & Klasen, Stephan, 2018. "Gender and multidimensional poverty in Nicaragua: An individual based approach," World Development, Elsevier, vol. 110(C), pages 466-491.
    2. Karen Clay & Werner Troesken, 2006. "Deprivation and Disease in Early Twentieth-Century America," NBER Working Papers 12111, National Bureau of Economic Research, Inc.
    3. Espinoza-Delgado, José & Silber, Jacques, 2018. "Multi-dimensional poverty among adults in Central America and gender differences in the three I’s of poverty: Applying inequality sensitive poverty measures with ordinal variables," MPRA Paper 88750, University Library of Munich, Germany.
    4. Espinoza-Delgado, José & López-Laborda, Julio, 2017. "Nicaragua: evolución de la pobreza multidimensional, 2001-2009," Revista CEPAL, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL), April.
    5. Vellore Arthi & James Fenske, 2018. "Polygamy and child mortality: Historical and modern evidence from Nigeria’s Igbo," Review of Economics of the Household, Springer, vol. 16(1), pages 97-141, March.
    6. Espinoza-Delgado, José & López-Laborda, Julio, 2017. "Nicaragua: trend of multidimensional poverty, 2001-2009," Revista CEPAL, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL), April.
    7. Wanyeki, Ian & Olson, Sherry & Brassard, Paul & Menzies, Dick & Ross, Nancy & Behr, Marcel & Schwartzman, Kevin, 2006. "Dwellings, crowding, and tuberculosis in Montreal," Social Science & Medicine, Elsevier, vol. 63(2), pages 501-511, July.
    8. Dilbağ Tokay, 2020. "Impact of Online Music Competitions on the Young Musicians’ Professional Skills and Their Musical Development During the Covid-19 Pandemic," European Journal of Social Sciences Education and Research Articles, Revistia Research and Publishing, vol. 7, September.
    9. Espinoza-Delgado, José & López-Laborda, Julio, 2016. "Las tres Is de la pobreza multidimensional en Nicaragua y el diferencial de género en los primeros quince años del siglo XXI, a partir de un enfoque centrado en la persona [The three I’s of multidi," MPRA Paper 74997, University Library of Munich, Germany.

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