Las desigualdades educativas en la mortalidad por tuberculosis en Europa

Título original: Educational inequalities in tuberculosis mortality in sixteen European populations

Resumen:
Objective: To describe the magnitude of socioeconomic inequalities in tuberculosis (TB) mortality by level of education in male, female, urban and rural populations in several European countries.

Design: Data were obtained from the Eurothine Project, covering 16 populations between 1990 and 2003. Age- and sex-standardised mortality rates, the relative index of inequality and the slope index of inequality were used to assess educational inequalities.

Results: The number of TB deaths reported was 8530, with a death rate of 3 per 100000 per year, of which 73% were males. Educational inequalities in TB mortality were present in all European populations. Inequalities in TB mortality were greater than in total mortality. Relative and absolute inequalities were large in Eastern European and Baltic countries but relatively small in Southern European countries and in Norway, Finland and Sweden. Inequalities in mortality were observed among both men and women, and in both rural and urban populations.

Conclusions: Socio-economic inequalities in TB mortality exist in all European countries. Firm political commitment is required to reduce inequalities in the social determinants of TB incidence. Targeted public health measures are called for to improve access to treatment of vulnerable groups and thereby reduce TB mortality.

Autores: Alvarez, JL (Alvarez, J. L.)1,2; Kunst, AE (Kunst, A. E.)2,3; Leinsalu, M (Leinsalu, M.)4; Bopp, M (Bopp, M.)5; Strand, BH (Strand, B. H.)6; Menvielle, G (Menvielle, G.)7; Lundberg, O (Lundberg, O.)8; Martikainen, P (Martikainen, P.)9; Deboosere, P (Deboosere, P.)10; Kalediene, R (Kalediene, R.)11; Artnik, B (Artnik, B.)12; Mackenbach, JP (Mackenbach, J. P.)2; Richardus, JH (Richardus, J. H.)2

Direcciones:
1. Rey Juan Carlos Univ, Dept Prevent Med & Publ Hlth, Madrid 28922, Spain
2. Univ Med Ctr Rotterdam, Erasmus MC, Dept Publ Hlth, Rotterdam, Netherlands
3. Univ Amsterdam, Acad Med Ctr, Dept Publ Hlth, NL-1105 AZ Amsterdam, Netherlands
4. Sodertorn Univ, Stockholm Ctr Hlth Societies Transit, Huddinge, Sweden
5. Univ Zurich, Inst Social & Prevent Med, CH-8006 Zurich, Switzerland
6. Norwegian Inst Publ Hlth, Div Epidemiol, Oslo, Norway
7. Univ Versailles, St Quentin en Yvelines, France
8. Stockholm Univ, Ctr Hlth Equ Studies, Stockholm, Sweden
9. Univ Helsinki, Dept Sociol, Helsinki, Finland
10. Centrum Sociol VUB, Brussels, Belgium
11. Kaunas Univ Med, Dept Hlth Management, Kaunas, Lithuania
12. Univ Ljubljana, Fac Med, Dept Publ Hlth, Ljubljana, Slovenia