'International Union Against Tuberculosis and Lung Disease'
Abstract
Introduction Economic crises affect the population’s health, especially among the most deprived. The increase in health inequalities in this recession may have influenced the incidence of tuberculosis (TB). We analyzed the effect of socioeconomic inequities and the recession on the incidence of TB. Methods We conducted a population-based incidence study of TB cases in Barcelona, Spain, who started treatment between 2003 and 2015. A multilevel interrupted time series analysis was done to analyze differences in incidence trends between the pre-recession (until 2008) and recession periods. Results We observed differences in TB incidence according to deprivation and immigration status. TB incidence among most deprived neighborhoods was 2.72 times higher than least deprived. Compared to natives, incidence was 9 times higher among those born in Africa, and 6 times higher among those born in Asia and Oceania. The previous decreasing trend in incidence (4%) was accentuated during the recession (7%). Conclusions The incidence of TB decreased during the recession, probably due to a reduction of new immigrants and the TB programme. However, incidence is highly unequal between districts with different levels of deprivation, and between foreign-born from different geographical regions. Social measures are important for reducing inequalities and TB incidence in Barcelona.</p
