Health in financial crises: economic recession and tuberculosis in Central and Eastern Europe
Health in financial crises: economic recession and tuberculosis in Central and Eastern Europe
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DOI：
10.1098/rsif.2010.0072
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发表时间：
2010-11-06
影响因子：
3.9
通讯作者：
Dye, Christopher
中科院分区：
文献类型：
--
作者：
Arinaminpathy, Nimalan;Dye, Christopher
始于2007年的全球金融危机引起了人们对经济状况恶化对公共卫生影响的关注。对以往事件进行定量分析，可以深入了解经济衰退对健康的潜在影响。1990年代初，随着苏联的解体，中欧和东欧出现了广泛的经济衰退。与此同时，尽管大多数国家的结核病发病率以前有所下降，但整个区域的结核病病例和死亡人数却激增。在这里，我们研究了经济生产力损失与结核病病例和死亡率之间的定量关系。我们使用世界卫生组织1980年至2006年的结核病报告和死亡数据，以及世界银行的国内生产总值数据。比较15个有足够数据的国家，我们发现每个国家在经济衰退期间损失的经济生产力与同期结核病病例（r（2）= 0.94，p < 0.001）和死亡（r（2）= 0.94，p < 0.001）之间有很强的线性关系。如果2009年的结核病流行病学和控制与1991年的经济联系在一起，那么波罗的海国家，特别是拉脱维亚，现在很容易再次出现结核病病例和死亡人数的上升。这些预测是根据新出现的毒品消费数据作出的，这些数据表明，这些国家的减少幅度是2008年初以来最大的。我们建议在当前经济衰退期间密切监视和监测，特别是在波罗的海国家。
The ongoing global financial crisis, which began in 2007, has drawn attention to the effect of declining economic conditions on public health. A quantitative analysis of previous events can offer insights into the potential health effects of economic decline. In the early 1990s, widespread recession across Central and Eastern Europe accompanied the collapse of the Soviet Union. At the same time, despite previously falling tuberculosis (TB) incidence in most countries, there was an upsurge of TB cases and deaths throughout the region. Here, we study the quantitative relationship between the lost economic productivity and excess TB cases and mortality. We use the data of the World Health Organization for TB notifications and deaths from 1980 to 2006, and World Bank data for gross domestic product. Comparing 15 countries for which sufficient data exist, we find strong linear associations between the lost economic productivity over the period of recession for each country and excess numbers of TB cases (r(2) = 0.94, p < 0.001) and deaths (r(2) = 0.94, p < 0.001) over the same period. If TB epidemiology and control are linked to economies in 2009 as they were in 1991 then the Baltic states, particularly Latvia, are now vulnerable to another upturn in TB cases and deaths. These projections are in accordance with emerging data on drug consumption, which indicate that these countries have undergone the greatest reductions since the beginning of 2008. We recommend close surveillance and monitoring during the current recession, especially in the Baltic states.