Investigating spatial variation and change (2006-2017) in childhood immunisation coverage in New Zealand
Investigating spatial variation and change (2006-2017) in childhood immunisation coverage in New Zealand
复制标题
DOI：
10.1016/j.socscimed.2020.113292
复制
发表时间：
2020-11-01
影响因子：
5.4
通讯作者：
Kingham, Simon
中科院分区：
文献类型：
--
作者：
Marek, Lukas;Hobbs, Matthew;Kingham, Simon
背景：免疫接种是保护儿童和成人免受有害疾病侵害的一种安全有效的方法。然而，在新西兰的一些地区，儿童免疫接种覆盖率正在下降。目的：使用全国样本，首先检查免疫覆盖率的社会经济和人口决定因素以及这些决定因素的空间差异。其次，它调查了新西兰免疫覆盖率随时间的变化。方法：从国家免疫登记（NIR）中获得个人免疫记录（2005-2017年；4482499起事件）。我们按年份和人口普查区单位（CAU）的里程碑年龄计算了平均免疫覆盖率，然后通过选定的社会经济和人口统计学决定因素检查了免疫覆盖率。最后，使用地理加权回归研究了免疫覆盖率与选定决定因素之间关联的局部变化。结果：研究结果显示，近年来，在最贫困地区免疫覆盖率高的CAUs，免疫接种率有所下降，而在较贫困地区，免疫接种率有所上升。几乎所有的解释变量在与免疫覆盖率的关联上都表现出空间差异。例如，在南岛北部、北岛中南部、奥克兰周围和北岛，可以观察到区域层面剥夺的最强烈的负面影响。结论：我们的研究结果表明，儿童免疫覆盖率因社会经济和人口因素而异，我们还发现了近年来重要的空间变异和随时间的变化。这一证据可用于改进新西兰的免疫相关政策。
Background: Immunisation is a safe and effective way of protecting children and adults against harmful diseases. However, immunisation coverage of children is declining in some parts of New Zealand.Aim: Use a nationwide sample to first, examine the socioeconomic and demographic determinants of immunisation coverage and spatial variation in these determinants. Second, it investigates change in immunisation coverage in New Zealand over time.Methods: Individual immunisation records were obtained from the National Immunisation Register (NIR) (2005-2017; 4,482,499 events). We calculated the average immunisation coverage by year and milestone age for census area units (CAU) and then examined the immunisation coverage by selected socioeconomic and demographic determinants. Finally, local variations in the association between immunisation coverage and selected determinants were investigated using geographically weighted regression.Results: Findings showed a decrease of immunisation rates in recent years in CAUs with high immunisation coverage in the least deprived areas and increasing immunisation rates in more deprived areas. Nearly all explanatory variables exhibited a spatial variation in their association with immunisation coverage. For instance, the strongest negative effect of area-level deprivation is observed in the northern part of the South Island, the central-southern part of the North Island, around Auckland, and in Northland.Conclusion: Our findings show that childhood immunisation coverage varies by socioeconomic and demographic factors across CAUs. We also identify important spatial variation and changes over time in recent years. This evidence can be used to improve immunisation related policy in New Zealand.