Inequalities in tuberculosis mortality: long-term trends in 11 European countries

Blin L. Nagavci, Rianne de Gelder, Pekka Martikainen, Patrick Deboosere, Matthias Bopp, Jitka Rychtarikova, Ramune Kalediene, Mall Leinsalu, Johan Mackenbach

Research output: Contribution to journalArticle

8 Citations (Scopus)


SETTING: Previous studies in many countries have shown that mortality due to tuberculosis (TB) is higher among people of lower socio-economic status.
OBJECTIVE: To assess the magnitude and direction of trends in educational inequalities in TB mortality in 11 European countries.
DESIGN: Data on TB mortality between 1980 and 2011 were collected among persons aged 35–79 years. Age-standardised mortality rates by educational level were calculated. Inequalities were estimated using the relative and slope indices of inequality.
RESULTS: In the first decade of the twenty-first century, educational inequalities in TB mortality occurred in all countries in this study. The largest absolute inequalities were observed in Lithuania, and the smallest in Denmark. In most countries, relative inequalities have remained stable since the 1980s or 1990s, while absolute inequalities remained stable or went down. In Lithuania and Estonia, however, absolute inequalities increased substantially.
CONCLUSION: The reduction in absolute inequalities in TB mortality, as seen in many European countries, is a major achievement; however, inequalities persist and are still a major cause for concern in the twenty-first century. Interventions aimed at preventing TB disease and reducing TB case fatality in lower socio-economic groups should be intensified, especially in the Baltic countries.
Original languageEnglish
Pages (from-to)574-581
Number of pages8
JournalThe International Journal of Tuberculosis and Lung Disease
Issue number5
Publication statusPublished - 1 May 2016


  • Europe
  • inequity
  • socio-economic
  • tuberculosis

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