Norwich Medical School.
School of Environmental Sciences, University of East Anglia, UK.
Scand J Public Health. 2020 Jun;48(4):351-361. doi: 10.1177/1403494819852830. Epub 2019 Jul 10.
It is unclear how economic factors impact on the epidemiology of infectious disease. We evaluated the relationship between incidence of selected infectious diseases and economic factors, including economic downturn, in 13 European countries between 1970 and 2010. : Data were obtained from national communicable disease surveillance centres. Negative binomial forms of the generalised additive model (GAM) and the generalised linear model were tested to see which best reflected transmission dynamics of: diphtheria, pertussis, measles, meningococcal disease, hepatitis B, gonorrhoea, syphilis, hepatitis A and salmonella. Economic indicators were gross domestic product per capita (GDPpc), unemployment rates and (economic) downturn. : GAM models produced the best goodness-of-fit results. The relationship between GDPpc and disease incidence was often non-linear. Strength and directions of association between population age, tertiary education levels, GDPpc and unemployment were disease dependent. Overdispersion for almost all diseases validated the assumption of a negative binomial relationship. Downturns were not independently linked to disease incidence.
经济因素如何影响传染病的流行病学尚不清楚。我们评估了 1970 年至 2010 年间 13 个欧洲国家传染病发病率与经济因素（包括经济衰退）之间的关系。数据来自国家传染病监测中心。我们测试了广义加性模型（GAM）和广义线性模型的负二项式形式，以观察哪种模型最能反映白喉、百日咳、麻疹、脑膜炎球菌病、乙型肝炎、淋病、梅毒、甲型肝炎和沙门氏菌的传播动态。经济指标包括人均国内生产总值（GDPpc）、失业率和（经济）衰退。GAM 模型产生了最佳的拟合效果。GDPpc 与疾病发病率之间的关系通常是非线性的。人口年龄、高等教育水平、GDPpc 和失业率之间的关联强度和方向取决于疾病。几乎所有疾病的过离散度都验证了负二项式关系的假设。衰退与疾病发病率没有独立联系。
