School of Resource and Environmental Sciences, Wuhan University, Wuhan, China.
Dong Fureng Institute of Economic and Social Development; Research Center of Health Economics and Management, Wuhan University, Beijing, China.
Hum Vaccin Immunother. 2021 Jul 3;17(7):2257-2267. doi: 10.1080/21645515.2020.1853999. Epub 2021 Jan 26.
: Hepatitis B (HB) is the most serious and common viral hepatitis in China. Previous studies on HB discrimination mainly have focussed on stratified analysis, and there has been no consideration of the impact of geographical-environmental factors on HB discrimination from a spatial perspective.: This study conducted a large nationwide village-based survey to test whether there were significant regional differences in HB discrimination, and to explore the relationship between different socio-economic geographical factors and HB discrimination.: The sample comprised 22618 rural adults, aged over 18 years old, from villages in seven provinces, representing central, southern, and eastern coastal regions of China. Using face-to-face interviews, we surveyed participants' discrimination against HB patients or carriers. Chi-square tests were used to analyze the effects of the region on differences in proportions between three discrimination levels (low, medium, and high). A geographical detector was used to explore the relationship between different socio-economic and geographical-environmental factors and HB discrimination.: The distribution of HB discrimination levels across the 42 villages was statistically significant. The level of HB discrimination in the central and southern regions was generally low, and the level of HB discrimination in the eastern coastal regions was higher. Both socio-economic and geographic-environmental factors had a significant relationship with HB discrimination. Most of these relationships were not linear.: Developing the economy and accelerating urbanization did not automatically eliminate discrimination against HB. We recommend government HB publicity and education campaigns to inform the population of HB causes and effects, and strengthen the education of students so that they can have a clear and correct understanding of HB from a young age, both of which will address HB discrimination.
乙型肝炎（HB）是中国最严重和最常见的病毒性肝炎。之前关于乙型肝炎歧视的研究主要集中在分层分析上，没有从空间角度考虑地理环境因素对乙型肝炎歧视的影响。本研究进行了一项大规模的全国性基于村庄的调查，以检验乙型肝炎歧视是否存在显著的区域差异，并探讨不同社会经济地理因素与乙型肝炎歧视之间的关系。该样本包括来自中国中、南、东部沿海地区七个省份的 22618 名 18 岁以上的农村成年人。通过面对面访谈，我们调查了参与者对乙型肝炎患者或携带者的歧视情况。卡方检验用于分析地区对三种歧视程度（低、中、高）之间比例差异的影响。地理探测器用于探索不同社会经济和地理环境因素与乙型肝炎歧视之间的关系。在 42 个村庄中，乙型肝炎歧视水平的分布具有统计学意义。中南部地区乙型肝炎歧视程度普遍较低，而东部沿海地区乙型肝炎歧视程度较高。社会经济和地理环境因素都与乙型肝炎歧视有显著关系。这些关系大多不是线性的。发展经济和加速城市化并不能自动消除对乙型肝炎的歧视。我们建议政府开展乙型肝炎宣传和教育活动，让公众了解乙型肝炎的病因和后果，并加强学生教育，使他们从小就能对乙型肝炎有清晰正确的认识，从而解决乙型肝炎歧视问题。
