Tocque K, Doherty M J, Bellis M A, Spence D P, Williams C S, Davies P D
Public Health Laboratory, Fazakerley Hospital, Liverpool, UK.
Int J Tuberc Lung Dis. 1998 Mar;2(3):213-8.
Metropolitan areas of England, including London boroughs, in 1991.
To investigate the relative importance of deprivation, immigration and the elderly in explaining variations in tuberculosis rate.
A retrospective study using multiple Poisson regression models to assess the interrelationship between various population parameters.
Significant differences ere observed between London and other metropolitan districts in the measures of tuberculosis, immigration and the elderly. In addition, all population parameters were significantly intercorrelated in London: areas with a high proportion of immigrants had high levels of deprivation and low proportions of elderly. In other metropolitan districts, only immigration and the Jarman index were significantly associated, and removing the immigration component from the index removed this statistical significance. Multiple Poisson regression models revealed that the immigrant index had the strongest explanatory power in explaining tuberculosis rates, but there were significant interactions between this and measures of urban deprivation indices. That is, there was a greater effect of increasing deprivation at lower levels of immigration than at higher levels. This phenomenon was more pronounced in London boroughs than other metropolitan districts. The elderly index had no significant influence on tuberculosis rates.
Although the association between tuberculosis and deprivation previously reported for the city of Liverpool is confirmed across all urban areas of England, the immigrant proportion of the population has a greater statistical power in explaining variations in rates of urban tuberculosis. However, tuberculosis notifications can be most accurately predicted by combining both measures than by either one alone.
1991年，英格兰的大都市地区，包括伦敦各区。
探讨贫困、移民和老年人因素在解释结核病发病率差异方面的相对重要性。
一项回顾性研究，使用多个泊松回归模型评估各种人口参数之间的相互关系。
在结核病、移民和老年人指标方面，伦敦与其他大都市地区存在显著差异。此外，伦敦所有人口参数之间均存在显著的相互关联：移民比例高的地区贫困程度高，老年人比例低。在其他大都市地区，只有移民与贾曼指数显著相关，从该指数中去除移民因素后，这种统计学显著性消失。多个泊松回归模型显示，移民指数在解释结核病发病率方面具有最强的解释力，但该指数与城市贫困指数之间存在显著的相互作用。也就是说，在移民水平较低时，贫困程度增加对结核病发病率的影响大于移民水平较高时。这种现象在伦敦各区比其他大都市地区更为明显。老年人指数对结核病发病率没有显著影响。
尽管之前在利物浦市报道的结核病与贫困之间的关联在英格兰所有城市地区都得到了证实，但人口中的移民比例在解释城市结核病发病率差异方面具有更大的统计学效力。然而，将这两种指标结合起来比单独使用任何一种指标都能更准确地预测结核病通报情况。
