December 31, 2018
2 min read

Socioeconomic inequalities linked to infectious diseases

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Socioeconomic factors such as employment status, educational level and income influence the type of infections that occur in patients in Sweden, according to study findings.

Researchers found “persistent socioeconomic inequalities in infectious diseases” in Sweden, a high-income country with universal health care, and said the findings should be used to identify priority interventions and to help monitor programs that address such issues.

“In the past few decades, overall population health indicators have improved across Europe, but not all population groups have benefited equally, implying that widespread health inequalities still exist between and within countries. Education, occupation and income account for most health inequalities within countries,” Alessandro Pini, MD, from the European Centre for Disease Prevention and Control and the Public Health Agency of Sweden, and colleagues wrote in The Lancet Infectious Diseases.

“Several studies have reported higher rates of non-communicable diseases in disadvantaged groups than in populations with higher socioeconomic status. Even though associations between socioeconomic conditions and infectious diseases have been reported in low-income and high-income countries, most studies have focused on a small number of diseases and infections, such as tuberculosis and HIV infection. Therefore, a scientific basis for public health priorities and effective strategies for interventions to achieve a more equal access to health care are scarce for many other infectious diseases.”

Pini and colleagues examined the association between socioeconomic characteristics and 29 infections in Sweden using data from SmiNet, a national register of infections and infectious diseases, and government socioeconomic statistics. They collected information on each patient — identified as a person aged between 18 and 65 with one of the 29 infections — including birthplace, education, employment status and income. They matched each case with five controls based on age, sex and county of residence.

In total, the researchers included 173,729 cases reported between Jan. 1, 2005, and Dec. 31, 2014, and 868,645 controls in the study. They found that unemployment, low education level and low income were most associated with invasive bacterial diseases, bloodborne infections, tuberculosis and antibiotic-resistant infections. Likewise, patients with foodborne and waterborne infections were less like to be unemployed, less likely to have low educational status and less likely to have low income.

“Our study indicates the existence of socioeconomic inequalities that are linked to some of the most notified infections and infectious diseases in Sweden,” the authors concluded. “Even if our study did not examine associations between infectious diseases and socioeconomic factors in specific groups, we recommend using these data to identify priority interventions to lessen the burden of these diseases and as a baseline to monitor programs aimed to address socioeconomic inequalities in health.” – by Caitlyn Stulpin

Disclosures: The authors report no relevant financial disclosures.