A Spatial Analysis of Tuberculosis and its Relationship to Social Characteristics in Korea

Abstract

Tuberculosis (TB) remains unceasing public health burden in Korea. Even the newly notified cases have been increasing steadily, while total case has not varied much and mortality has decreased. The study focuses on social characteristics pertinent TB incidence based on the concept that TB is a social disease. This study is an ecological approach to identify whether TB and social characteristics were significantly local correlated in South Korea, using surveillance data collected during 2012. It differentiates from preceding studies by conducting spatial analysis which leads a conclusion that social characteristics or structures at contiguous areas can affect TB incidence in the neighborhood in specific regions. Distribution of TB in South Korea was mapped at Si, Gu, and Gun, district level in the aspects of age and sex standardized incidence. Analysis for the local correlation between social characteristics and TB incidence was conducted by using OSL regression, univariate local index of spatial association and bivariate local index of spatial association (BiLISA). Economic status, Occupational status, Education level, Overcrowded accommodation, housing environment, social participation and TB incidence rate were hardly spatial autocorrelated. What was significantly related to TB distribution in South Korea were proportion of service workers or salesclerk and proportion of residents living in households with insufficient housing facilities. This conclusion should be considered that these factors were also related to poor social determinants in neighbor districts according to bivariate LISA analysis, therefore the correlation coefficient or precision could be exaggerated. However, there were statistically significant high-high and low-low clusters, located in eastern coast and south coast areas and northwestern of the country respectively for one of occupational status and of housing environment variables. In conclusion, this study suggests that this study also can help decision makers and field staff direct prevention and control interventions for improving living conditions or operational environment in order to control high TB incidence rates in the high risk local areas

eastern and southern part of South Korea.