中国肝炎疫情分布变化与社会决定因素研究

Distribution changes of hepatitis epidemic in China and its social determinants

病毒性肝炎是危害国民健康的重要传染病之一,综合采用重心曲线、基尼系数、空间分析等方法对中国31个省区2004-2014年肝炎新发疫情的分布变化特征进行考察,并利用灰色关联方法探索新发疫情的社会决定因素。结果表明:①2004年以来,我国肝炎新发规模经历了"先增、后减、总体增加"的时序过程,疫情重心向西、向南迁移,在地理分布上呈现"东高、西低,南多、北少"格局。②各省区肝炎新发规模差异随时间变化波动上升,空间集聚趋势相对增强,逐步形成多个高发连片区和低发连片区。③在诸多社会因素中,上一年的发病水平、居民贫困水平、文化教育水平与医疗卫生条件是影响地区新发疫情的主要因子,政府卫生经费投入强度、区域经济水平、居民支付能力、人口密度等因子的影响作用相对较弱。

Hepatitis is an harmful infectious disease. This paper explored the spatial-temporary characteristics of hepatitis epidemic during 2004-2014 in China and its social determinants with gravity center curve, Gini coefficient, spatial analysis, and gray correlation. The results showed that： ①The incidence of hepatitis increased from 2004 to 2009, and then decreased from 2009 to 2014, but its overall incidence increased. Meanwhile, the gravity center moved from northeast to southwest, showing a pattern that eastern and southern regions had a higher prevalence than western and northern regions. ②The differences of hepatitis epidemic between provinces displayed undulation escalation from 2004 to 2014, and trend of spatial agglomeration was stronger relatively, showing several high-incidence areas and low-incidence areas gradually. ③Among the 8 social determinants, the incidence of previous year, residents＇ poverty level, educational level, and medical and health conditions were the main social determinants that affected the hepatitis epidemic mostly, while government health investment, regional economic level, residents＇ capacity to pay, and population density had weak influence on hepatitis epidemic.