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KMID : 1155220210460010088
Journal of the Korean Society of Health Information and Health Statistics
2021 Volume.46 No. 1 p.88 ~ p.99
Spatially Filtered Multilevel Analysis on Spatial Inequality of Tuberculosis in Gyeongsangbuk-do, Korea
Im Chang-Min

Kim Young-Ho
Abstract
Objectives: This study aims to identify the spatial inequality of tuberculosis (TB) and related socio-environmental factors in Gyeongsangbuk-do, Korea.

Methods: This study explains TB incidences in a spatial perspective. A spatial multilevel regression model was applied to account for the spatial inequality of TB and related factors. Applied socio-environmental factors were average age, population density, Normalized Difference Built-up Index (NDBI), particulate matter (PM10), medical insurance, financial independence rate, and medical doctors per 1,000 people.

Results: This study finds evident spatial inequality of TB in Gyeongsangbuk-do. Most TB hotspots are identified around Yeongyang-gun, the area with the lowest socio-economic status in Korea.
The regression result shows that level 1 factors (Average age, NDBI, PM10) and level 2 factors (medical insurance, financial independence rate) were statistically significant related to TB incidences. Furthermore, spatial filtering applied to multilevel regression accounts for spatial autocorrelation of TB incidence.

Conclusions: Regional socio-economic and demographic conditions in Gyeongsangbuk-do influence TB incidences. Given low expectations on Gyeongsangbuk-do¡¯s socio-economic and demographic growth, reducing the spatial inequality of TB would be challenging.
KEYWORD
Tuberculosis, Spatial inequality, Spatial distribution, Hotspot analysis, Spatially filtered multilevel analysis
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