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Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2019 September;178(9):676-93

DOI: 10.23736/S0393-3660.18.03932-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Social, cultural and political aspects concerning tuberculosis and its persistence in the world and within societies. An overview

Martina RONCHETTO 1, Flavio RONCHETTO 2

1 Assolombarda Confindustria Milano, Milan, Italy; 2 Private practitioner, Turin, Italy



Tuberculosis is especially rooted in contexts of extreme poverty (low income countries). Its asymmetric geographical distribution in the word testifies the existence and persistence of health disparities, associated to different level of wealth (Gross Domestic Product) between countries. Nevertheless, health inequalities are documented in contexts far from conditions of absolute poverty. Studies have shown that TB prevalence and incidence depend on distribution of wealth within society, rather than on overall wealth. Structure of society (organization and stratification), strongly influences health of individuals, groups and community. Socially disadvantaged people because of low income, low social position, poor education, polluted environments, lake of social protection, inaccessibility to health services, are more exposed to TB (and other diseases) and death. It is important to consider that ‘health inequality’ mostly assumes the connotation of ‘health iniquity’ (expression indicating a condition of social health inequality commonly considered unnecessary, avoidable, unfair and unjustifiable). In this paper, authors focused their attention, examining epidemiological and sociological literature, on some aspects regarding the fundamental role for TB infection and active disease play by socioeconomic, political and cultural factors. An emphasis is placed on the link that is between TB and poverty/low socio-economic status, gender, cultural context, environmental and institutional factors, welfare state, diagnostic delay and consequences. Finally, in according with WHO, they underline the central importance of political strategies and interventions to control the diffusion of disease in the world e within societies.


KEY WORDS: Tuberculosis; Poverty; Health status disparities; Socioeconomic factors; Public policy; Social welfare

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