title: Inequalities in tuberculosis mortality: long-term trends in 11 European countries.
abstract: METHODS
  Previous studies in many countries have shown that mortality due to tuberculosis (TB) is higher among people of lower socio-economic status.
  
  
  OBJECTIVE
  To assess the magnitude and direction of trends in educational inequalities in TB mortality in 11 European countries.
  
  
  METHODS
  Data on TB mortality between 1980 and 2011 were collected among persons aged 35-79 years. Age-standardised mortality rates by educational level were calculated. Inequalities were estimated using the relative and slope indices of inequality.
  
  
  RESULTS
  In the first decade of the twenty-first century, educational inequalities in TB mortality occurred in all countries in this study. The largest absolute inequalities were observed in Lithuania, and the smallest in Denmark. In most countries, relative inequalities have remained stable since the 1980s or 1990s, while absolute inequalities remained stable or went down. In Lithuania and Estonia, however, absolute inequalities increased substantially.
  
  
  CONCLUSIONS
  The reduction in absolute inequalities in TB mortality, as seen in many European countries, is a major achievement; however, inequalities persist and are still a major cause for concern in the twenty-first century. Interventions aimed at preventing TB disease and reducing TB case fatality in lower socio-economic groups should be intensified, especially in the Baltic countries.
authors.affiliation: Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: B L
authors.initials: BL
authors.lastname: Nagavci
authors.affiliation: Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: de Gelder
authors.affiliation: Department of Sociology, University of Helsinki, Helsinki, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Martikainen
authors.affiliation: Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Deboosere
authors.affiliation: Institute of Social and Preventive Medicine, University of Zürich, Zurich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Bopp
authors.affiliation: Department of Demography, Charles University, Prague, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Rychtaříková
authors.affiliation: Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: R
authors.initials: R
authors.lastname: Kalediene
authors.affiliation: Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia; Stockholm Centre for Health and Social Change, Södertörn University, Huddinge, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Leinsalu
authors.affiliation: Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: J P
authors.initials: JP
authors.lastname: Mackenbach
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D004522:Educational Status; D005060:Europe / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D012307:Risk Factors; D013997:Time Factors; D014376:Tuberculosis / Q000401:mortality* / Q000628:therapy