Tuberculosis and the "Social Complex" in Glasgow

Abstract

A brief historical survey of respiratory tuberculosis mortality and notification rates shows an unusual trend in Glasgow, differing not only from those of England and most other countries but even from the rest of Scotland. Notifications in Glasgow have increased sharply since the war, the number of new cases in 1949 being the highest since 1910 and affecting particularly the younger age groups, especially girls and women of 15-24 yrs. The purpose of the study is to investigate the relation of socio-economic conditions in Glasgow to tuberculosis rates (comparing this with their relation to other disease rates) for the yrs. 1930-47, to evaluate the relative importance of components of the "social complex" and estimate their varying influence at different times and places. The elements of the "complex" considered are unemployment, poverty, "ordinary crowding" (density of dwelling occupation), and overcrowding as defined by statute. Records for wards and Employment Exchange areas are analyzed by correlation, regression and analysis of variance. Some conclusions drawn are [long dash]Incidence of respiratory tuberculosis is strongly correlated with crowding and overcrowding, and somewhat less closely correlated with unemployment and poverty, though there is a marked connection of poverty with tuberculosis mortality. There is a strong and consistent association between tuberculosis notification and mortality rates, with a relative upward post-war trend of the latter. Absolute increases were greatest in worst-housed wards, but percentage increases in individual wards were negatively associated with poverty and overcrowding. Associations of social factors with distributions of other mortality rates differ from their relationships with respiratory tuberculosis. Social conditions cannot be adequately investigated in terms of one component only.