Spatial-temporal variations of global viral hepatitis mortality rate and its influencing factors from 2000 to 2019

doi:10.3969/j.issn.1004-9479.2025.01.20230331

Abstract

Abstract:

Viral hepatitis is one of the significant global disease burdens, and revealing its spatial patterns and influencing factors holds vital significance for reducing the disease burden caused by hepatitis. Based on global viral hepatitis mortality data, utilizing methods such as standard deviation ellipses, spatial autocorrelation analysis, and geographic detectors, this study investigates the spatiotemporal variation characteristics and influencing factors of global viral hepatitis from 2000 to 2019. The findings indicate: ①Global hepatitis mortality counts have remained relatively stable over the long term, while the mortality rate has shown a significant decline. ②There is a notable spatial disparity in hepatitis mortality rates, with hotspots concentrated in underdeveloped regions such as Africa and South Asia, while coldspots are concentrated in developed regions like Europe and the Americas. ③Countries and regions with high mortality rates experience significantly faster declines in mortality rates compared to those with lower mortality rates.④Various influencing factors exhibit spatial correlation or spatial effects on hepatitis mortality rate, among which the prevalence of hepatitis B and C, smoking rate, and indoor and ambient air pollution significantly affect hepatitis mortality rate. For countries with lower income, prioritizing economic development to enhance healthcare services is crucial for reducing mortality rates. The research findings of this paper can provide scientific basis and theoretical support for optimizing the allocation of healthcare resources, improving healthcare service quality, and lowering viral hepatitis mortality rates.

Key words: viral hepatitis, spatial-temporal differentiation, influencing factors, geographical detector, mortality rate

摘要：

病毒性肝炎是全球重要疾病负担之一，揭示其空间格局及影响因素对减少因肝炎造成的疾病负担具有重要意义。基于全球病毒性肝炎死亡数据，运用标准差椭圆、空间自相关分析、地理探测器和空间误差分析方法，探讨2000—2019年全球病毒性肝炎时空分异变化特征及其影响因素。研究发现：①全球病毒性肝炎死亡数长期维持不变，而死亡率出现显著下降。②病毒性肝炎死亡率空间差异显著，热点区集中于非洲、南亚等欠发达地区，而冷点区集中于欧洲、美洲等发达地区。③高死亡率国家与地区的死亡率下降速度显著高于低死亡率国家与地区。④多种因素对病毒性肝炎死亡率存在空间相关性或空间影响，其中乙肝与丙肝流行率、吸烟率、室内与室外空气污染对病毒性肝炎死亡率存在显著的空间影响。对于经济发展落后的国家，应当首先关注经济发展，以提高卫生服务水平，从而降低死亡率。本文研究结果可为优化卫生资源配置、提高卫生服务质量、降低病毒性肝炎死亡率提供科学依据与理论支撑。

关键词: 病毒性肝炎, 时空分异, 影响因素, 地理探测器, 死亡率

Jie LI, Zejia XU, Xudan LIN. Spatial-temporal variations of global viral hepatitis mortality rate and its influencing factors from 2000 to 2019[J]. World Regional Studies, 2025, 34(1): 43-55.

李颉, 许泽嘉, 林煦丹. 2000—2019年全球病毒性肝炎死亡率的时空分异与影响因素[J]. 世界地理研究, 2025, 34(1): 43-55.

Figures/Tables 9

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因素分类	影响因素	指标定义	可持续发展目标
医疗保健	人均健康支出	当前人均健康支出/千美元	SDG 1.a.2
	全民健康覆盖	全民健康覆盖率/ %	SDG 3.8.1
	乙肝免疫率	1岁儿童乙型肝炎免疫接种覆盖率 /%	SDG 3.a.1
健康状况	乙肝流行率	每十万人乙型肝炎流行率/（人/10万）	SDG 3.4
	丙肝流行率	每十万人丙型肝炎流行率/（人/10万）	SDG 3.4
	酒精消耗量	15岁及以上人口的人均酒精消费量/L	SDG 3.5.2
	吸烟率	每日吸烟人口占总人口的比例/%	SDG 3.a.1
	年龄中位数	国家总人口年龄中位数/岁	—
环境条件	室内空气污染	主要依赖污染性燃料进行日常生活的人口比例 /%	SDG 7.1.2
环境条件	室外空气污染	细颗粒物（PM2.5）浓度/（μg/m³）	SDG 11.6.2

因素分类	影响因素	指标定义	可持续发展目标
医疗保健	人均健康支出	当前人均健康支出/千美元	SDG 1.a.2
	全民健康覆盖	全民健康覆盖率/ %	SDG 3.8.1
	乙肝免疫率	1岁儿童乙型肝炎免疫接种覆盖率 /%	SDG 3.a.1
健康状况	乙肝流行率	每十万人乙型肝炎流行率/（人/10万）	SDG 3.4
	丙肝流行率	每十万人丙型肝炎流行率/（人/10万）	SDG 3.4
	酒精消耗量	15岁及以上人口的人均酒精消费量/L	SDG 3.5.2
	吸烟率	每日吸烟人口占总人口的比例/%	SDG 3.a.1
	年龄中位数	国家总人口年龄中位数/岁	—
环境条件	室内空气污染	主要依赖污染性燃料进行日常生活的人口比例 /%	SDG 7.1.2
环境条件	室外空气污染	细颗粒物（PM2.5）浓度/（μg/m³）	SDG 11.6.2

地区	死亡人数/万人				每十万人死亡率/(人/10万)
地区	2000	2010	2015	2019	2000	2010	2015	2019
非洲	18.40	20.43	20.72	21.2	41.32	34.03	29.47	26.68
北美洲	4.50	5.60	6.45	6.7	9.12	8.21	8.50	8.02
南美洲	2.55	2.83	3.00	3.12	9.87	8.13	7.32	7.05
中亚	0.98	1.05	1.02	0.99	24.66	23.60	20.06	17.42
东亚	40.24	28.06	27.47	28.95	37.54	33.36	28.81	26.69
南亚	22.98	25.96	25.66	25.89	24.40	18.80	16.33	15.39
东南亚	12.61	13.89	14.39	15.64	32.07	27.88	24.86	23.90
西亚	2.85	2.87	3.18	3.44	19.50	15.57	14.01	13.18
欧洲	8.86	9.94	9.37	9.07	8.62	7.81	6.81	6.40
大洋洲	0.19	0.25	0.34	0.36	23.45	20.72	20.58	19.68
全球	114.17	110.88	111.61	115.36	23.59	19.88	17.63	16.29

地区	死亡人数/万人				每十万人死亡率/(人/10万)
地区	2000	2010	2015	2019	2000	2010	2015	2019
非洲	18.40	20.43	20.72	21.2	41.32	34.03	29.47	26.68
北美洲	4.50	5.60	6.45	6.7	9.12	8.21	8.50	8.02
南美洲	2.55	2.83	3.00	3.12	9.87	8.13	7.32	7.05
中亚	0.98	1.05	1.02	0.99	24.66	23.60	20.06	17.42
东亚	40.24	28.06	27.47	28.95	37.54	33.36	28.81	26.69
南亚	22.98	25.96	25.66	25.89	24.40	18.80	16.33	15.39
东南亚	12.61	13.89	14.39	15.64	32.07	27.88	24.86	23.90
西亚	2.85	2.87	3.18	3.44	19.50	15.57	14.01	13.18
欧洲	8.86	9.94	9.37	9.07	8.62	7.81	6.81	6.40
大洋洲	0.19	0.25	0.34	0.36	23.45	20.72	20.58	19.68
全球	114.17	110.88	111.61	115.36	23.59	19.88	17.63	16.29

因素分类	影响因素	Q-statistic	P-value
医疗保健	人均健康支出	0.500^***	0.000
	全民健康覆盖	0.532^***	0.000
	乙肝免疫率	0.099^*	0.089
健康状况	乙肝流行率	0.056	0.217
	丙肝流行率	0.037	0.248
	酒精消耗量	0.208^***	0.000
	吸烟率	0.104^***	0.000
	年龄中位数	0.548^***	0.000
环境条件	室内空气污染	0.531^***	0.000
环境条件	室外空气污染	0.240^***	0.000