Spatiotemporal heterogeneity and influencing factors of hepatitis B in China: a 17-year national surveillance analysis

Hepatitis B remains a major global public health concern, and China bears one of the heaviest burdens worldwide. However, existing research on factors influencing hepatitis B incidence in China remains insufficient, with limited attention paid to educational, environmental, and meteorological factors. Data on hepatitis B incidence were obtained from the Public Health Science Data Center. Spatial correlation analysis was performed using GeoDa 1.20 software, and a geotemporally weighted regression (GTWR) model was applied to examine spatial heterogeneity in the incidence of hepatitis B. Between 2004 and 2020, hepatitis B incidence in China exhibited a decreasing trend and significant seasonality, peaking in March. Spatially, incidence was lower in the eastern regions and higher in the western regions, particularly in Tibet and Xinjiang, indicating marked spatial heterogeneity. High-high clusters were primarily concentrated in Guangdong, whereas low-low clusters were identified in Jiangsu and Shanghai. NDVI and the number of licensed (assistant) physicians per 1,000 population were positively associated with hepatitis B incidence, while the number of healthcare beds per 1,000 population and the illiteracy rate were negatively associated. This underscores the importance of formulating hepatitis B policies in light of local conditions. Priority should be given to high-incidence areas such as western China and Guangdong. Government efforts should focus on increasing investment in healthcare resources, enhancing hepatitis B prevention awareness among the floating population, and expanding vaccination coverage to reduce infection risk. Our findings highlight that geospatial methods can provide crucial insights into optimizing healthcare resource allocation for hepatitis B control and other infectious diseases.