Regional socioeconomic and environmental correlates of mushroom poisoning: an ecological panel study in Sichuan Province, China

Abstract

Mushroom poisoning is a significant foodborne disease in China, with southwestern regions being high-risk areas. These incidents place ongoing pressure on primary healthcare facilities and the public health surveillance system. This study aimed to examine area-level factors associated with reported mushroom poisoning case incidence using aggregated prefecture-level data in Sichuan Province. This ecological panel study used surveillance data from the National Foodborne Disease Outbreak Surveillance System in Sichuan Province from 2019 to 2024. The unit of analysis was prefecture-level cities, and all variables were aggregated at the regional level. Potential determinants were selected based on the Social Determinants of Health framework. Panel regression models were used to estimate associations between area-level variables and reported mushroom poisoning case incidence. From 2019 to 2024, Sichuan Province reported 1,029 mushroom poisoning incidents involving 3,551 cases. The average annual reported incidence rate was 7.07 per million people, showing a fluctuating upward trend over the study period. In the multivariable analysis, per capita GDP (β = 0.109, 95% CI: 0.016 to 0.202) was positively associated with the reported mushroom poisoning case incidence, while the climate index (β = −0.072, 95% CI: −0.118 to −0.026) and urbanization rate (β = −0.140, 95% CI: −0.224 to −0.056) were negatively associated with incidence. The medical staff allocation index (β = 0.069, 95% CI: 0.010 to 0.129) and education level index (β = 0.064, 95% CI: 0.010 to 0.119) were positively associated with the reported incidence rate. Between 2019 and 2024, the reported mushroom poisoning case incidence in Sichuan Province exhibited an increasing trend with substantial regional variation. Regional differences in reported incidence may be associated with a combination of socioeconomic conditions, environmental context, and healthcare system characteristics. Strengthening surveillance capacity, improving mushroom species identification, and implementing region-specific health education and risk communication strategies may help reduce the burden of mushroom poisoning.