Social capital, poverty, and income inequality as predictors of gonorrhoea, syphilis, chlamydia and AIDS case rates in the United States.
BACKGROUND
Social capital has been related to a number of important public health variables such as child welfare, mortality, and health status. However, the relation of social capital to infectious diseases has received relatively little attention. The relation of social capital to health measures is often posited to be related to the key societal variables of poverty and income inequality. Therefore, any exploration of the correlation between social capital and infectious diseases should also include examination of the association with poverty and income inequality.


OBJECTIVE
This study examined the state level association between social capital, poverty, income inequality, and four infectious diseases that have important public health implications given their long term sequelae: gonorrhoea, syphilis, chlamydia, and AIDS.


METHODS
A state level, correlational analysis (including bivariate linear correlational analysis, and multivariate linear stepwise regression analysis) was carried out. 1999 state level rates of gonorrhoea, syphilis, chlamydia, and AIDS were the main outcome measures.


RESULTS
In bivariate analyses, poverty was significantly correlated with chlamydia; income inequality was significantly correlated with chlamydia and AIDS case rates; and social capital was significantly correlated with all outcome measures. In stepwise multiple regression analyses, social capital was always the strongest predictor variable.


CONCLUSIONS
These results suggest that social capital is highly predictive of at least some infectious diseases. The results indicate the need for further research into this relation, and suggest the potential need for structural interventions designed to increase social capital in communities.
Holtgrave
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Emory University, Rollins School of Public Health, Center for AIDS Research, 1518 Clifton Road NE, Room 540, Atlanta, GA 30322, USA. dholtgr@sph.emory.edu
Crosby
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D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology; D002201:Capital Expenditures; D002690:Chlamydia Infections / Q000453:epidemiology; D006069:Gonorrhea / Q000453:epidemiology; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D011203:Poverty / Q000706:statistics & numerical data*; D011204:Poverty Areas; D012044:Regression Analysis; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D013587:Syphilis / Q000453:epidemiology; D014481:United States / Q000453:epidemiology