Changes in community socioeconomic status and racial distribution associated with gonorrhea rates: an analysis at the community level.
BACKGROUND
Gonorrhea persists despite nationwide disease control measures. Research has not focused on the longitudinal impact of community characteristics on gonorrhea. The authors assessed the association between community demographic and socioeconomic changes and gonorrhea rates.


METHODS
Gonorrhea incident cases reported in 1992-1993 and 2001-2002 were aggregated at the census tract level in New York State exclusive of New York City and then matched to the census data. Census tract characteristics were obtained from the 1990 and 2000 decennial censuses and adjusted for changes in geographic boundaries.


RESULTS
Gonorrhea incidence declined considerably between 2 study periods (1992-1993 and 2001-2002) among urban census tracts, but gradually increased in suburbs and rural areas. Changes in community socioeconomic status (SES) were significantly associated with change in gonorrhea rates (e.g., gonorrhea rate ratio given a 5% increase in household poverty rate = 1.08; 95% confidence interval: 1.02-1.14), independent of changes in community demographics. Increases in gonorrhea rates related to the proportion of non-Hispanic black population within urban census tracts persisted after multiple SES variables were controlled (rate ratio = 1.20; 95% confidence interval: 1.16-1.24).


CONCLUSIONS
This study found that temporal changes in community SES and demographic characteristics were associated with changes in gonorrhea rates.
Du
Ping
P
Department of Medicine, Department of Public Health Sciences, Penn State Hershey College of Medicine 600 Centerview Drive, Suite 2200, A210, Hershey, PA 17033-0855, USA. ping.du@psu.edu
McNutt
Louise-Anne
LA
O'Campo
Patricia
P
Coles
F Bruce
FB
D001741:Black or African American; D019352:Censuses; D006069:Gonorrhea / Q000453:epidemiology* / Q000208:ethnology*; D006801:Humans; D015994:Incidence; D009518:New York / Q000453:epidemiology; D011203:Poverty; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012424:Rural Population; D012923:Social Class; D013383:Suburban Population; D014505:Urban Population