Socioeconomic and racial/ethnic disparities in the incidence of bacteremic pneumonia among US adults.
OBJECTIVE
We examined associations between the socioeconomic characteristics of census tracts and racial/ethnic disparities in the incidence of bacteremic community-acquired pneumonia among US adults.


METHODS
We analyzed data on 4870 adults aged 18 years or older with community-acquired bacteremic pneumonia identified through active, population-based surveillance in 9 states and geocoded to census tract of residence. We used data from the 2000 US Census to calculate incidence by age, race/ethnicity, and census tract characteristics and Poisson regression to estimate rate ratios (RRs) and 95% confidence intervals (CIs).


RESULTS
During 2003 to 2004, the average annual incidence of bacteremic pneumonia was 24.2 episodes per 100 000 Black adults versus 10.1 per 100 000 White adults (RR = 2.40; 95% CI = 2.24, 2.57). Incidence among Black residents of census tracts with 20% or more of persons in poverty (most impoverished) was 4.4 times the incidence among White residents of census tracts with less than 5% of persons in poverty (least impoverished). Racial disparities in incidence were reduced but remained significant in models that controlled for age, census tract poverty level, and state.


CONCLUSIONS
Adults living in impoverished census tracts are at increased risk of bacteremic pneumonia and should be targeted for prevention efforts.
Burton
Deron C
DC
Respiratory Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Flannery
Brendan
B
Bennett
Nancy M
NM
Farley
Monica M
MM
Gershman
Ken
K
Harrison
Lee H
LH
Lynfield
Ruth
R
Petit
Susan
S
Reingold
Arthur L
AL
Schaffner
William
W
Thomas
Ann
A
Plikaytis
Brian D
BD
Rose
Charles E
CE
Whitney
Cynthia G
CG
Schuchat
Anne
A
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D006192:Haemophilus Infections / Q000453:epidemiology / Q000208:ethnology*; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000208:ethnology*; D011204:Poverty Areas; D012044:Regression Analysis; D012306:Risk; D013292:Streptococcus agalactiae / Q000302:isolation & purification; D013297:Streptococcus pyogenes / Q000302:isolation & purification; D014481:United States / Q000453:epidemiology; D044465:White People; D055815:Young Adult