title: Neighborhood socio-economic characteristics, African ancestry, and Helicobacter pylori sero-prevalence.
abstract: OBJECTIVE
  The authors recently reported high Helicobacter pylori sero-prevalence among African-Americans of high African ancestry. We sought to determine whether neighborhood-level socio-economic characteristics are associated with H. pylori prevalence and whether this helps explain the link between African ancestry and H. pylori.
  
  
  METHODS
  Antibodies to H. pylori proteins were assessed in the serum of 336 African-American and 329 white Southern Community Cohort Study participants. Prevalence odds ratios (ORs) and 95 % confidence intervals (CIs) for CagA+ and CagA- H. pylori were calculated using polytomous logistic regression in relation to 10 Census block group-level measures of socio-economic status.
  
  
  RESULTS
  After adjusting for individual-level characteristics, three neighborhood-level factors were significantly inversely related to CagA+ H. pylori: percent completed high school; median house values; and percent employed (comparing highest to lowest tertile, OR, 0.47, 95 % CI, 0.26-0.85; OR, 0.56, 95 % CI, 0.32-0.99; and OR, 0.59, 95 % CI, 0.34-1.03, respectively). However, accounting for these measures did not attenuate the association between African ancestry and CagA+ H. pylori, with African-Americans of low, medium, and high African ancestry maintaining two-, seven-, and ninefold increased odds, respectively, compared to whites.
  
  
  CONCLUSIONS
  Neighborhood-level measures of education, employment, and house values are associated with CagA+ H. pylori sero-prevalence, but do not explain the persistent strong relationship between African ancestry level and CagA+ H. pylori. The findings suggest that neighborhood socio-economic status can help to highlight high-risk areas for prevention and screening efforts and that the link between African ancestry and H. pylori may have a biological basis.
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, 2525 West End Avenue, 6th floor, Nashville, TN 37203-1738, USA. meira.epplein@vanderbilt.edu
authors.forename: Meira
authors.initials: M
authors.lastname: Epplein
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Cohen
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Sonderman
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.forename: Scott M
authors.initials: SM
authors.lastname: Williams
authors.forename: William J
authors.initials: WJ
authors.lastname: Blot
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Signorello
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood / Q000276:immunology; D000942:Antigens, Bacterial / Q000097:blood / Q000276:immunology; D001426:Bacterial Proteins / Q000276:immunology; D044383:Black People / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000208:ethnology* / Q000276:immunology; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors; D015144:Southeastern United States / Q000453:epidemiology; D001741:Black or African American
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins