title: Invasive pneumococcal disease and socioeconomic deprivation: a population study from the North East of England.
abstract: BACKGROUND
  Some communicable diseases disproportionately affect poor and vulnerable groups. Invasive pneumococcal disease (IPD) is an important cause of morbidity and mortality; however, the relationship between IPD and deprivation has not been well described.
  
  
  METHODS
  Population based study assessing the relationship between incidence of IPD and deprivation in the North East of England using data from an enhanced IPD surveillance system and the 2010 Indices of Multiple Deprivation and the Rural and Urban Area Classification.
  
  
  RESULTS
  The incidence of IPD increased linearly with increasing deprivation from 7.0 per 100 000 population to 13.6 per 100 000 population. This association was demonstrated for the 16-64 and ≥65 year age groups, but not the <16 year age group. IPD incidence was strongly associated with all individual domains of deprivation except for the 'barriers to housing and services' domain. IPD incidence was higher in urban than rural areas.
  
  
  CONCLUSIONS
  The risk of IPD is strongly associated with deprivation in adults, but not children. The mechanisms producing the associations observed remain unclear and require further investigation. Findings from this study reinforce the need to address social inequalities to reduce the burden of disease. Targeting vaccination at adults living in deprived areas could reduce the burden of IPD.
authors: Regional Epidemiology Unit, Health Protection Agency North East, Floor 2, Citygate, Gallowgate, Newcastle upon Tyne NE1 4WH, UK.
authors: K E
authors: KE
authors: Chapman
authors: D
authors: D
authors: Wilson
authors: R
authors: R
authors: Gorton
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000453:epidemiology*; D011159:Population Surveillance; D011203:Poverty / Q000706:statistics & numerical data*; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: communicable diseases; pneumococcal; social determinants; socioeconomics factors