title: Impact of rurality, broiler operations, and community socioeconomic factors on the risk of campylobacteriosis in Maryland.
abstract: OBJECTIVE
  We evaluated the combined impact of community-level environmental and socioeconomic factors on the risk of campylobacteriosis.
  
  
  METHODS
  We obtained Campylobacter case data (2002-2010; n = 3694) from the Maryland Foodborne Diseases Active Surveillance Network. We obtained community-level socioeconomic and environmental data from the 2000 US Census and the 2007 US Census of Agriculture. We linked data by zip code. We derived incidence rate ratios by Poisson regressions. We mapped a subset of zip code-level characteristics.
  
  
  RESULTS
  In zip codes that were 100% rural, incidence rate ratios (IRRs) of campylobacteriosis were 6 times (IRR = 6.18; 95% confidence interval [CI] = 3.19, 11.97) greater than those in urban zip codes. In zip codes with broiler chicken operations, incidence rates were 1.45 times greater than those in zip codes without broilers (IRR = 1.45; 95% CI = 1.34, 1.58). We also observed higher rates in zip codes whose populations were predominantly White and had high median incomes.
  
  
  CONCLUSIONS
  The community and environment in which one lives may significantly influence the risk of campylobacteriosis.
authors.affiliation: Barbara Zappe Pasturel, Rachel E. Rosenberg Goldstein, Sam W. Joseph, Robin Puett, and Amy R. Sapkota are with the Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park. Raul Cruz-Cano and Mei-Ling Ting Lee are with the Department of Epidemiology and Biostatistics, University of Maryland School of Public Health. Amanda Palmer, David Blythe, Pat Ryan, Brenna Hogan, and Carrianne Jung are with the Infectious Disease and Environmental Health Administration, Maryland Department of Health and Mental Hygiene, Baltimore. Min Qi Wang is with the Department of Behavioral and Community Health, University of Maryland School of Public Health.
authors.forename: Barbara
authors.initials: B
authors.lastname: Zappe Pasturel
authors.forename: Raul
authors.initials: R
authors.lastname: Cruz-Cano
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Rosenberg Goldstein
authors.forename: Amanda
authors.initials: A
authors.lastname: Palmer
authors.forename: David
authors.initials: D
authors.lastname: Blythe
authors.forename: Patricia
authors.initials: P
authors.lastname: Ryan
authors.forename: Brenna
authors.initials: B
authors.lastname: Hogan
authors.forename: Carrianne
authors.initials: C
authors.lastname: Jung
authors.forename: Sam W
authors.initials: SW
authors.lastname: Joseph
authors.forename: Min Qi
authors.initials: MQ
authors.lastname: Wang
authors.forename: Mei-Ling
authors.initials: ML
authors.lastname: Ting Lee
authors.forename: Robin
authors.initials: R
authors.lastname: Puett
authors.forename: Amy R
authors.initials: AR
authors.lastname: Sapkota
mesh_terms: D000293:Adolescent; D000328:Adult; D000822:Animal Husbandry / Q000706:statistics & numerical data*; D000818:Animals; D002169:Campylobacter Infections / Q000453:epidemiology / Q000209:etiology*; D002645:Chickens; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D062306:Geography, Medical; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D016012:Poisson Distribution; D011159:Population Surveillance; D018570:Risk Assessment; D012424:Rural Population; D012923:Social Class; D055815:Young Adult