title: Disparities in Reportable Communicable Disease Incidence by Census Tract-Level Poverty, New York City, 2006-2013.
abstract: OBJECTIVE
  We described disparities in selected communicable disease incidence across area-based poverty levels in New York City, an area with more than 8 million residents and pronounced household income inequality.
  
  
  METHODS
  We geocoded and categorized cases of 53 communicable diseases diagnosed during 2006 to 2013 by census tract-based poverty level. Age-standardized incidence rate ratios (IRRs) were calculated for areas with 30% or more versus fewer than 10% of residents below the federal poverty threshold.
  
  
  RESULTS
  Diseases associated with high poverty included rickettsialpox (IRR = 3.69; 95% confidence interval [CI] = 2.29, 5.95), chronic hepatitis C (IRR for new reports = 3.58; 95% CI = 3.50, 3.66), and malaria (IRR = 3.48; 95% CI = 2.97, 4.08). Diseases associated with low poverty included domestic tick-borne diseases acquired through travel to areas where infected vectors are prevalent, such as human granulocytic anaplasmosis (IRR = 0.08; 95% CI = 0.03, 0.19) and Lyme disease (IRR = 0.34; 95% CI = 0.32, 0.36).
  
  
  CONCLUSIONS
  Residents of high poverty areas were disproportionately affected by certain communicable diseases that are amenable to public health interventions. Future work should clarify subgroups at highest risk, identify reasons for the observed associations, and use findings to support programs to minimize disparities.
authors.affiliation: Sharon K. Greene, Alison Levin-Rector, and Annie D. Fine are with the Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, Queens, NY. James L. Hadler is with the Commissioner's Office, New York City Department of Health and Mental Hygiene, Queens.
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Greene
authors.affiliation: Sharon K. Greene, Alison Levin-Rector, and Annie D. Fine are with the Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, Queens, NY. James L. Hadler is with the Commissioner's Office, New York City Department of Health and Mental Hygiene, Queens.
authors.forename: Alison
authors.initials: A
authors.lastname: Levin-Rector
authors.affiliation: Sharon K. Greene, Alison Levin-Rector, and Annie D. Fine are with the Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, Queens, NY. James L. Hadler is with the Commissioner's Office, New York City Department of Health and Mental Hygiene, Queens.
authors.forename: James L
authors.initials: JL
authors.lastname: Hadler
authors.affiliation: Sharon K. Greene, Alison Levin-Rector, and Annie D. Fine are with the Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, Queens, NY. James L. Hadler is with the Commissioner's Office, New York City Department of Health and Mental Hygiene, Queens.
authors.forename: Annie D
authors.initials: AD
authors.lastname: Fine
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000453:epidemiology*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011204:Poverty Areas; D017062:Small-Area Analysis; D055815:Young Adult