title: Association between community socioeconomic factors, animal feeding operations, and campylobacteriosis incidence rates: Foodborne Diseases Active Surveillance Network (FoodNet), 2004-2010.
abstract: Campylobacter is a leading cause of foodborne illness in the United States. Campylobacter infections have been associated with individual risk factors, such as the consumption of poultry and raw milk. Recently, a Maryland-based study identified community socioeconomic and environmental factors that are also associated with campylobacteriosis rates. However, no previous studies have evaluated the association between community risk factors and campylobacteriosis rates across multiple U.S. states.
  
  
  
  We obtained Campylobacter case data (2004-2010; n = 40,768) from the Foodborne Diseases Active Surveillance Network (FoodNet) and socioeconomic and environmental data from the 2010 Census of Population and Housing, the 2011 American Community Survey, and the 2007 U.S. Census of Agriculture. We linked data by zip code and derived incidence rate ratios using negative binomial regression models.
  
  
  
  Community socioeconomic and environmental factors were associated with both lower and higher campylobacteriosis rates. Zip codes with higher percentages of African Americans had lower rates of campylobacteriosis (incidence rate ratio [IRR]) = 0.972; 95 % confidence interval (CI) = 0.970,0.974). In Georgia, Maryland, and Tennessee, three leading broiler chicken producing states, zip codes with broiler operations had incidence rates that were 22 % (IRR = 1.22; 95 % CI = 1.03,1.43), 16 % (IRR = 1.16; 95 % CI = 0.99,1.37), and 35 % (IRR = 1.35; 95 % CI = 1.18,1.53) higher, respectively, than those of zip codes without broiler operations. In Minnesota and New York FoodNet counties, two top dairy producing areas, zip codes with dairy operations had significantly higher campylobacteriosis incidence rates (IRR = 1.37; 95 % CI = 1.22, 1.55; IRR = 1.19; 95 % CI = 1.04,1.36).
  
  
  
  Community socioeconomic and environmental factors are important to consider when evaluating the relationship between possible risk factors and Campylobacter infection.
authors.affiliation: Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, School of Public Health Building (255), 4200 Valley Drive, Room 2234P, College Park, MD, 20742, USA.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Rosenberg Goldstein
authors.affiliation: Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA.
authors.forename: Raul
authors.initials: R
authors.lastname: Cruz-Cano
authors.affiliation: Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, School of Public Health Building (255), 4200 Valley Drive, Room 2234P, College Park, MD, 20742, USA.
authors.forename: Chengsheng
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Prevention and Health Promotion Administration, Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Palmer
authors.affiliation: Prevention and Health Promotion Administration, Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA.
authors.forename: David
authors.initials: D
authors.lastname: Blythe
authors.affiliation: Prevention and Health Promotion Administration, Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ryan
authors.affiliation: Prevention and Health Promotion Administration, Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA.
authors.forename: Brenna
authors.initials: B
authors.lastname: Hogan
authors.affiliation: Emerging Infections Program, Disease Control and Environmental Epidemiology Division, Colorado Department of Public Health and Environment, Denver, CO, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: White
authors.affiliation: Communicable and Environmental Disease Surveillance, Tennessee Department of Health, Nashville, TN, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Dunn
authors.affiliation: California Emerging Infections Program, Oakland, CA, USA.
authors.forename: Tanya
authors.initials: T
authors.lastname: Libby
authors.affiliation: Acute Disease Epidemiology Section, Georgia Department of Public Health, Atlanta, GA, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Tobin-D'Angelo
authors.affiliation: Office of Infectious Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Jennifer Y
authors.initials: JY
authors.lastname: Huang
authors.affiliation: New York State Department of Health, Albany, NY, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: McGuire
authors.affiliation: New Mexico Emerging Infections Program, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Scherzinger
authors.affiliation: Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA.
authors.forename: Mei-Ling Ting
authors.initials: ML
authors.lastname: Lee
authors.affiliation: Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, School of Public Health Building (255), 4200 Valley Drive, Room 2234P, College Park, MD, 20742, USA. ars@umd.edu.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Sapkota
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000822:Animal Husbandry; D000818:Animals; D002169:Campylobacter Infections / Q000453:epidemiology* / Q000209:etiology; D002645:Chickens; D002648:Child; D002675:Child, Preschool; D004777:Environment; D005260:Female; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000209:etiology; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011202:Poultry Products / Q000506:poisoning*; D062486:Public Health Surveillance; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Broiler chicken; Campylobacter; Community socioeconomic and environmental factors; Dairy; FoodNet