Sociodemographic factors and the variation in syphilis rates among US counties, 1984 through 1993: an ecological analysis.

Abstract:

OBJECTIVES:Syphilis in the United States is focally distributed, with high incidence rates in the South and in metropolitan areas nationwide. In this study an ecological analysis, using the county as the unit of analysis, was performed to generate hypotheses about community-level determinants of syphilis rates. METHODS:Bivariate rank correlations and multivariate, backward stepwise elimination linear regressions were performed. Mean annual incidence of primary- and secondary-stage syphilis in a county was the dependent variable, and county sociodemographic characteristics (from census data) were the independent variables. RESULTS:In the multivariate regression model, sociodemographic characteristics accounted for 71% of the variation in syphilis rates among counties. With other factors accounted for, the most highly correlated characteristics were percentage non-Hispanic Black population, county location in the South, percentage of the population that was urban, percentage Hispanic population, and percentage of births to women younger than 20 years. CONCLUSIONS:Most of the variation in syphilis rates among counties is accounted for by sociodemographic characteristics. Identification and remediation of modifiable health determinants for which these factors are markers are needed to improve the health status of these populations.

journal_name

Am J Public Health

authors

Kilmarx PH,Zaidi AA,Thomas JC,Nakashima AK,St Louis ME,Flock ML,Peterman TA

doi

10.2105/ajph.87.12.1937

subject

Has Abstract

pub_date

1997-12-01 00:00:00

pages

1937-43

issue

12

eissn

0090-0036

issn

1541-0048

journal_volume

87

pub_type

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