Disparities in reportable communicable disease incidence by census tract-level poverty, New York City, 2006-2013

S.K. Greene, A. Levin-Rector, J.L. Hadler and A.D. Fine

American Journal of Public Health, 2015, vol. 105, issue 9, e27-e34

Abstract: Objectives. 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.

Keywords: adolescent; adult; aged; child; cluster analysis; Communicable Diseases; female; health disparity; human; incidence; male; middle aged; poverty; preschool child; United States; young adult, Adolescent; Adult; Aged; Child; Child, Preschool; Communicable Diseases; Female; Health Status Disparities; Humans; Incidence; Male; Middle Aged; New York City; Poverty Areas; Small-Area Analysis; Young Adult (search for similar items in EconPapers)
Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2015.302741_9

DOI: 10.2105/AJPH.2015.302741

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