189922 AIDS Mortality Clusters in Texas Counties: How Health Administrators can Address the Disparities by Demographic Groups

Monday, October 27, 2008

Roshanak Jafari, MD , College of Science, Department of Biological Sciences, University of Texas at El Paso, El Paso, TX
Chiehwen Ed Hsu, PhD, MS, MPH , Preventive Health Informatics and SpaTial Analysis (PHISTA) Lab, UT School of Health Information Sciences, University of Texas Health Science Center at Houston, Houston, TX
Hector Balcazar, MS, PhD , El Paso, Regional Campus, UT Health Science Center-School of Public Health, EL Paso, TX
Michael P. Eastman, PhD , Department of Chemistry, University of Texas at El Paso, El Paso, TX
Francisco Soto Mas, MD, PhD, MPH , Translational Hispanic Health Research Initiative, University of Texas at El Paso, El Paso, TX
Background: AIDS is a major health concern with increasing mortality in Texas paralleling national trends. This study sought to analyze the spatial and temporal trends of potential clustering of HIV/AIDS mortality in Texas counties, and to determine if detected trends vary by demographic groups across different times. Method: Spatial and Temporal Scan Statistics were employed to determine geographic excess and time trends of AIDS mortality in 254 Texas counties between 1999 and 2003, and verify excess mortality and its potential continuation to the present. Results: In the 5 year study period 5,266 deaths attributable to HIV/AIDS occurred in Texas. Several mortality clusters (excess mortality) were identified in this study. In all population groups, the most likely cluster occurred 2002-2003 in Southwest Texas (centered in Chambers County) and in North Texas (Dallas County). In Hispanics, excess mortality existed between 2002-2003 in Central to Southeast Texas (centered in Austin County). Several likely mortality clusters occurred in the past (1999-2000) in two racial groups. Blacks had the highest mortality rate (of 19.4) in Harris and Anderson Counties. Whites had the highest in Dallas County, followed by Southeast Texas (centered in Chambers County). Conclusion: AIDS mortality disparities of spatial and temporal variations exist in diverse populations in Texas, particularly in North Texas and Southeast Texas, and in most recent clusters among Hispanics in Southeast Texas. Policy and program intervention should focus on the groups most affected differentially by geographic area.

Learning Objectives:
1. Become familiar with the application of public health informatics, such as employing the openly available Space-Time Scan statistics to characterize the spatiotemporal variaitons of AIDS mortality. 2. Identify one important measurement of racial/ethnic disparities for AIDS mortality by geographic regions. 3. Assess AIDS mortality disparities by temporal and spatial variations in demographic groups and explore the implications of targeted interventions and resource allocations.

Keywords: HIV/AIDS, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceived research questions, applied public health informatics, conducted the analysis and interpreted the results and wrote the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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