To evaluate the relationship between race/ethnicity, socioeconomic status (SES), and sexually transmitted diseases (STDs), we examined the distribution of gonorrhea and chlamydia at the census block group level in the Twin Cities metropolitan area. Cases of gonorrhea and chlamydia reported to the Minnesota Department of Health for three 12-month periods were obtained and assigned to block group of residence. We also obtained 1990 census data for the 2115 block groups in the metropolitan area. Multivariate poisson regression was used to identify socioeconomic variables associated with increased STD rates at the block group level. Independent variables included the proportion of residents who were: women, non-white, unemployed, and with less than a high school education. Population density, median household income, poverty areas (block groups with greater than 20% of residents below the poverty line), and a measure of residential racial segregation also were included. After adjustment for SES variables, non-white race/ethnicity remained significantly associated with these STDs, although rate ratios were attenuated when compared to univariate analyses. Rate ratios comparing the highest to lowest quartiles of non-white race/ethnicity decreased from 22.2 in univariate analyses to 2.4 after multivariate adjustment for gonorrhea, and fell from 8.7 to 1.9 for chlamydia. Socioeconomic factors may account for much of the difference in STD rates by race/ethnicity. Persistent racial/ethnic differences may reflect reduced access to medical screening or care, differential reporting, inability of our analyses to completely control for the full effect of socioeconomic status on STDs, or factors related to social networks and sexual mixing.
Learning Objectives: At the conclusion of this presentation, the participant will be able to: 1. Describe how socioeconomic variables may confound the relationship between race/ethnicity and STD at the community level. 2. List 5 SES variables associated with rates of gonorrhea and/or chlamydia at the census block group level in the Twin Cities metropolitan area
Keywords: STD, Social Inequalities
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.