Detecting Demographic Variations of AIDS Mortality in Florida - A New Application of Spatio-Temporal Analysis

Objectives: The purpose of the present study is to characterize, geographically and temporally, the patterns of AIDS death disparity in Florida, and to determine if detected trends vary by demographic characteristics.

Methods: The Space-Time Scan Statistic proposed by Kulldorff et al. was employed to examine potential geographic and temporal excess of AIDS mortality by age, race, and gender in 67 Florida jurisdictions between 1987 and 2004. Results were geographically referenced in maps using Epi Info and Epi Map made available by the CDC.

Results: Among 40,106 AIDS deaths in Florida between 1987 and 2004, 48.5% occurred in the African-American/Black population, whereas 51.3% were found in the White population. AIDS-related mortality in the White population peaked earlier in the study period whereas mortality in African-American peaked in the later periods persisting until 2004. Excess deaths of AIDS in all demographic groups were detected in Miami-Dade, Broward, Martin, Palm Beach, Union, Monroe, Hillsborough, St. Lucie, Orange, Duval, and Lee County. AIDS mortality peaked in 1995 and then sharply dropped until 1998 when it stabilized.

Conclusions: We provide a new application regarding spatio-temporal characteristics on AIDS mortality employing practically statistical method. By accounting for the temporal dimension of disease clustering, the present study captures the persistence of geographic clusters, which is not often afforded by other geographic detection methods. These findings may inform medical resources allocation and focus public health intervention strategies for AIDS care.