25 Environmental and socioeconomic risk factors associated with West Nile Virus cases 26 were investigated in the Northern San Joaquin Valley region of California, a largely rural area. 27 The study included human West Nile Virus (WNV) cases from the years 2011-2015 in the three 28 county area of San Joaquin, Stanislaus and Merced Counties, and examined whether factors were 29 associated with WNV using census tracts as the unit of analysis. Environmental factors included 30 temperature, precipitation, mosquitoes positive for WNV, and habitat. Socioeconomic variables 31 included age, education, housing age, home vacancies, median income, population density, 32 ethnicity, and language spoken. Chi-squared independence tests were used to examine whether 33 each variable was associated with WNV in each county, and then also used for the three counties 34 combined. Logistic regression was used for a three-county combined analysis, to examine which 35 environmental and socioeconomic variables were most likely associated with WNV cases. The 36 chi-squared tests found that the variables associated with WNV varied in each of the three 37 counties. The chi-squared tests for data combined from the three counties found that WNV cases 38 were significantly associated with mosquitoes positive for WNV, urban habitat, higher home 39 vacancies, higher population density, higher education, and ethnicity. Logistic regression 40 analysis revealed that overall, the environmental factors precipitation, mean temperature, and 41 WNV positive mosquitoes were the strongest predictors of WNV cases. Results support efforts 42 of mosquito control districts, which aim for source reduction of mosquito breeding sites. In 43 addition, findings suggest that residents with higher income and education may be more aware of 44 WNV and its symptoms, and more likely to request testing from physicians. Lower income and 45 education residents may not be aware of WNV. Public health education might increase its 3 46 prevention messages about vector-borne disease in the various languages of the region, which 47 would contribute overall to public health in the region.