Neighborhood Factors Affecting Rates of Sexually Transmitted Diseases in Chicago

Abstract

High rates of gonorrhea have been shown to be associated with high rates of incarceration in the prior year. One hypothesized chain of events is that there is a negative effect of incarceration on neighborhood social characteristics, which in turn affect behaviors facilitating transmission of sexually transmitted diseases (STDs). This study examined whether neighborhood characteristics were associated with the incidence of STDs and homicide rates as a proxy for incarceration rates. Data were from the 1995 Program on Human Development in Chicago Neighborhoods, the Chicago Health Department, and the Chicago Police Department. Neighborhood gonorrhea rates increased by 192.2 (95% confidence interval (CI) 131.6, 252.9) cases per 100,000 population with a change from the 25th to the 75th percentile of social disorder. This rate difference was a value greater than the median neighborhood gonorrhea rate. Similar increases were observed for other neighborhood measures and for Chlamydia infection. We hypothesize that high rates of incarceration may play a role in undermining neighborhood social cohesion and control. Using homicide rates as a proxy for incarceration, a change from the 25th to the 75th percentile of 1995 neighborhood homicide rates yielded a gonorrhea rate increase of 164.6 (95% CI 124.4, 204.7) cases per 100,000. Factors that undermine the social fabric of a community can become manifest in health outcomes such as STDs. The effects of high rates of incarceration on neighborhoods merit further exploration.

Ecological analysis examining the association between census tract-level incarceration and reported chlamydia incidence among female adolescents and young adults in San Francisco

“…(17) An ecologic study in Chicago neighbourhoods employed homicide rates as a proxy for incarceration rates, and identified an association with STI rates. (18) Thomas et al has posited several potential mechanisms for the association between incarceration in communities and STIs. First, recently released individuals could bring infection (acquired prior to incarceration and never treated, or acquired while incarcerated) back to the community upon release, resulting in increased STI rates.…”

“…Neighbourhoods experiencing the prolonged absence of many residents while incarcerated or the re-entry of the recently released may be fundamentally different from other communities and lacking in collective efficacy or social capital. (16, 18)…”

Sexual Health Risk and the Movement of Women Between Disadvantaged Communities and Local Jails

“…These women were also significantly more likely to have exchanged sex for money, drugs, or life necessities, signifying the intersection of violence, crime, and sexual health risk at the individual and community levels. 41 Ultimately, we attempted to demonstrate that the most vulnerable members of a community are often concentrated in disadvantaged communities to begin with, reducing the chance that they'll avoid health risks and experience long-term success.…”

Racial Isolation and Chlamydia Rates in US Counties

“…These explanations suggest that the communities in which individuals find themselves are related to health outcomes (Diez Roux 2007; Thomas et al 2010). Communities become sites for differential exposure to resources and risk factors that mediate transmission and treatment of STDs and help shape social interactions that may increase risk of transmission (LaVeist 2005;Massey and Denton 1993;Upchurch et al 1999;Adler 2006).…”

“…Previous studies also suggest that socioenvironmental factors offer additional explanations of racial disparities in health outcomes generally and STDs in particular (e.g., Diez Roux 2007; Thomas et al 2010;LaVeist 2005;Massey and Denton 1993;Upchurch et al 1999;Adler 2006;Jennings et al 2013). In particular, education and income are major drivers of racial disparities in health outcomes (Williams and Collins 1995), and research suggests that low levels of socioeconomic status (i.e., education and income) are related to higher rates of infectious disease (Aral et al 2005) and lower levels of community socioeconomic status were related to higher levels (Du et al 2009).…”