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Linear and Non-Linear Associations of Gonorrhea Diagnosis Rates with Social Determinants of Health
Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA 30333, USA
Centers for Disease Control and Prevention, Division of Applied Sciences, Epidemic Intelligence Service, Scientific Education and Professional Development Program Office, Atlanta, GA 30333, USA
* Author to whom correspondence should be addressed.
Received: 25 July 2012; in revised form: 6 August 2012 / Accepted: 23 August 2012 / Published: 3 September 2012
Abstract: Identifying how social determinants of health (SDH) influence the burden of disease in communities and populations is critically important to determine how to target public health interventions and move toward health equity. A holistic approach to disease prevention involves understanding the combined effects of individual, social, health system, and environmental determinants on geographic area-based disease burden. Using 2006–2008 gonorrhea surveillance data from the National Notifiable Sexually Transmitted Disease Surveillance and SDH variables from the American Community Survey, we calculated the diagnosis rate for each geographic area and analyzed the associations between those rates and the SDH and demographic variables. The estimated product moment correlation (PMC) between gonorrhea rate and SDH variables ranged from 0.11 to 0.83. Proportions of the population that were black, of minority race/ethnicity, and unmarried, were each strongly correlated with gonorrhea diagnosis rates. The population density, female proportion, and proportion below the poverty level were moderately correlated with gonorrhea diagnosis rate. To better understand relationships among SDH, demographic variables, and gonorrhea diagnosis rates, more geographic area-based estimates of additional variables are required. With the availability of more SDH variables and methods that distinguish linear from non-linear associations, geographic area-based analysis of disease incidence and SDH can add value to public health prevention and control programs.
Keywords: social determinants of health; gonorrhea diagnosis rates; product moment correlation; maximal information coefficient
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Moonesinghe, R.; Fleming, E.; Truman, B.I.; Dean, H.D. Linear and Non-Linear Associations of Gonorrhea Diagnosis Rates with Social Determinants of Health. Int. J. Environ. Res. Public Health 2012, 9, 3149-3165.
Moonesinghe R, Fleming E, Truman BI, Dean HD. Linear and Non-Linear Associations of Gonorrhea Diagnosis Rates with Social Determinants of Health. International Journal of Environmental Research and Public Health. 2012; 9(9):3149-3165.
Moonesinghe, Ramal; Fleming, Eleanor; Truman, Benedict I.; Dean, Hazel D. 2012. "Linear and Non-Linear Associations of Gonorrhea Diagnosis Rates with Social Determinants of Health." Int. J. Environ. Res. Public Health 9, no. 9: 3149-3165.