Socioeconomic and Racial/Ethnic Disparities in the Incidence of Bacteremic Pneumonia Among US Adults

• Published in: American journal of public health (1971) Vol. 100; no. 10; pp. 1904 - 1911
• Main Authors: BURTON, Deron C, FLANNERY, Brendan, THOMAS, Ann, PLIKAYTIS, Brian D, ROSE, Charles E, WHITNEY, Cynthia G, SCHUCHAT, Anne, BENNETT, Nancy M, FARLEY, Monica M, GERSHMAN, Ken, HARRISON, Lee H, LYNFIELD, Ruth, PETIT, Susan, REINGOLD, Arthur L, SCHAFFNER, William
• Format: Journal Article
• Language: English
• Published: Washington, DC American Public Health Association 01.10.2010
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; Adults; Aged; AIDS; Bacterial diseases; Bacterial infections; Bacterial sepsis; Biological and medical sciences; Black or African American; Censuses; Cultural differences; Disease prevention; Economic indicators; Education; Ethnicity; Family income; General aspects; Haemophilus Infections - epidemiology; Haemophilus Infections - ethnology; Haemophilus influenzae - isolation & purification; Health disparities; Health Status Disparities; Health surveillance; Hispanic or Latino; Hispanic people; Households; Human bacterial diseases; Humans; Immunization; Incidence; Infectious diseases; Laboratories; Medical records; Medical sciences; Middle Aged; Miscellaneous; Pathogens; Pneumology; Pneumonia; Pneumonia, Pneumococcal - epidemiology; Pneumonia, Pneumococcal - ethnology; Population; Poverty; Poverty Areas; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Race; Regression Analysis; Research and Practice; Respiratory system : syndromes and miscellaneous diseases; Risk; Software; Streptococcus agalactiae - isolation & purification; Streptococcus infections; Streptococcus pyogenes - isolation & purification; Success; Surveillance; United States - epidemiology; White People; Young Adult; United States; United States > US; Human; Lung disease; Pneumonia; Socioeconomic status; Respiratory disease; Socioeconomic study; Socioeconomics; Bacteremia; Ethnic group; Incidence; Infection; Race; Bacteriosis; Adult; Economic aspect; Disparity; Social aspect; Public health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2009.181313

We examined associations between the socioeconomic characteristics of census tracts and racial/ethnic disparities in the incidence of bacteremic community-acquired pneumonia among US adults. We analyzed data on 4870 adults aged 18 years or older with community-acquired bacteremic pneumonia identified through active, population-based surveillance in 9 states and geocoded to census tract of residence. We used data from the 2000 US Census to calculate incidence by age, race/ethnicity, and census tract characteristics and Poisson regression to estimate rate ratios (RRs) and 95% confidence intervals (CIs). During 2003 to 2004, the average annual incidence of bacteremic pneumonia was 24.2 episodes per 100 000 Black adults versus 10.1 per 100 000 White adults (RR = 2.40; 95% CI = 2.24, 2.57). Incidence among Black residents of census tracts with 20% or more of persons in poverty (most impoverished) was 4.4 times the incidence among White residents of census tracts with less than 5% of persons in poverty (least impoverished). Racial disparities in incidence were reduced but remained significant in models that controlled for age, census tract poverty level, and state. Adults living in impoverished census tracts are at increased risk of bacteremic pneumonia and should be targeted for prevention efforts.