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. 2010 Oct;100(10):1904-11.
doi: 10.2105/AJPH.2009.181313. Epub 2010 Aug 19.

Socioeconomic and racial/ethnic disparities in the incidence of bacteremic pneumonia among US adults

Deron C Burton  1 , Brendan Flannery, Nancy M Bennett, Monica M Farley, Ken Gershman, Lee H Harrison, Ruth Lynfield, Susan Petit, Arthur L Reingold, William Schaffner, Ann Thomas, Brian D Plikaytis, Charles E Rose Jr, Cynthia G Whitney, Anne Schuchat; Active Bacterial Core Surveillance/Emerging Infections Program Network
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Socioeconomic and racial/ethnic disparities in the incidence of bacteremic pneumonia among US adults

Deron C Burton et al. Am J Public Health. 2010 Oct.

Abstract

Objectives: 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.

Methods: 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).

Results: 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.

Conclusions: Adults living in impoverished census tracts are at increased risk of bacteremic pneumonia and should be targeted for prevention efforts.

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Figures

FIGURE 1
FIGURE 1
Distribution of the adult population according to percentage of census tract poverty, by race/ethnicity: Active Bacterial Core surveillance areas, United States, 2000. Note. Percentage of census tract poverty was defined according to the percentage of persons living below the federal poverty threshold according to the 2000 US Census. The total adult population included all racial/ethnic groups except multiracial categories.
FIGURE 2
FIGURE 2
Average annual incidence of invasive bacteremic pneumonia in adults, by race/ethnicity and percentage of census tract poverty: Active Bacterial Core surveillance areas, United States, 2003–2004. Note. Percentage of census tract poverty was defined according to the percentage of persons living below the federal poverty threshold according to the 2000 US Census.
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