An ecological analysis of sociodemographic factors associated with the incidence of salmonellosis, shigellosis, and E. coli O157:H7 infections in US counties

Abstract

Identifying county-level sociodemographic and economic factors associated with the incidence of enteric disease may provide new insights concerning the dynamics of community transmission of these diseases as well as opportunities for prevention. We used data from the National Notifiable Diseases Surveillance System, the U.S. Census Bureau, and the Health Resources and Services Administration to conduct an ecological analysis of 26 sociodemographic and economic factors associated with the incidence of salmonellosis, shigellosis, and E. coli O157:H7 infections in US counties for the period 1993 to 2002. Our study indicates that race, ethnicity, place of residence, age, educational attainment, and poverty may affect the risk of acquiring one of these enteric bacterial diseases. The lack of specificity of information regarding salmonellae and shigellae serotypes may have led to less specific associations between community-level determinants and reported incidence of those diseases. Future ecological analyses should use serotype-specific data on incidence, which may be available from laboratory-based surveillance systems.

Presence of animal feeding operations and community socioeconomic factors impact salmonellosis incidence rates: An ecological analysis using data from the Foodborne Diseases Active Surveillance Network (FoodNet), 2004–2010

“…3). Similarly, Chang et al (2009) found that salmonellosis incidence rates were moderately positively correlated with higher percentages of the population (at the county-level) composed of African Americans (Chang et al, 2009). In addition, in a recent survey of consumers in FoodNet sites that evaluated exposures of children to raw meat and poultry in grocery stores and shopping carts, exposure of children to raw products was higher among African American children compared to Caucasian children (Patrick et al, 2010).…”

“…In three of the seven FoodNet sites studied (Maryland, New Mexico and Tennessee), higher poverty levels in zip codes were associated with higher rates of infection with one or more Salmonella serotypes. Chang et al (2009) previously identified a positive association between poverty levels and salmonellosis incidence rates at the county-level (Chang et al, 2009). More recently, in a Canadian study, Pardhan-Ali et al (2013) showed that rates of Salmonella infection were positively associated with the number of "households in core need" (homes that fall below defined standards and have low household incomes) (Pardhan-Ali et al, 2013).…”

“…(Haley et al, 2009;Jenkins et al, 2006;Maurer et al, 2015;Vereen et al, 2013). In addition, several studies have provided evidence that socioeconomic factors can influence rates of infection with Salmonella (Chang et al, 2009;Newman et al, 2015).…”

“…Chang et al (2009) conducted a countylevel, ecological analysis of the influence of sociodemographic factors on the incidence of salmonellosis and showed that race, ethnicity, location of residence, age and socioeconomic factors may affect Salmonella incidence (Chang et al, 2009); however, they did not focus on agricultural or environmental risk factors that may also impact rates of infection.…”

Risk factors for Shiga toxin-producing Escherichia coli infections in preadolescent schoolchildren in Buenos Aires, Argentina

“…Worldwide, approximately 1.7 million deaths per year from infectious diarrhoea are attributable to these three factors [21]. Recent epidemiological results highlight the importance of socioeconomic risk factors in rates of disease associated with E. coli O157 [22]. Nevertheless, how socioeconomic level relates to these individual risk factors is unknown and warrants further evaluation [23].…”