Population-Level Predictors of STI Rate Changes in Missouri From 2008-2017

Abstract

BackgroundSexually transmitted infection rates continue to increase across the US, further developing health disparities and economic burdens of disease, especially as migration occurs. In this study, we assessed the relationships among STI rates and migration at the county-level in Missouri from 2008–2017.MethodsTwo data sources were used: STI rates of chlamydia, gonorrhea, syphilis, HIV reported to Missouri DHSS and ACS 1-year county population estimates. Linear regression models and ANOVA tests were conducted in SPSS for each STI from year-to-year and 2008–2017. Covariates included in the analyzes were county-level income, employment rate, race, ethnicity, age, and percent poverty. Further, Akaike Information Criterion tests were performed to indicate the best predictor models and averaged standardized beta values.ResultsSignificant relationships among STI rates and population growth were identified. Chlamydia, syphilis, and HIV were positively associated with population growth from 2008–2017 (β = 0.15; β = 0.01; β = 0.05, respectively). Gonorrhea was negative associated with population growth (β= -0.02) but positively associated with unemployment rates (β = 0.01) highlighting the need to address population growth, as well as other variables in a population.ConclusionsThere seems to be a positive relationship among population change and rates of STIs. As populations change, rates of STIs change. Moving forward, quantitative work should be conducted in various states and the nation to understand this relationship in different contexts. Qualitative studies should assess individual county health departments, identifying strengths and weaknesses, implementation of community health improvement plans. Lastly, public policy should be implemented to buffer the impact of migration on health outcomes.