Neighborhood poverty and the resurgence of tuberculosis in New York City, 1984-1992
Neighborhood poverty and the resurgence of tuberculosis in New York City, 1984-1992
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DOI：
10.2105/ajph.91.9.1487
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发表时间：
2001-09-01
影响因子：
12.7
通讯作者：
Pablos-Méndez, A
中科院分区：
文献类型：
--
作者：
Barr, RG;Diez-Roux, AV;Pablos-Méndez, A
目标.结核病（TB）在纽约市的复苏被归因于艾滋病和移民;然而，贫困在流行病中的作用尚不清楚。我们评估了1984年至1992年结核病流行高峰期和纵向社区贫困与结核病之间的关系。人口普查街区组被用作社区的代理。根据结核病防治局和艾滋病监测局的数据计算了1984年和1992年每个社区的结核病和艾滋病发病率，并从人口普查中获得贫困率。1992年，3343例结核病病例分布在5482个社区，平均发病率为每10万人46.5例。社区贫困与结核病相关（相对风险= 1.33; 95%置信区间= 1.30，贫困每增加10%为1.36）。在调整了艾滋病、外国出生的比例和种族/民族因素后，这种关联仍然存在。从1980年到1990年，收入下降的社区比收入增加的社区有更大的结核病发病率增加。在纽约市结核病流行的高峰期，社区贫困与结核病发病率密切相关。公共卫生干预措施应针对贫困地区。
Objectives. The resurgence of tuberculosis (TB) in New York City has been attributed to AIDS and immigration; however the role of poverty in the epidemic is unclear. We assessed the relation between neighborhood poverty and TB at the height of the epidemic and longitudinally from 1984 through 1992.Methods. Census block groups were used as proxies for neighborhoods. For each neighborhood, we calculated TB and AIDS incidence in 1984 and 1992 with data from the Bureaus of Tuberculosis Control and AIDS Surveillance and obtained poverty rates from the census.Results. For 1992, 3343 TB cases were mapped to 5482 neighborhoods, yielding a mean incidence of 46.5 per 100000. Neighborhood poverty was associated with TB (relative risk = 1.33; 95% confidence interval = 1.30, 1.36 per 10% increase in poverty). This association persisted after adjustment for AIDS, proportion foreign-born, and race/ethnicity. Neighborhoods with declining income from 1980 to 1990 had larger increases in TB incidence than did neighborhoods with increasing income.Conclusions. Leading up to and at the height of the TB epidemic in New York City, neighborhood poverty was strongly associated with TB incidence. Public health interventions should target impoverished areas.