Connecticut Department of Public Health, Emerging Infections Program, Hartford, CT 06134-0308, USA.
Public Health Rep. 2011 Sep-Oct;126 Suppl 3(Suppl 3):81-8. doi: 10.1177/00333549111260S313.
We compared invasive pneumococcal disease (IPD) incidence by race/ethnicity and neighborhood poverty level and assessed their relative utility to describe disparities in IPD in 1998-1999 and again in 2007-2008, after introduction of the 7-valent pneumococcal conjugate vaccine (PCV7).
We conducted laboratory surveillance for pneumococcal isolates from sterile body sites and serotyped the isolates. Home address was geocoded to the census-tract level. Census-tract data on the percentage of people below poverty were grouped into three categories. The difference in the magnitude of incidence by race/ethnicity and by census-tract socioeconomic status (SES) (high poverty minus low poverty) was compared for 1998-1999 and 2007-2008 for PCV7 and non-PCV7 serotypes.
In 1998-1999, incidence difference (all per 100,000 population) for PCV7 serotypes for black people compared with white people was 14.3 and by poverty level was 13.9. The highest rate was among white people in high-poverty tracts (77.3). By 2007-2008, there were only slight differences between rates for black and white people (0.7) and SES (1.4). In 1998-1999, the incidence difference for non-PCV7 serotypes was 4.7 between black and white people and 6.0 by SES. By 2007-2008, the differences were 11.6 and 11.7, respectively. Among those living in the highest-poverty tracts, white people had the highest rate (42.9).
In the absence of vaccine, IPD incidence is higher among people living in higher-poverty census tracts and among black people. Emerging serotypes also follow this trend. Differences in neighborhood poverty levels reveal disparities in rates of IPD as large as those seen by race/ethnicity and could be used to routinely describe disparities and target prevention.
我们比较了种族/民族和社区贫困水平与侵袭性肺炎球菌病（IPD）发病率之间的关系，并评估了它们在 1998-1999 年和 2007-2008 年（7 价肺炎球菌结合疫苗（PCV7）引入后）描述 IPD 差异的相对效用。
我们对来自无菌部位的肺炎球菌分离株进行了实验室监测，并对分离株进行了血清分型。家庭地址被地理编码到普查地段水平。普查地段中贫困人口比例分为三类。比较了 1998-1999 年和 2007-2008 年 PCV7 和非 PCV7 血清型的种族/民族和普查地段社会经济地位（SES）（高贫困与低贫困）之间发病率差异的幅度。
1998-1999 年，与白人相比，黑人 PCV7 血清型的发病率差异（每 10 万人中）为 14.3，贫困水平为 13.9。在高贫困地区，白人的发病率最高（77.3）。到 2007-2008 年，黑人与白人之间的发病率差异仅略有差异（0.7）和 SES（1.4）。1998-1999 年，非 PCV7 血清型的发病率差异为黑人与白人之间的 4.7 和 SES 之间的 6.0。到 2007-2008 年，差异分别为 11.6 和 11.7。在居住在最高贫困地区的人群中，白人的发病率最高（42.9）。
在没有疫苗的情况下，生活在较高贫困普查地段的人群和黑人的 IPD 发病率较高。新兴的血清型也遵循这一趋势。邻里贫困水平的差异揭示了 IPD 发病率的差异与种族/民族一样大，可以用来常规描述差异并针对预防目标。
