Valleroy Ella, Reed Aaron, Lightner Joseph S
University of Missouri-Kansas City, Kansas City, MO, USA.
University of Kansas - Medical Center, Kansas City, KS, USA.
Arch Public Health. 2023 Jan 23;81(1):12. doi: 10.1186/s13690-022-01019-6.
Sexually 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 aim to assess the relationship between STI rates and population-level variables from 2008 to 2017 at the county level in Missouri.
Two 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.
Significant relationships among STI rates and population growth were identified. Chlamydia, syphilis, and HIV were positively associated with population growth from 2008 to 2017 (β = 0.15; β = 0.01; β = 0.05, respectively). Gonorrhea was negatively 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.
There 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. Future studies should be qualitative word focused on county health departments and community health improvement plans. Lastly, public policy should be implemented to buffer the impact of migration on health outcomes.
美国各地性传播感染率持续上升，进一步加剧了健康差距和疾病的经济负担，尤其是在人口迁移的情况下。在本研究中，我们旨在评估2008年至2017年密苏里州县一级性传播感染率与人口层面变量之间的关系。
使用了两个数据源：向密苏里州卫生与社会服务部报告的衣原体、淋病、梅毒、艾滋病毒的性传播感染率以及美国社区调查1年的县人口估计数。在SPSS中针对每种性传播感染逐年以及2008 - 2017年进行了线性回归模型和方差分析测试。分析中纳入的协变量包括县级收入、就业率、种族、民族、年龄和贫困率。此外，进行了赤池信息准则测试以确定最佳预测模型并计算平均标准化β值。
确定了性传播感染率与人口增长之间的显著关系。2008年至2017年，衣原体、梅毒和艾滋病毒与人口增长呈正相关（β分别为0.15；0.01；0.05）。淋病与人口增长呈负相关（β = -0.02），但与失业率呈正相关（β = 0.01），这凸显了应对人口增长以及人口中的其他变量的必要性。
人口变化与性传播感染率之间似乎存在正相关关系。随着人口变化，性传播感染率也会改变。未来，应在各州和全国开展定量研究，以了解不同背景下的这种关系。未来的研究应以关注县卫生部门和社区健康改善计划的定性研究为主。最后，应实施公共政策以缓冲移民对健康结果的影响。
