Investigating Census Tract Level Disparities and Race as a Pre-Cursor to Invasive Group B Streptococcus Infections in Adults 18+ in the 20-county Metropolitan Statistical Area of Georgia using a Neighborhood Deprivation Index Pubblico

Vega, Allie (Spring 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/9k41zf96c?locale=it
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Abstract

Invasive Group B Streptococcus (GBS) infections continue to increase as a threat of morbidity and mortality to non-pregnant adults. Risk factors for invasive GBS infections include older age, diabetes, and renal failure. Investigation of incidence rates have found black persons as having a higher incidence of disease than other races. There is an interest to understand how race interacts with disparities that may lead to invasive GBS incidence. Literature produced regarding social determinants such as socioeconomic status that lead to adverse health outcomes stress on the necessity to correctly analyze these variables to understand the holistic effect of depravation on health. The purpose of this study was to analyze invasive GBS data derived from the Georgia Emerging Infections Program and utilize a principal component analysis with a Neighborhood Deprivation Index to understand if there was a relationship between deprivation at the census tract level, and if this relationship was present, if it was modified by race. A retrospective cohort study with correlating ACS 5-year estimates census tract data to determine rates of incidence was performed using Georgia Emerging Infection Program MSA database information collected from Active Bacterial Core Surveillance Case Report Forms. Principal component analysis was used to create a Neighborhood Deprivation Index for the census tracts in the 20-county MSA area. Poisson regression was utilized for model development. The magnitude of the Neighborhood Deprivation Index differed by race and was found to be statistically significantly associated with increased rates of invasive GBS. The data from this study demonstrated that there is a statistically significant relationship between the Neighborhood Deprivation Index (NDI) and increase in invasive GBS incidence rates, and that race significantly modifies this relationship among non-Hispanic White race, Asian race, Pacific Islander / Hawaiian race, and American Indian / Alaska Native race.

Table of Contents

TABLE OF CONTENTS

 

Chapter I: Background…………………………………………………………………………….1

Chapter II: Manuscript

Abstract……………………………………………………………………………………………6

Introduction………………………………………………………………………………………..7

Methods…………………………………………………………………………………………...8

Results…………………………………………………………………………………………….13

Discussion………………………………………………………………………………………...16

References………………………………………………………………………………………...20

Tables……………………………………………………………………………………………..24

Figures…………………………………………………………………………………………….27

Chapter III: Public Health Implications…………………………………………………………..30

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