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Examining associations in congenital syphilis infection and socioeconomic factors between California’s small-to-medium and large metro counties

Journal of Perinatology volume 42, pages 1434–1439 (2022)Cite this article

Subjects

Abstract

Objective

To investigate differences in congenital syphilis (CS) infection between California’s small-to-medium and large metropolitan counties and the socioeconomic mechanisms behind these differences.

Study design

County-level data from 2019 and 2020 on CS infection and other socioeconomic covariates were obtained from the California Department of Public Health and the United States Census Bureau. Counties were stratified into small-to-medium or large metropolitan counties by the National Center for Health Statistics Urban-Rural Classification Scheme and analyzed using simple and multiple Poisson regression models.

Results

California’s small-to-medium metropolitan counties reported significantly higher rates of CS incidence, female poverty, and uninsured females, and significantly lower rates of English-language speaking ability and female education level compared to large metropolitan counties. CS infection was significantly associated with female poverty and education level.

Conclusion

Rates of CS infection in the California counties are more dependent on socioeconomic indicators than county classification itself.

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Fig. 1: Geographical heat maps of CS incidence, female poverty rate and county classification in California.

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Acknowledgements

We thank the CDC, CDPH and CPQCC for providing retrospective data for our study’s analysis.

Funding

This work was supported in part by the Children’s Miracle Network Grant at UC Davis Children’s Hospital (DS) and grants from the National Institute for Occupational Health and Safety U54 OH07550 and National Institutes of Health P51 OD011107.

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Authors and Affiliations

  1. Center for Health and the Environment, University of California, Davis, CA, USA

    Juliet Fang, Rona M. Silva & Kent E. Pinkerton

  2. Department of Pediatrics, University of California, Davis School of Medicine, Sacramento, CA, USA

    Daniel J. Tancredi & Kent E. Pinkerton

  3. Western Center for Agricultural Health and Safety, University of California, Davis, CA, USA

    Kent E. Pinkerton & Deepika Sankaran

Authors
  1. Juliet Fang
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  2. Rona M. Silva
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  3. Daniel J. Tancredi
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  4. Kent E. Pinkerton
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  5. Deepika Sankaran
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Contributions

JF contributed to the conception, design, data acquisition, analysis, interpretation, and drafting of the manuscript. DJT contributed to the study’s methodology, statistical analysis, and description of the study’s methods. DS, KEP, and RMS contributed additional concepts, ideas, refinements, guidance, and revisions in preparing the final manuscript and analysis.

Corresponding author

Correspondence to Deepika Sankaran.

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The authors declare no competing interests.

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Fang, J., Silva, R.M., Tancredi, D.J. et al. Examining associations in congenital syphilis infection and socioeconomic factors between California’s small-to-medium and large metro counties. J Perinatol 42, 1434–1439 (2022). https://doi.org/10.1038/s41372-022-01445-y

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