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Article << Previous     |     Next >>   Contents Vol 10(5)

Violent crime rates as a proxy for the social determinants of sexually transmissible infection rates: the consistent state-level correlation between violent crime and reported sexually transmissible infections in the United States, 1981–2010

Harrell W. Chesson A B, Kwame Owusu-Edusei Jr A, Jami S. Leichliter A and Sevgi O. Aral A

A Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
B Corresponding author. Email: hbc7@cdc.gov

Sexual Health 10(5) 419-423 http://dx.doi.org/10.1071/SH13006
Submitted: 9 January 2013  Accepted: 4 June 2013   Published: 30 August 2013

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Background: Numerous social determinants of health are associated with violent crime rates and sexually transmissible infection (STI) rates. This report aims to illustrate the potential usefulness of violent crime rates as a proxy for the social determinants of STI rates. Methods: For each year from 1981 to 2010, we assessed the strength of the association between the violent crime rate and the gonorrhoea (Neisseria gonorrhoeae) rate (number of total reported cases per 100?000) at the state level. Specifically, for each year, we calculated Pearson correlation coefficients (and P-values) between two variables (the violent crime rate and the natural log of the gonorrhoea rate) for all 50 states and Washington, DC. For comparison, we also examined the correlation between gonorrhoea rates, and rates of poverty and unemployment. We repeated the analysis using overall syphilis rates instead of overall gonorrhoea rates. Results: The correlation between gonorrhoea and violent crime was significant at the P < 0.001 level for every year from 1981 to 2010. Syphilis rates were also consistently correlated with violent crime rates. In contrast, the P-value for the correlation coefficient exceeded 0.05 in 9 of the 30 years for the association between gonorrhoea and poverty, and in 17 of the 30 years for that between gonorrhoea and unemployment. Conclusions: Because violent crime is associated with many social determinants of STIs and because it is consistently associated with STI rates, violent crime rates can be a useful proxy for the social determinants of health in statistical analyses of STI rates.

Additional keywords: epidemiology, gonorrhoea, poverty, syphilis.


[1]  Hogben M, Leichliter JS. Social determinants and sexually transmitted disease disparities. Sex Transm Dis 2008; 35: S13–8.
CrossRef | PubMed |

[2]  Aral SO. The social context of syphilis persistence in the southeastern United States. Sex Transm Dis 1996; 23: 9–15.
CrossRef | CAS | PubMed |

[3]  Aral SO, Adimora AA, Fenton KA. Understanding and responding to disparities in HIV and other sexually transmitted infections in African Americans. Lancet 2008; 372: 337–40.
CrossRef | PubMed |

[4]  Nakashima AK, Rolfs RT, Flock ML, Kilmarx P, Greenspan JR. Epidemiology of syphilis in the United States, 1941–1993. Sex Transm Dis 1996; 23: 16–23.
CrossRef | CAS | PubMed |

[5]  Thomas JC, Clark M, Robinson J, Monnett M, Kilmarx PH, Peterman TA. The social ecology of syphilis. Soc Sci Med 1999; 48: 1081–94.
CrossRef | CAS | PubMed |

[6]  Du P, McNutt LA, O’Campo P, Coles FB. Changes in community socioeconomic status and racial distribution associated with gonorrhea rates: an analysis at the community level. Sex Transm Dis 2009; 36: 430–8.
CrossRef | PubMed |

[7]  Thomas JC, Torrone E. Incarceration as forced migration: effects on selected community health outcomes. Am J Public Health 2008; 98: S181–4.
CrossRef | PubMed |

[8]  Thomas JC, Sampson LA. High rates of incarceration as a social force associated with community rates of sexually transmitted infection. J Infect Dis 2005; 191: S55–60.
CrossRef | PubMed |

[9]  Owusu-Edusei K, Chesson HW. Using spatial regression methods to examine the association between county-level racial/ethnic composition and reported cases of chlamydia and gonorrhea: an illustration with data from the state of Texas. Sex Transm Dis 2009; 36: 657–64.
CrossRef | PubMed |

[10]  Owusu-Edusei K, Doshi SR. County-level sexually transmitted disease detection and control in Texas: do sexually transmitted diseases and family planning clinics matter? Sex Transm Dis 2011; 38: 970–5.
CrossRef | PubMed |

[11]  Chesson HW, Dee TS, Aral SO. AIDS mortality may have contributed to the decline in syphilis rates in the United States in the 1990s. Sex Transm Dis 2003; 30: 419–24.
CrossRef | PubMed |

[12]  Chesson H, Owusu-Edusei K. Examining the impact of federally-funded syphilis elimination activities in the USA. Soc Sci Med 2008; 67: 2059–62.
CrossRef | PubMed |

[13]  Chesson HW, Harrison P, Scotton CR, Varghese B. Does funding for HIV and sexually transmitted disease prevention matter? Evidence from panel data. Eval Rev 2005; 29: 3–23.
CrossRef | PubMed |

[14]  Cohen D, Spear S, Scribner R, Kissinger P, Mason K, Wildgen J. ‘Broken windows’ and the risk of gonorrhea. Am J Public Health 2000; 90: 230–6.
CrossRef | CAS | PubMed |

[15]  Rundle AG, Bader MD, Richards CA, Neckerman KM, Teitler JO. Using Google Street View to audit neighborhood environments. Am J Prev Med 2011; 40: 94–100.
CrossRef | PubMed |

[16]  Marx R, Aral SO, Rolfs RT, Sterk CE, Kahn JG. Crack, sex, and STD. Sex Transm Dis 1991; 18: 92–101.
CrossRef | CAS | PubMed |

[17]  Martínez R, Rosenfeld R, Mares D. Social disorganization, drug market activity, and neighborhood violent crime. Urban Aff Rev 2008; 43: 846–74.
CrossRef |

[18]  Thomas JC, Torrone EA, Browning CR. Neighborhood factors affecting rates of sexually transmitted diseases in Chicago. J Urban Health 2010; 87: 102–12.
CrossRef | PubMed |

[19]  Krivo LJ, Peterson RD, Kuhl DC. Segregation, racial structure, and neighborhood violent crime. AJS 2009; 114: 1765–802.
| PubMed |

[20]  Wilcox P, Quisenberry N, Cabrera DT, Jones S. Busy places and broken windows? Toward defining the role of physical structure and process in community crime models. Sociol Q 2004; 45: 185–207.
CrossRef |

[21]  Owusu-Edusei K, Chesson HW, Leichliter JS, Kent CK, Aral SO. The association between racial disparity in income and reported sexually transmitted infections. Am J Public Health 2013; 103: 910–16.
CrossRef | PubMed |

[22]  Centers for Disease Control and Prevention. Sexually transmitted disease surveillance, 2010. Atlanta: US Department of Health and Human Services; 2011.

[23]  United States Department of Justice, Federal Bureau of Investigation (FBI). Crime in the United States, 2010. Clarksburg: FBI; 2010. Available online at: http://www.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/2010/crime-in-the-u.s.-2010/index-page [verified March 2013]

[24]  Weinstock H, Berman S, Cates W. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health 2004; 36: 6–10.
CrossRef | PubMed |

[25]  Satterwhite CL, Torrone E, Meites E, Dunne EF, Mahajan R, Ocfemia MC, et al Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis 2013; 40: 187–93.
CrossRef | PubMed |

[26]  US Census Bureau (USCB). Current population survey design and methodology. Technical Paper 66. Washington DC: USCB; 2006.

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