Neighborhood Poverty Characteristics of Pertussis Cases among Young Children in San Bernadino County, CA, in 2010-2011
Background: The burden of most infectious diseases falls heavily on persons living in neighborhoods of lower socioeconomic status. This study examined the distribution of pertussis among children ages 0-5 years by neighborhood poverty categories and ethnicity in San Bernardino County, California, during an epidemic in 2010-2011. Methods: One hundred twenty-seven cases were identified and their residences were geocoded to determine the poverty rate of the census tract the residence was in. All residences were categorized as belonging to one of four poverty categories: 0-4.9% of residents (low poverty, reference group), 5-9.9% (medium low poverty), 10-19.9% (medium high poverty), and 20-100% (high poverty). Pertussis incidence rates were calculated for the four categories. Results: Pertussis incidence rates did not significantly vary among the poverty categories. Furthermore the ethnic distribution of pertussis cases did not significantly vary among the poverty categories. Conclusions: The usual socioeconomic disparity found for childhood infectious diseases was not found for pertussis incidence. This may be due to the fact that childhood pertussis vaccinations are state-mandated and publicly-funded, therefore more accessible to children of all neighborhoods. To further reduce pertussis incidence, health education efforts might include the elimination of personal belief exemptions from vaccinations, as was done in California.