Ethnic/racial homogeneity and sexually transmitted disease: A study of 77 Chicago community areas

BACKGROUND: Sexually transmitted diseases (STDs) remain an intractable public health problem in the United States. Wide ethnic and racial disparities persist in the rates of reported STDs. Blacks and Hispanics have higher rates of chlamydia and gonorrhea than European Americans. METHODS: With data collected in 2002 from 77 well defined communities in Chicago, we examined the association of ethnic/racial homogeneity of the communities and incidence of chlamydia and gonorrhea. The multivariate regression models controlled for other sociodemographic variables. RESULTS: Communities where at least 60% of the residents were black had significantly higher incidence rates of these 2 STDs compared with communities where at least 60% of the residents were Hispanic. Independent of ethnic/racial homogeneity of the community, the incidence of these STDs was higher in communities that had a larger percentage of persons living in poverty, a larger percentage unemployed, fewer high school graduates, and more residents between the ages of 15 and 44. CONCLUSION: The challenge for public health authorities is to consider policy options that respond not only to sexual risk behaviors, but also to the contextual attitudes, cultural traditions, and norms, and social circumstances in ethnically homogeneous communities that may affect the spread of STDs in disadvantaged urban populations.