Economic deprivation and AIDS incidence in Massachusetts

Objectives. This study quantified AIDS incidence in Massachusetts in relati on to economic deprivation. Method. Using 1990 census blockgroup data. 1990 census population counts. a nd AIDS surveillance registry data fbr the years 1988 through 1994, we gene rated yearly and cumulative AIDS incidence data for the state of Massachuse tts stratified by sex and by neighborhood measures of economic position for the total, Black, Hispanic, and White populations. Results. Incidence of AIDS increased with economic deprivation, with the ma gnitude of these trends varying by both race/ethnicity and sex. The cumulat ive incidence of AIDS in the total population was nearly 7 times higher amo ng persons in block-groups where 40% or more of the population was below th e poverty line (362 per 100 000) than among persons in block-groups where l ess than 2% of the population was below poverty (53 per 100 000). Conclusions. Observing patterns of disease burden in relation Po neighborho od levels of economic well-being elucidates further the role of poverty as a population-level determinant of disease burden. Public health agencies an d researchers can use readily available census data to describe neighborhoo d-level socioeconomic conditions. Such knowledge expands options for diseas e prevention and increases the visibility of economic inequality as an unde rlying cause of AIDS.