Detecting spatiotemporal clusters of accidental poisoning mortality among Texas counties, U.S., 1980 – 2001
Detecting spatiotemporal clusters of accidental poisoning mortality among Texas counties, U.S., 1980 – 2001
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Date
2004-10-27
Authors
Nkhoma, Ella T
Hsu, Chiehwen Ed
Hunt, Victoria I
Harris, Ann Marie
Advisor
Citation
Nkhoma, E.T., Ed Hsu, C., Hunt, V.I. et al. Detecting spatiotemporal clusters of accidental poisoning mortality among Texas counties, U.S., 1980 – 2001. Int J Health Geogr 3, 25 (2004).
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Abstract
Background: Accidental poisoning is one of the leading causes of injury in the United States,
second only to motor vehicle accidents. According to the Centers for Disease Control and
Prevention, the rates of accidental poisoning mortality have been increasing in the past fourteen
years nationally. In Texas, mortality rates from accidental poisoning have mirrored national trends,
increasing linearly from 1981 to 2001. The purpose of this study was to determine if there are
spatiotemporal clusters of accidental poisoning mortality among Texas counties, and if so, whether
there are variations in clustering and risk according to gender and race/ethnicity. The Spatial Scan
Statistic in combination with GIS software was used to identify potential clusters between 1980 and
2001 among Texas counties, and Poisson regression was used to evaluate risk differences.
Results: Several significant (p < 0.05) accidental poisoning mortality clusters were identified in
different regions of Texas. The geographic and temporal persistence of clusters was found to vary
by racial group, gender, and race/gender combinations, and most of the clusters persisted into the
present decade. Poisson regression revealed significant differences in risk according to race and
gender. The Black population was found to be at greatest risk of accidental poisoning mortality
relative to other race/ethnic groups (Relative Risk (RR) = 1.25, 95% Confidence Interval (CI) = 1.24
– 1.27), and the male population was found to be at elevated risk (RR = 2.47, 95% CI = 2.45 – 2.50)
when the female population was used as a reference.
Conclusion: The findings of the present study provide evidence for the existence of accidental
poisoning mortality clusters in Texas, demonstrate the persistence of these clusters into the
present decade, and show the spatiotemporal variations in risk and clustering of accidental
poisoning deaths by gender and race/ethnicity. By quantifying disparities in accidental poisoning
mortality by place, time and person, this study demonstrates the utility of the spatial scan statistic
combined with GIS and regression methods in identifying priority areas for public health planning
and resource allocation.