IMPACT OF RURALITY, BROILER OPERATIONS, AND COMMUNITY SOCIOECONOMIC FACTORS ON THE RISK OF CAMPYLOBACTERIOSIS IN MARYLAND
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The combined impact of community-level environmental and socioeconomic factors on the risk of campylobacteriosis were evaluated. Campylobacter case data (2002-2010, n=3,694) were obtained from the Maryland Foodborne Diseases Active Surveillance Network. Community-level socioeconomic and environmental data were obtained from the 2000 U.S. Census and the 2007 U.S. Census of Agriculture. Data were linked by zip code. Incidence rate ratios were derived by Poisson regressions. A subset of zip code-level characteristics was mapped. In zip codes that were 100% rural, incidence rates of campylobacteriosis were 6 times (IRR=6.18; 95%CI=3.19-11.97) that of urban zip codes. In zip codes with broiler chicken operations, incidence rates were 1.45 times that of zip codes without broilers (IRR=1.45, 95%CI=1.34-1.58). Higher rates were also observed for zip codes that were predominantly white and had high median incomes. Findings suggest that the risk of campylobacteriosis could be significantly influenced by the community and environment where one lives.