Neighborhood factors affecting rates of sexually transmitted diseases in Chicago.

High rates of gonorrhea have been shown to be associated with high rates of incarceration in the prior year. One hypothesized chain of events is that there is a negative effect of incarceration on neighborhood social characteristics, which in turn affect behaviors facilitating transmission of sexually transmitted diseases (STDs). This study examined whether neighborhood characteristics were associated with the incidence of STDs and homicide rates as a proxy for incarceration rates. Data were from the 1995 Program on Human Development in Chicago Neighborhoods, the Chicago Health Department, and the Chicago Police Department. Neighborhood gonorrhea rates increased by 192.2 (95% confidence interval (CI) 131.6, 252.9) cases per 100,000 population with a change from the 25th to the 75th percentile of social disorder. This rate difference was a value greater than the median neighborhood gonorrhea rate. Similar increases were observed for other neighborhood measures and for Chlamydia infection. We hypothesize that high rates of incarceration may play a role in undermining neighborhood social cohesion and control. Using homicide rates as a proxy for incarceration, a change from the 25th to the 75th percentile of 1995 neighborhood homicide rates yielded a gonorrhea rate increase of 164.6 (95% CI 124.4, 204.7) cases per 100,000. Factors that undermine the social fabric of a community can become manifest in health outcomes such as STDs. The effects of high rates of incarceration on neighborhoods merit further exploration.