{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:25:07Z","timestamp":1792513507914,"version":"4.5.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2017,4,12]],"date-time":"2017-04-12T00:00:00Z","timestamp":1491955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We used area-level indicators of poverty to describe economic disparities in the incidence rate of infectious syphilis in Massachusetts to (1) determine whether methods developed in earlier AIDS analyses in Massachusetts could be applied to syphilis and (2) characterize syphilis trends during a time of increased rates of syphilis incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Using census tract data and population counts from the US Census Bureau and Massachusetts data on syphilis, we analyzed the incidence rate of syphilis infection from 2001 to 2013 by the poverty level of the census tract in which people with syphilis resided, stratified by age, sex, and race\/ethnicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The syphilis incidence rate increased in all census tract groups in Massachusetts from 2001 to 2013, and disparities in incidence rates by area poverty level persisted over time. The overall incidence rate of syphilis increased 6.9-fold from 2001 to 2013 in all census tract poverty-level groupings (from 1.5 to 10.3 per 100\u2009000 population), but the rise in rate was especially high in the poorest census tracts (from 5.6 to 31.0 per 100\u2009000 population) and among men (from 2.2 to 19.4 per 100\u2009000 population). The highest syphilis incidence rate was among non-Hispanic black people. The largest changes in incidence rate occurred after 2010. One region had a disproportionate increase in incidence rates and a disproportionate impact on the statewide trend.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Census tract poverty analyses can inform the targeting of interventions that make progress toward reducing disparities in rates of syphilis incidence possible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0033354916688269","type":"journal-article","created":{"date-parts":[[2017,4,12]],"date-time":"2017-04-12T17:56:14Z","timestamp":1492019774000},"page":"309-315","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Economic Disparities and Syphilis Incidence in Massachusetts, 2001-2013"],"prefix":"10.1177","volume":"132","author":[{"given":"Laura","family":"Smock","sequence":"first","affiliation":[{"name":"Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Caten","sequence":"additional","affiliation":[{"name":"Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Hsu","sequence":"additional","affiliation":[{"name":"Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"},{"name":"Boston Medical Center, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Alfred","family":"DeMaria","sequence":"additional","affiliation":[{"name":"Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,4,12]]},"reference":[{"key":"bibr1-0033354916688269","doi-asserted-by":"publisher","DOI":"10.1136\/sti.77.3.214"},{"key":"bibr2-0033354916688269","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199010000-00003"},{"key":"bibr3-0033354916688269","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199501000-00010"},{"key":"bibr4-0033354916688269","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.80.7.853"},{"key":"bibr5-0033354916688269","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199118020-00008"},{"key":"bibr6-0033354916688269","unstructured":"Division of STD Prevention. Sexually Transmitted Disease Surveillance 2012. Atlanta, GA: National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention; 2012. http:\/\/www.cdc.gov\/std\/stats12\/Surv2012.pdf. Accessed July 30, 2014."},{"key":"bibr7-0033354916688269","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2005.070417"},{"issue":"18","key":"bibr8-0033354916688269","first-page":"402","volume":"63","author":"Patton ME","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"bibr9-0033354916688269","doi-asserted-by":"publisher","DOI":"10.1093\/phr\/118.3.240"},{"key":"bibr10-0033354916688269","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.93.10.1655"},{"key":"bibr11-0033354916688269","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.90.7.1064"},{"key":"bibr12-0033354916688269","unstructured":"Centers for Disease Control and Prevention. National Notifiable Diseases Surveillance System: Syphilis\n                      (Treponema pallidum)\n                      1996 Case Definition. http:\/\/wwwn.cdc.gov\/NNDSS\/script\/casedef.aspx?CondYrID=861&DatePub=1996-01-01. Accessed February 16, 2015."},{"key":"bibr13-0033354916688269","volume-title":"ArcGIS Version 9.3.1","author":"ESRI","year":"2009"},{"key":"bibr14-0033354916688269","doi-asserted-by":"publisher","DOI":"10.1007\/BF03403822"},{"key":"bibr15-0033354916688269","unstructured":"US Census Bureau. 2010 census urban and rural classification and urban area criteria. https:\/\/www.census.gov\/geo\/reference\/ua\/urban-rural-2010.html. Accessed August 5, 2016."},{"key":"bibr16-0033354916688269","unstructured":"US Census Bureau. Census 2000\/2010 summary file. http:\/\/factfinder.census.gov\/faces\/nav\/jsf\/pages\/download_center.xhtml. Accessed July 30, 2014."},{"key":"bibr17-0033354916688269","unstructured":"US Census Bureau. Poverty. http:\/\/www.census.gov\/topics\/income-poverty\/poverty.html. Accessed September 12, 2014."},{"key":"bibr18-0033354916688269","volume-title":"SAS Version 9.3","author":"SAS Institute Inc","year":"2011"},{"key":"bibr19-0033354916688269","volume-title":"R Version 3.1","author":"R Group","year":"2014"},{"key":"bibr20-0033354916688269","first-page":"1","volume":"20","author":"Klein RJ","year":"2001","journal-title":"Healthy People 2010 Stat Notes"},{"key":"bibr21-0033354916688269","unstructured":"US Census Bureau. Profiles of General Demographic Characteristics: 2000 Census of Population and Housing, Massachusetts. Washington, DC: US Census Bureau; 2001. http:\/\/www.census.gov\/prod\/cen2000\/dp1\/2kh25.pdf. Accessed July 30, 2014."},{"key":"bibr22-0033354916688269","unstructured":"US Census Bureau. Race and Hispanic or Latino origin: 2010. 2010 census summary file 1. http:\/\/factfinder2.census.gov\/faces\/tableservices\/jsf\/pages\/productview.xhtml?pid=DEC_10_SF1_QTP3. Accessed July 30, 2014."},{"key":"bibr23-0033354916688269","unstructured":"American FactFinder. United States population: income 2012 [Springfield City, MA, and Holyoke City, MA, poverty tabs]. http:\/\/factfinder.census.gov\/faces\/nav\/jsf\/pages\/community_facts.xhtml. Accessed January 6, 2016."},{"key":"bibr24-0033354916688269","unstructured":"QuickFacts. Massachusetts [table, income, and poverty section, median household income]. http:\/\/www.census.gov\/quickfacts. Accessed September 12, 2014."},{"key":"bibr25-0033354916688269","unstructured":"Caten E, Cocoros N, John B. Incidence of HIV infection and census tract poverty level in Massachusetts\u2014an update to results from early in the epidemic (CSTE pilot project). Presented at: 2013 Annual CSTE Conference; June 10, 2013; Pasadena, CA. https:\/\/cste.confex.com\/cste\/2013\/webprogram\/Paper1865.html. 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