{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:37:23Z","timestamp":1787963843752,"version":"build-2784847793"},"reference-count":68,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"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":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Racial and socioeconomic disparities in the incidence of Legionnaires\u2019 disease have been documented for the past 2 decades; however, the social determinants of health (SDH) that contribute to these disparities are not well studied. The objective of this narrative review was to characterize SDH to inform efforts to reduce disparities in the incidence of Legionnaires\u2019 disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a narrative review of articles published from January 1979 through October 2019 that focused on disparities in the incidence of Legionnaires\u2019 disease and pneumonia (inclusive of bacterial pneumonia and\/or community-acquired pneumonia) among adults and children (excluding articles that were limited to people aged &lt;18 years). We identified 220 articles, of which 19 met our criteria: original research, published in English, and examined Legionnaires\u2019 disease or pneumonia, health disparities, and SDH. We organized findings using the Healthy People 2030 SDH domains: economic stability, education access and quality, social and community context, health care access and quality, and neighborhood and built environment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 19 articles reviewed, multiple articles examined disparities in incidence of Legionnaires\u2019 disease and pneumonia related to economic stability\/income (n = 13) and comorbidities (n = 10), and fewer articles incorporated SDH variables related to education (n = 3), social support (none), health care access (n = 1), and neighborhood and built environment (n = 6) in their analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neighborhood and built-environment factors such as housing, drinking water infrastructure, and pollutant exposures represent critical partnership and research opportunities. More research that incorporates SDH and multilevel, cross-sector interventions is needed to address disparities in Legionnaires\u2019 disease incidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00333549211026781","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T16:43:16Z","timestamp":1624984996000},"page":"660-671","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Racial Disparities in Incidence of Legionnaires\u2019 Disease and Social Determinants of Health: A Narrative Review"],"prefix":"10.1177","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8063-1758","authenticated-orcid":false,"given":"Candis M.","family":"Hunter","sequence":"first","affiliation":[{"name":"Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone W.","family":"Salandy","sequence":"additional","affiliation":[{"name":"Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica C.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Edens","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Hubbard","sequence":"additional","affiliation":[{"name":"Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"key":"bibr1-00333549211026781","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268811002858"},{"key":"bibr2-00333549211026781","unstructured":"Centers for Disease Control and Prevention. 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