Abstract
OBJECTIVE: The study's objective was to find the association between salmonellosis and socioeconomic status (SES) in hot spot areas and statewide counties. DESIGN: A retrospective cohort study. SETTING: The data were recorded regarding salmonellosis in 2017 from the Texas surveillance database. It included assessment of hot spot analysis and SES association with salmonellosis at the county level. PARTICIPANTS: Patients with salmonellosis of all age groups in Texas. RESULTS: There were a total of 5113 salmonellosis from 254 counties with an unadjusted crude rate of 18 per 100 000 person-years. Seven SES risk factors in the hot spot counties were as follows: low values of the severe housing problem, unemployment, African American and high values of social association rate, fast food/full-service restaurant use, Hispanic and Hispanic senior low access-to-store (p<0.05). A 12% difference existed between local health departments in hot (25%) and cold spot (37%) counties (χ(2) (1, n=108)=0.5, p=0.81).Statewide independent risk factors were severe housing problem (incidence rate ratio (IRR)=1.1; 95% CI: 1.05 to 1.14), social association rate (IRR=0.89; 95% CI: 0.87 to 0.92), college education (IRR=1.05; 95% CI: 1.04 to 1.07) and non-Hispanic senior local access-to-store (IRR=1.98; 95% CI: 1.26 to 3.11). The severe housing problem predicted zero occurrences of infection in a county (OR=0.51; 95% CI: 0.28 to 0.95). CONCLUSIONS: Disparity exists in salmonellosis and SES. Attention to unmet needs will decrease salmonellosis. Severe housing problem is a notable risk.