Detecting Trends in AIDS Mortality after Adjustment of temporal trend: An Application of the Space-Time Scan Statistic
Abstract
There is sparse literature characterizing spatial and temporal trends of AIDS mortality among different race, gender, and age groups in some of the most affected states in the U.S., including the state of Florida. The purpose of the present study is to describe the patterns of AIDS deaths in Florida geographically and temporally, and to determine if detected trends of health disparities vary by demographic characteristics. Methods: The Space-Time Scan Statistic was employed to examine potential geographic and temporal excess of AIDS mortality by age, race, and gender in 67 Florida jurisdictions between 1987 and 2004. Results were depicted in cluster maps using Epi Info and Epi Map made available by the CDC. Results: Among 40,106 AIDS deaths in Florida between 1987 and 2004, 48.5% occurred in the African-American/Black population, whereas 51.3% were found in the White population. AIDS-related mortality in the White population peaked earlier in the study period persisted through [YEAR], whereas mortality in African-American peaked in the later periods persisting until the most recent study period. Excess deaths of AIDS in all demographic groups were detected in Miami-Dade, Broward, Martin, Palm Beach, Union, Monroe, Hillsborough, St. Lucie, Orange, Duval, and Lee County. The time frame and cluster information was geographically referenced in maps. AIDS mortality peaked in 1995 and then sharply dropped until 1998 when it stabilized. Conclusion: This study quantitatively describes geographic and temporal variations of AIDS mortality in Florida by race, gender and age groups. By accounting for the time frame, this study captures the persistence of geographic clusters, which is not often afforded by other geographic detection methods. These findings may serve to inform medical resources allocation and focus public health intervention strategies for AIDS care.