What’s measured The report examines sexually transmitted disease rates for gonorrhea and chlamydia from 2002 through 2006, as cases per 100,000 persons. Data are available from the North Carolina Department of Health and Human Services and the South Carolina Department of Health and Environmental Control. The regional rates are calculated from the number of cases in the region and the U.S. Census population estimates for the region’s counties. The county rates are as published by the two state agencies. The report’s authors planned to include rates for syphilis, but data inconsistencies between North and South Carolina precluded inclusion. Future reports will attempt to include incidence rates for all three sexually transmitted diseases. Why it’s measured Incidence rates for gonorrhea and chlamydia provide important information about the prevalence of sexually transmitted diseases in the region, and indirectly, about the incidence of unsafe sex. These diseases have far-reaching consequences for those who are infected and for their sexual partners. Indicator results In 2006, the gonorrhea rate per 100,000 people in the region was 199.1, up from 186.7 in 2002. The rate increased from 2002 to 2003 but dropped in 2004 before rising again in 2005 and then holding relatively steady in 2006. Still, the region’s 2006 rate per 100,000 for gonorrhea was lower than the rates for North and South Carolina (199.3 and 209.9 cases per 100,000 persons, respectively). Within the region, six of the fourteen counties had gonorrhea rates higher than either North or South Carolina. Among those six, Anson, and Chester had the highest incidences of gonorrhea, at 317.7 and 301.1 cases per 100,000 persons, respectively. The lowest rates in the region were reported by Lincoln and Union counties (55.8 and 98.8 cases per 100,000, respectively). In 2006, the chlamydia rate per 100,000 people in the region was 306.4. The rate increased each year from 2002 through 2005 (from 264.0 to 354.6) before dropping in 2006. The region’s 2006 chlamydia rate was lower than the rates for North and South Carolina (387.1 and 441.7 cases per 100,000 persons, respectively). Chester and Anson counties reported the highest 2006 incidences of the disease, at 550.6 and 419.6 cases per 100,000 persons, respectively. Lincoln and Union counties reported the lowest 2006 chlamydia rates (124.6 and 168.2, respectively). Since people with chlamydia often don’t experience symptoms, the reported incidence of the disease is directly related to screening. Increases in screening through new initiatives tend to produce increases in the reported incidence of chlamydia. Therefore, chlamydia trends have to be interpreted in this light. Higher numbers can mean that access or outreach has improved rather than a true increase has occurred within the population. Evaluation The region as a whole appears to have a healthier (that is, lower) rate of sexually transmitted diseases than North or South Carolina. This is good news for the health of the region’s population. The trend lines for gonorrhea and chlamydia were slightly different. The number of gonorrhea cases remained fairly stable, while the number of chlamydia cases rose for three consecutive years and then decreased in the latest period, from 2005 to 2006. This may signal to health-care professionals and nonprofits a need to change priorities in their efforts against sexually transmitted diseases. Moreover, in analyzing which counties within the region had the highest rates of each disease, the report’s authors saw many of the same counties, rural and urban, with high incidences of both diseases. This is not surprising because the transmission of both diseases results from unprotected sex. This situation suggests that these counties need assistance in fighting sexually transmitted diseases, which is a matter of prevention and good sex education. The existence of this problem in both urban and rural counties presents a challenge because programs in one county may not work in a county that is demographically different. Connections The rate of sexually transmitted diseases (STDs) has obvious connections to other aspects of public health in the region. Rising rates of STDs may signal a failure to educate residents about the dangers of unsafe sex, just as declining rates may signal success in such educational efforts. The number of gonorrhea and chlamydia cases also may be related to demographic change. That is, rising rates may indicate that more single, sexually active people are living in the region. Declining rates, on the other hand, may signal a relative decline in that population.
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