The Burden of Pertussis In Georgia: An Examination of Racial Disparities, 2009-2010

Background: Approximately 30% of Georgia’s population is non-Hispanic black – the third largest black population in the U.S. The Hispanic population in Georgia has steadily increased, with at least a half-million Hispanic residents (accounting for 8% of the total population). Non-Hispanic blacks represent a small proportion of pertussis case-patients when compared to Hispanic and non-Hispanic whites in Georgia.

Objectives: Examine racial/ethnic differences among pertussis cases in Georgia during 2009-2010

Methods: Descriptive statistics were obtained from pertussis case data reported into Georgia’s electronic notifiable disease surveillance system during 2009 – 2010. Demographics, clinical characteristics, outcomes, and health insurance status were compared between non-Hispanic blacks, non-Hispanic whites, and Hispanics.

Results: In 2009, race and ethnicity data were available for 209 of 230 pertussis case-patients reported in Georgia. Thirteen case-patients (6.2%), 31 case-patients (14.8%), and 140 (67.0%) case-patients were reported as non-Hispanic black, Hispanic and non-Hispanic white respectively. The pertussis incidence rate was six times higher among non-Hispanic whites than non-Hispanic blacks (2.6 versus 0.4). Similarly, the incidence rate was ten times higher among Hispanics than non-Hispanic blacks (4.2 versus 0.4). Among pertussis case-patients < 1 year of age, 5% (n=5) identified as non-Hispanic black and 25% (n=25) identified as Hispanic; by comparison, an estimated 44% and 16% of infants born each year in Georgia are non-Hispanic black and Hispanic, respectively.

Conclusions: Differences in the frequency of pertussis case-patients reported among non-Hispanic blacks, Hispanics and non-Hispanic whites in Georgia needs further study. Whether non-Hispanic blacks truly have a lower burden of disease is unclear. Pertussis may be unrecognized and/or underreported by non-Hispanic black parents compared to other racial/ethnic groups assessed. Further information on knowledge and attitudes about pertussis, general healthcare seeking behavior, and sociocultural differences is necessary to understand this disparity. Such information could be used to target appropriate preventive health messages to specific racial/ethnic populations.