Background:
Gonorrhea rates in the United States have been declining since 1976. The magnitude of this decline has varied geographically.

Objective:
To explore associations of economic and socio-demographic factors with the percentage change in gonorrhea incidence rates at the city level, and generate hypotheses regarding factors that may influence changes in gonorrhea rates.


Method:
Annual gonorrhea rates (per 100,000 population) for 63 selected cities were calculated for 1992 and 2002. Percentage change in rates between 1992 and 2002 was calculated for each city. Data for 35 economic and socio-demographic factors for 1998-2000 were obtained from the US Census Bureau. Pearson's correlation coefficients were calculated to assess associations between these variables and the percentage change in gonorrhea rates. A multiple regression model with percentage change in gonorrhea rates as dependent variable, and economic and socio-demographic factors as independent variables was built to find factors associated with changes in gonorrhea rates.

Result:
Four of the 35 socio-demographic and economic variables were significantly (p < 0.05) associated with the percentage change in gonorrhea rates. On the other hand, 19 of these variables were significantly associated with 2002 gonorrhea rates. In multivariate regression model for percentage change in gonorrhea rates, three factors; percentage of black population, percentage of population 25-44 years and median age accounted for 25% of the variation. While for 2002 gonorrhea rates; percentage black population, percentage females with children, crime rate, expenditure on police, percentage of population 25-44 years, percentage change in labor force and male to female ratio, accounted for 75% of the variation among these rates.


Conclusion:
Socio-demographic and economic factors are highly correlated with annual 2002 gonorrhea rates among large US cities, but not with the percentage change in 1992 to 2002 rates.

Implications:
Identification of modifiable health determinants associated with declines in gonorrhea incidence may improve gonorrhea control interventions.