Putting Chlamydia on the Map

Background: Although 76% of New Yorkers support condom availability programs (CAP) for High Schools, many school districts in New York outside of New York City (NYC) do not provide CAP.  The aim of this project was to provide data driven tools to state and local stakeholders seeking to provide CAP in local High Schools.   

Methods: Two sets of maps were produced. First, age-adjusted Chlamydia morbidity from 2012 to 2014 among females ages 10 to 19 was mapped using school district geographic areas. Boundary areas and populations were obtained from National Center for Education Statistics. Second, bivariate mapping was used to illustrate more complex issues affecting local Chlamydia morbidity data, such as burden contrasted with risk, the intersection of screening and morbidity, and urban/rural patterns of disease.  

Results: The main product of the project was the release of six regional maps showing the pattern of Chlamydia morbidity along with a list of school district geographic areas rank by morbidity relative to all of NYS excluding NYC.  These maps illustrated the pervasiveness of Chlamydia among young women across all regions of New York. Bivariate maps of morbidity by number of cases revealed a more complex pattern, highlighting that although suburban areas tended towards lower than expected infections, absolute number of cases per year still warranted interventions. Bivariate maps by Medicaid screening rates illustrated the problem of rural areas with higher than expected morbidity coupled with lower than average screening.   

Conclusions: The project illustrates the use of straightforward incidence mapping and more advanced spatial analysis to provide information to support policy initiatives.  Maps and supportive information have been shared with local health entities and stakeholders.  In this case, use of Chlamydia burden and risk among women ages 10 to 19 years was used to support condom availability programs in High Schools.