Kaohsiung Journal of Medical Sciences
Volume 24, Issue 11 , Pages 568-576, November 2008

A New Application of Spatiotemporal Analysis for Detecting Demographic Variations in AIDS Mortality: An Example from Florida

  • Yu-Wen Chiu

      Affiliations

    • Department of Public and Community Health, University of Maryland, Maryland, USA
    • Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Min-Qi Wang

      Affiliations

    • Department of Public and Community Health, University of Maryland, Maryland, USA
    • ,
  • Hung-Yi Chuang

      Affiliations

    • Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Corresponding Author InformationAddress correspondence and reprint requests to: Dr Hung-Yi Chuang, Department of Community Medicine, Kaohsiung Medical University Hospital, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan
    • ,
  • Chiehwen Ed Hsu

      Affiliations

    • Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • University of Texas School of Health Information Sciences and School of Public Health, UTHSC-Houston, Texas, USA
    • ,
  • Ella T. Nkhoma

      Affiliations

    • Department of Epidemiology, University of North Carolina at Chapel Hill, North Carolina, USA

Received 16 July 2008; accepted 18 November 2008.

Article Outline

The purpose of the present study was to characterize, geographically and temporally, the patterns of acquired immune deficiency syndrome (AIDS) death disparity in 67 Florida jurisdictions, and to determine if the detected trends varied according to age, race, and sex. The space-time scan statistic proposed by Kulldorff et al was used to examine the excess AIDS deaths that occurred between 1987 and 2004. Results were geographically referenced in maps using EpiInfo and EpiMap made available by the Centers for Disease Control. Miami-Dade and the nearby counties including Broward, Martin, and Palm Beach are the most likely clusters (observed/expected: 1505.16) with temporal dimension (also called cluster's age) persisting from 1996 to the present. Union county had the longest cluster for the cluster period 1987–1998, but not for 1999–2004. African-Americans contributed to more clusters compared with whites. Time trends indicated that AIDS mortality peaked in 1995 and then sharply dropped until 1998, when the decrease stopped. By accounting for the temporal dimension of disease clustering, the present study revealed the persistence of geographic clusters, which is not often provided by other geographic detection methods. These findings may be informative for medical resource allocation and better focus public health intervention strategies for AIDS care.

Key Words:  acquired immunodeficiency syndrome , cluster , mortality , spatiotemporal analysis

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PII: S1607-551X(09)70018-X

doi:10.1016/S1607-551X(09)70018-X

Kaohsiung Journal of Medical Sciences
Volume 24, Issue 11 , Pages 568-576, November 2008

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