Presenting author: Erica E. Smith, MPH, Drexel University Urban Health Collaborative

Abstract

Background: Nontyphoidal Salmonella spp. and Campylobacter spp. are major causes of acute gastroenteritis, causing an estimated 1,000,000 and 850,000 illnesses annually in the United States, respectively. Recent reports indicate infections associated with contaminated fresh produce items are being recognized more frequently. Fresh, healthy foods are an important part of eating a healthy diet, but limited access to contaminated fresh produce may actually reduce the risk of contracting foodborne illness from these sources.

Objectives: The purpose of this study was to compare the spatial distribution by urbanicity of reported Salmonella and Campylobacter infections with measures of food access and household income in Pennsylvania.

Methods: Mean reported annual crude county rates of reported Salmonella and Campylobacter infections were calculated during 2001-2015. Measures of food access and household income were compared. Measures were contrasted in rural and urban Pennsylvania census tracts.

Results: The statewide mean rate of Salmonella (14 cases/100,000) was lower than Campylobacter (16 cases/100,000). Categorized mean Campylobacter rates were significantly higher in rural counties (Fisher’s exact p-value = 0.0043). Urban tracts were significantly more likely to have low food access and be low income (Chi-squared p-values < 0.0001). City centers of both Philadelphia and Pittsburgh appeared less likely to be low food access than outlying areas.

Implications:Higher rates of Campylobacter, an important enteric pathogen, were identified in rural areas of Pennsylvania, where food access was significantly greater than in urban areas. The complex relationship between food access and household income in rural and urban areas suggests differential public health approaches may be useful.

Authors: Erica E. Smith, MPH