Project By: Rae Mann, Caroline Roberts, and Meredith Moore
Back in February, Dr. Peterson brought to our attention the daunting numbers of sexually transmitted diseases contracted within our population. These diseases include but are not limited to Chlamydia, Syphilis, and Gonorrhea. According to the Centers for Disease Control, “nearly 20 million new sexually transmitted infections” occur within the United States each year. While these numbers within themselves are a cause for concern, it is more interesting to note that a large number of these infections occur within the age range of 15-24 years old. Research from the Centers for Disease Control shows that 1 in 4 adolescent females currently possess an STD. Statistically, the Southern region of the United States has the highest number of reported STD cases according to the latest findings from the Centers of Disease Control. These numbers are especially high in the Center of Disease Control’s “HHS Region #4” which includes: Alabama, Mississippi, Georgia, Florida, Kentucky, North Carolina, South Carolina, and Tennessee. But why is this?
We chose to focus on one sexually transmitted disease, Chlamydia, in order to take a closer look at what might be contributing to the overwhelming and increasing numbers of the young adult population contracting these easily preventable infections.We chose to compare the following possible contributing factors within our select states to an overall look at the rest of the United States: access to healthcare, insurance coverage, required sexual education, required STD and HIV/Aids education, permission to be tested and or treated for an STD, poverty, unemployment, and dropout rates. Maps illustrating the rate of Chlamydia cases in both age ranges are provided below:
- Chlamydia Rates Ages 20-24
Link to maps in Google Fusion Tables:
“C. trachomatis infection is the most commonly reported notifiable disease in the United States. It is among the most prevalent of all STDs.” (CDC) Reported cases alone number well over 1.4 million new cases in 2013(CDC). Chlamydia can be diagnosed using a diagnostic test such as Nucleic Acid Amplification Test or a Cell Culture. Due to Chlamydia’s bacterial nature, it can be treated with a round of antibiotic treatment and a period of sexual abstinence. Antibiotics typically prescribed include: amoxicillin, azithromycin, doxycycline, levofloxacin. These medications range in price from $4 to $18 depending on which pharmacy the patient utilizes. STD testing prices differ based on location. Free or low cost testing can be secured at free health clinics. Other clinics can charge a testing fee and lab fee ranging up to $200. Most of these tests are filed with health insurance. Map illustrating the ratio of population to the number of free health clinics and the state percentage without healthcare coverage are provided below:
- Ratio of Free Health Clinics versus Population
- Percent of the Population without Health Insurance
Link to map in Google Fusion Tables:
Ratio of Population to Free Health Clinics
Percentage of Population Without Insurance
After taking the maps into close consideration, a clear connection can be made between the states with fewer free health clinics and states with the high rates of lack of insurance. The states with low free health clinic rates and high lack of insurance rates are also the states that have high rates of Chlamydia, like Alabama, Florida, and Georgia.
Required sexual education in the public school setting has been a heated debated in the late couple of years. Currently only 22 out of the 50 states require mandatory sexual education in the public school setting. It is often stated that more open discussion around the topic of sex will increase the number of teenagers having sexual intercourse. A poll conducted by the National Public Radio concludes that 55% of parents believe that increased sexual education will not lead to more sexual intercourse while 37% believe that increased sexual education will lead to increased sexual intercourse. Yet, according to a recent survey conducted by the Centers for Disease Control, 47.7% of teenagers are sexually active. 41% percent of that same population report that the last time that they had sexual intercourse they did not use a condom. Only 22% have ever been tested for an STD. With these staggering numbers in mind, parents report that their main concern for their teens is their involvement with alcohol and drugs (48%) not STDs (4%). One does not have to be a legal adult to purchase a condom in any state. All sexaully active young adults should be using condoms to prevent STDs and HIV/AIDS. This is why sexual education and STD and HIV/AIDS education is crucial for a young person to fully understand how to stay safe. There are maps below illustrating the states requiring sexual education, states requiring HIV/AIDS and STD education, and states requiring parental permission to be tested for an STD or HIV/AIDS.
Link to maps in Google Fusion Tables:
Required Sexual Education in Public Schools
Required HIV/AIDS and STD Education in Public Schools
Parental Requirements for HIV/AIDS and STD Testing
When looking at the maps, it helps to take notice of which states offer sexual education and ones who do not, especially the Southern states we are focusing on. Kentucky, Georgia, Florida, North Carolina, South Carolina, and Tennessee all require sexual education in their school systems. Alabama and Louisiana do not require sexual education. Mississippi is the only state to require abstinence-only education. Florida, Mississippi, and Louisiana do not require STD and HIV/AIDS education. Alabama, Kentucky, Georgia, North Carolina, South Carolina, and Tennessee all require STD and HIV/AIDS education. It is interesting to compare and contrast each states state requirements. Why do some states require sexual education but not STD and HIV/AIDS education and vice versa? For instance, Alabama does not require sexual education but it does require STD and HIV/AIDS education. How are students supposed to properly learn about STDs like chlamydia if they haven’t had the proper education on how to contract such a disease in the first place? And then there are states like Florida who do require sexual education, but not STD and HIV/AIDS education. What’s the benefit to learning about sex, if students don’t also learn about the possible consequences as well? These are some questions to consider when analyzing the STD rates in the South. In the South, Mississippi is the only state that does require parental permission to get tested for STD and HIV/AID testing. The rest of the states don’t require permission but the states do vary in whether the doctor may be allowed to notify a parent. These requirements could in fact affect whether an adolescent or young adult would want to get tested or not. Many households in the South have extremely traditional values, and if a young adult is more concerned with pleasing their parents, they may put off getting tested altogether to avoid their parents finding out.
The poverty line for a single person is currently $11,770 and for a family of four it is $24,250. In 2013, 45. 3 million people lived in poverty in the United States. That is roughly 14% of the population. Most of these people live in what is considered a “poverty area.” These areas are where 20% or more of population is currently at or below the poverty line. The Huffington Post reports that 25.7% of American currently reside in a poverty area. 30.8% of the southern United States currently reside in a poverty area in 2010 which is up from the 21.8% in 2000. PBS recently conducted a study that finds that 30.8% of high school dropouts live in poverty. The large percentages of people residing within the HHS Region # 4 without health insurance coupled with the less than optimal distribution of free health clinics point to the possible influence of socioeconomic factors such as poverty, unemployment, and high school dropout rates. Therefore, maps illustrating poverty, unemployment, and high school dropout rates are provided below:
Links to the maps in Google Fusion Tables:
The poverty and unemployment data represented in the maps are continuous with the highest rates of chlamydia represented in both the 15-19 and 20-24 year old maps especially in Alabama, Mississippi, Tennessee, Georgia, Louisiana, and South Carolina. It is more difficult to create a direct link between the dropout rates and the chlamydia rates. However, it is evident that there is both increased dropout rates and chlamydia in Mississippi. This comparison in data points to the relationship between socioeconomic factors especially poverty and unemployment and increased rates of sexually transmitted disease within the southern United States.
These maps indicate that there are a host of social, cultural, and economic factors that could contribute to the higher STD rates amongst young people living in the southern United States. There is no one concrete answer that can be derived. Rather, it is a combination of the above mentioned factors in each individual state as well as factors that we may have overlooked in our research.
Research Derived from the Following Sites:
- National Public Radio
- Centers of Disease Control
- Sex. Etc.
- Huffington Post
- Rural Assistance Center
- PBS