Archive | December 3, 2010

Jesus Can’t Even Help Us: HIV in Mississippi

Most people who know me know that I grew up in Mississippi. Everyone who knows that I grew up in Mississippi knows the extent of my disdain for the place. However, I’m thankful for having had the experience, as it has informed much of the kind of person I’ve become, for better or worse. It’s a place filled with incredible challenges and problems, economic inequality is incredible and those on top aren’t interested in the problems of those on bottom. Compound this with a bloody and inexcusable history of slavery, human trafficking, lynchings and hate motivated violence that extended even to my lifetime and you might conclude that Mississippi is an extension of Africa. All of this lined along a background Muzak of Jesus, hellfire and unattainable moral standards that few people actually adhere to. My assessments might seem unfair, but it’s worth mentioning that they are largely fueled through my childhood and high school eyes, rather than adult reason.

Mississippi is already a hotspot for STI’s, with infection rates dwarfing many other states in the union, often on par with those of developing countries. People still die of syphilis in Mississippi in 2010. Low insurance coverage among the largely African American poor, distrust in medical professionals through the fault of exploitative and unforgivable events such as the famed Tuskegee syphilis study, lack of education, lack of political will and political representation create conditions that fuel the spread of a host of infectious diseases, not the least of which is HIV.

HIV is hitting the American South at levels not seen in any other part of the country, outside of Washington, D.C. Most people living with HIV are heterosexual African American men, and African American women aren’t far behind. Mississippi jails more people per capita than any other state besides Louisiana, Georgia and Texas. Incarcerations among African American men are common in the South, often under reprehensible conditions that facilitate HIV transmission. Couple that with social conditions that are unfathomable in other parts of the country (outside of Native American reservations), and it’s easy to see why it’s so bad.

I pulled a table of county level HIV data for Mississippi of of the Mississippi State Department of Health website and fed it into ArcGIS to produce the map above. Logically, population centers produce the largest number of overall cases. However, adjusted rates indicate that the large urban centers (of which there aren’t that many), are not the places facing the highest overall spread of the disease, but rather areas along the Mississippi Delta and traditionally African American counties proximal to Hinds (where Jackson is) are.

A Getis-Ord hot spot analysis finds areas that deviate greatly from the overall mean, both above and below. Basically, it points out areas where the outcome is extreme, relative to everyone else. An analysis of HIV rates for Mississippi counties confirms the existence of areas of extreme concern, when accounting for neighbor effects and overall mean rates. From this, we conclude that rural Holmes and Leflore counties in the middle of the state are by far the worst. While counties in the north and northeast are disproportionately low, these counties west and north of Hinds are of incredible concern. I’ve been to these places. I don’t find this results surprising. I also don’t find it surprising that very few people care.

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