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Variance in AIDS rates across Norfolk County, Massachusetts can be attributed to multiple factors of racial, ethnic, financial, health, and educational significance. The direct relationship of greater populations having higher instance of AIDS (Figure 1) is a result of the greater frequency of these five factors. To lessen the blow the AIDS epidemic has in any community, it is necessary to investigate which factors correlate the strongest with AIDS rate. For the 25 cities surveyed in Norfolk County, a correlation coefficient (p) of 0.381 or greater suggested a significant correlation (p<0.05).

ECONOMICS

Financial resources greatly determine one’s risk of AIDS for multiple reasons. Poorer communities tend to have high instances of drug rates, as well as fewer economic resources to prevent and treat HIV, and thus higher AIDS rates. The percent of the Norfolk County population living below the poverty level correlated positively (p = 0.789) with the cumulative cases of AIDS per 100,000 people (Figure 4). Even without the two outliers of Brookline, 9.07%, and Quincy 7.14%, the correlation was still significant (p= 0.552). Also, the median household income of a population would also indicate a community’s economic standing, and was correlated to show an inverse relationship with the rate of AIDS (Figure 5).

IMMIGRANTS

A new demographic that is showing high instances of HIV contraction is immigrants. “Statewide, from 2002 to 2004, 785 people born outside the United States were diagnosed with HIV, representing 28 percent of all HIV diagnoses in the Bay State during that period.”¹In Norfolk County, the correlation of AIDS rate to residence of foreign born people was strongly positive (Figure 2). The two outliers of Brookline, 15.02%, and Randolph 8.60% cause a stronger correlation (Table 2), but without them, p= 0.542 (which is still statistically significant). Because developing countries usually have fewer resources to put towards disease prevention, education, and health care, epidemics typically reach deep into the population. Besides what the “American Dream” has to offer a hopeful immigrant – especially a refugee, the US is also better medically equipped than most underdeveloped nations. Thus, communities with more residents that have immigrated (within the past 20 years) would display higher AIDS rates.

EDUCATION

Because disease prevention is mandated by the Massachusetts department of education, those who do not complete their high school education may not have access to the knowledge that could prevent HIV contraction. In the 2000 census, residents of Norfolk County were polled on their highest level of education. Those between the ages of 18 and 24 who had at least begun high school, but did not graduate, surprisingly displayed a negative correlation to AIDS rates (p = -0.408) (Figure 3). Although the percentages were geographically dispersed, most of the high percentages of non-graduates tended to be in the western end of the County (Map 6), farther away from the other risks that are present near the city. When correlating the number of non-graduates with the rural population, the p value displayed a significance of 0.507, denoting a significantly positive correlation. More non-graduates live in rural areas, where the chance of getting AIDS is slim.

STDs

Since certain infectious diseases can transmitted by the same behaviors, they can be indicative of the presence of AIDS in a community. As sexual contact is one of the main sources of HIV contraction, monitoring other sexually transmitted infections would help to forecast the instance of AIDS. For the year of 2005, Syphilis rates turned out to be statistically insignificant in Norfolk County; however, the only town with more than five cases also happened to have the second highest AIDS rate in the county (Table 6). Gonorrhea and Chlamydia rates seemed to correlate quite strongly with AIDS rates, with correlation coefficients of 0.792, 0.645, respectively (Figure 6). The Chlamydia trend was only slightly skewed, by the outlier of Randolph with a rate of 277.8. Without this city, the AIDS rate and Chlamydia rate correlation would have shown a p value of 0.660. The general trend seemed to show that the closer to Boston (shown in Map 1) a city was, the greater the instance of AIDS (Map 3), Gonorrhea (Map 8), and Chlamydia (Map 9).

RACE

Different racial backgrounds have been affected by AIDS at varied levels and for different reasons. Because certain communities in Norfolk County, Massachusetts seem to be racially concentrated, to find out which race has the highest association with AIDS rates, multiple races were correlated. The White alone (one race only) population showed a highly negative, mostly linear relationship with AIDS rates (Figure 7), and a correlation coefficient of -0.696. Whites are the large majority in all cities in Norfolk, County, thus a low incidence of AIDS is not surprising. The Latino or Hispanic population correlated to display a coefficient of 0.387. Besides Whites, this was the lowest correlation among the races, although still significantly positive. Blacks or African Americans alone showed a significant correlation to AIDS Rate (0.401), but this association was largely due to the two outliers with the largest concentration of Black residents: Randolph (20.53%), and Milton (10.03%) (Table 9). Without these cities, the trend was generally flat (Figure 9), with a statistically insignificant p value of 0.316. The Asian alone population exhibited the strongest correlation (p = 0.757), but again there were outliers (Figure 10). Without the three cities with the highest concentrations (Quincy=15.36%, Brookline=12.79%, Randolph= 10.16%) (Table 10) the correlation was significantly weakened (p = 0.149). The rest of the races were correlated into one category of “Other”, and showed a generally steady trend (p = 0.643) (Figure 11).

SUMMARY

Correlations of AIDS rate with demographics within Norfolk County, Massachusetts confirmed that certain groups are more susceptible to the disease than others. Less affluent communities usually received a high incidence of AIDS. Foreign born residents of Norfolk County (immigrating after the outbreak of AIDS) are also more at risk. Although correlations suggested that graduating from high school leads to a higher risk of AIDS, it is more likely that the communities were farther away from risks present near Boston. Also, without graduating from high school, it is possible that most of that population will remain in contact with a generally homogeneous population within their hometowns. Those with sexually transmitted diseases, especially Gonorrhea and Chlamydia, showed a significant rate of AIDS. White residents of Norfolk County displayed a highly negative correlation with AIDS rate, while Hispanic residents showed a significant, but weaker positive association. Asian residents, followed by a weaker correlation of “Other” racial residents, followed by a weaker correlation of Black residents, still exhibited the stronger links with AIDS. Generally, minorities, immigrants, the poor, and those with other sexually transmitted infections are at higher risk of AIDS.