Does investing in education reduce STI risk in California?
Introduction
The objective of this post is to analyze the impact of education investment in California counties from 2003-2020 to determine if increased education funding correlates with a decrease in sexually transmitted infection (STI) infection rates.
More specifically, I'll be analyzing the following STIs: Chlamydia, Gonorrhea, and Syphilis. I chose these because they are curable and they account for more than $1.1 billion in direct medical care costs for the US government.
Although these STIs are treatable, if left untreated, they can lead to severe complications, including death.
Please see my Github repo for details on the code details.
Data
Three distinct datasets were used, all obtained from the California Health and Human Services Open Data Portal (https://data.chhs.ca.gov):
I. Incidence of Gonorrhea, Syphilis, and Chlamydia cases among males and females in California counties (excluding San Francisco) spanning 2001 to 2020 and the rate of infection out of 1000 people
II. Comprehensive county expenditure information across various sectors, encompassing education, spanning 2003 to 2020.
III. County Federal Information Processing Standards (FIPS) codes.
Charting cases
Growing cases
As we can see, while the cases of all three diseases shows an upward trend, Chlamydia consistently tops the charts as the most prevalent and highly infectious disease over the years.
Approximately only 20% of the time over the span of 18 years, there was a decrease in STI infections. In 2020 the number of cases decreased. This was likely due to people refraining from socializing and coming into close contact with people during COVID-19
Rates by gender
Women are at a greater risk group for these STI infections.
Chlamydia itself isn’t fatal, but if it damages a woman's fallopian tubes, leading to an ectopic pregnancy, the fallopian tube can rupture, causing internal bleeding and death if not treated promptly.
STI by County
Chlamydia has the highest rate, and as seen above, some counties have an infection rate higher than 1% for the female population.
Investment in education
The investment in education has risen considerably in the last years.
Conclusion Investment in education X STI cases
The box plot above shows the correlation between education investment and STI rates among counties between 2003 and 2020. Despite increased investment in education over the years, STI spread in California remained unchecked.
Finally, for the year 2019, the projected infection rates for each infection in different counties of California are shown. As seen above, the highlighted county has a high infection rate for all three infections. That county is none other than Los Angeles, a state with a soaring infection rate despite significant investments in education.
As Leandro Mena, MD, MPH, Director of CDC’s Division of STD Prevention, observed in a 2023 release concerning the growing number of people infected with STIs : “The U.S. sexually transmitted infection (STI) epidemic shows no signs of slowing down. The reasons for the ongoing increases are complex – and so are the solutions”
Future work
For future work I would seek out answers to these questions:
•Why do some counties have such a large rate of infected people compared to others?
•What specific type of investment in education can help to prevent STI?
•What specifically influences a person to be safe in sexual activities?
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