As the rates of sexually transmitted infections, or STIs, continue to rise rapidly across the country, including the Chicago area, it’s black residents in high-poverty areas who are most affected, according to data from local agencies.
Nationally, chlamydia rates have nearly doubled in the past 20 years; gonorrhea rates have increased by nearly 50% in the past decade.
In Chicago, black residents represented 41% of reported chlamydia cases. Among Chicago residents, African Americans were more than twice as likely to report the STI as Latinos, and more than four times as likely as whites, according to 2017 data from the latest Chicago Department of Public Health HIV/STI Surveillance Report.
Similarly, black Chicagoans represented almost 48% of reported gonorrhea cases in the city; they were around four times as likely to report the infection as Latino and white residents.
The community areas with the highest rates of both chlamydia and gonorrhea were North Lawndale and West Garfield Park on the city’s West Side along with Englewood and Riverdale on the city’s South Side. All four communities are predominantly African American and considered low-income areas of high economic hardship.
“A lot of these high-hardship communities have a high burden of all diseases,” said Dr. Julie Morita, commissioner of the Chicago Department of Public Health. “It’s not just STIs, it’s heart disease, lung disease, it’s mental health problems, it’s substance use disorders. That’s not surprising because when you look at contributing factors that impact health overall, things like housing, education, economic development or economic opportunity, all those factors really contribute to how healthy a person is.”
The picture is similar in many suburbs just outside the city, according to the Cook County STI Surveillance 2017 report released earlier this month. According to the data, black residents accounted for about 45% of chlamydia cases and 64% of gonorrhea cases. The report, produced by the county’s department of public health, excludes Chicago, Evanston, Oak Park, Skokie and Stickney Township, which have their own public health agencies.
The infection rates were far higher for black residents than they were for white residents — 10 times higher for chlamydia and more than 20 times higher for gonorrhea — according the report from the county’s public health department. Some of the highest rates of both STIs were in villages like Maywood, McCook, Robbins, and Sauk Village, suburbs in the western and southern parts of Cook County.
Stemming the rise of these two infections is a “top priority” at the county, according to Dr. Terry Mason, chief operating officer for the Cook County Department of Public Health. He cited a lack of access to adequate health care as one of the issues plaguing black residents reporting STIs.
“Many of these things are situated in areas where there are not a lot of resources,” Mason said. “When we get these STI reports, many of those are coming from emergency rooms, which are exactly the wrong places for these things to be treated.”
Morita said the uptick, both nationally and locally, is due to the decrease in federal funds, over many decades, for both clinics and awareness campaigns. Mason added that a “highly sexualized culture” and the rise of dating apps might also contribute to the record-breaking STI rates, although those factors are not specific to low-income communities.
Neil Rana, the Health Equity manager at the National Coalition of STD Directors in Washington, D.C., said that a lack of understanding and sensitivity from health care providers also contributes to the problem — be it with low-income patients, youth, minorities, or LGBTQ communities.
“A lot of these health care providers might not be culturally competent,” Rana said. “They might contribute to a sense of internalized oppression and just kind of foster a sense of uncomfortability that a lot of these communities experience when they’re going to receive care.”
For its part, Cook County’s public health department hosted a free STI screening in Forest Park in March, with more such events to be announced in coming months. Mason said making them available during weekends and evenings is key to reaching low-income populations.
In addition, the county’s public health department launched an STD awareness campaign this month via social media, according to spokesperson Kimberley Conrad Junius. The Centers for Disease Control has declared April as STD Awareness Month, as well as National Minority Health Month.
Morita, of Chicago’s department of public health, said the city is in the process of hiring a medical director who will focus on HIV and STI care and prevention. She also said the department has partnered with Chicago Public Schools to reach young people in high-hardship communities, since patients between the ages of 13 and 29 accounted for more than 70% of all chlamydia and gonorrhea cases.
If left untreated, STIs can cause serious complications, especially for women and babies, Mason warned. “The damage they can cause, and the relationship to future issues for women particularly around sterility with infected tubes, or whether there’s a relationship with that and some of the low birthweight babies or preterm labors that were seeing.”
Experts said that gonorrhea has, over time, become increasingly resistant to antibiotics. And, with these STIs often being asymptomatic, they said the only way to confirm infection is to get tested.
“You can have an STD and you might not know it — and you might not ever know it, until you get tested,” Rana said.
Esther Yoon-Ji Kang is a reporter for WBEZ’s Race, Class and Communities desk. Follow her on Twitter at @estheryjkang.