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Updated: Sep 13, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Incarceration is a key driver of racial disparities in community-associated methicillin-resistant Staphylococcus
Hannah Steinberg1, William Trick2, Chad Zawitz3
1University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI, USA; University of Michigan School of Public Health, Center for Social Epidemiology and Population Health, Ann Arbor, MI, USA.
Purpose:
Describe inequities in community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections and identify social factors contributing to these disparities.
Methods:
We characterized census tract-level risk factors for CA-MRSA infections in the Cook County Health (CCH) catchment population in Cook County, IL from 2009 to 2022 using hierarchical Poisson regression models. We conducted mediation analyses to estimate a) the total risk attributable to and b) proportion of between-tract disparities in CA-MRSA accounted for by census tract-level inequities in risk factors.
Results:
CCH patients living in majority Black census tracts in Cook County had double the rate of CA-MRSA infections as compared to CCH patients living in majority white census tracts. Socio-economic indicators such as public transportation use and the presence of homeless shelters in a census tract were associated with CA-MRSA rates in multivariate analyses. However, jail admission rates explained the largest proportion of CA-MRSA burden (30 %) and racial inequities in CA-MRSA incidence (69 %).
Discussion:
High risks of MRSA infection and colonization have consistently been documented among incarcerated and recently incarcerated individuals. Our results suggest that incarceration may also drive infections among non-incarcerated individuals living in communities with high levels of indirect exposure to jails, especially in majority Black census tracts.
Insights
Racial inequities in community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are linked to socioeconomic factors. Jail admission rates significantly drive CA-MRSA burden and racial disparities, particularly in Black communities.
Area of Science:
- Public Health
- Infectious Diseases
- Health Equity
Background:
- Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections disproportionately affect certain populations.
- Understanding the social determinants of CA-MRSA disparities is crucial for targeted interventions.
Purpose of the Study:
- To describe inequities in CA-MRSA infections within the Cook County Health (CCH) catchment population.
- To identify social factors contributing to observed disparities in CA-MRSA incidence.
Main Methods:
- Hierarchical Poisson regression models were used to analyze census tract-level risk factors for CA-MRSA infections from 2009-2022.
- Mediation analyses quantified the risk attributable to and proportion of disparities explained by census tract inequities.
Main Results:
- Patients in majority Black census tracts had double the CA-MRSA infection rate compared to those in majority White census tracts.
- Socioeconomic indicators like public transportation use and homeless shelters were associated with CA-MRSA rates.
- Jail admission rates explained 30% of the CA-MRSA burden and 69% of racial inequities.
Conclusions:
- Incarceration is a significant driver of CA-MRSA infections and colonization.
- Indirect exposure to jails may contribute to CA-MRSA infections in non-incarcerated individuals, especially in majority Black communities.
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