Geographic Variation of Amyotrophic Lateral Sclerosis Incidence in New Jersey, 2009-2011

Kevin A. Henry, Jerald Fagliano, Heather M. Jordan, Lindsay Rechtman, Wendy E. Kaye

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations

Abstract

Few analyses in the United States have examined geographic variation and socioeconomic disparities in amyotrophic lateral sclerosis (ALS) incidence, because of lack of population-based incidence data. In this analysis, we used population-based ALS data to identify whether ALS incidence clusters geographically and to determine whether ALS risk varies by area-based socioeconomic status (SES). This study included 493 incident ALS cases diagnosed (via El Escorial criteria) in New Jersey between 2009 and 2011. Geographic variation and clustering of ALS incidence was assessed using a spatial scan statistic and Bayesian geoadditive models. Poisson regression was used to estimate the associations between ALS risk and SES based on census-tract median income while controlling for age, sex, and race. ALS incidence varied across and within counties, but there were no statistically significant geographic clusters. SES was associated with ALS incidence. After adjustment for age, sex, and race, the relative risk of ALS was significantly higher (relative risk (RR) = 1.37, 95% confidence interval (CI): 1.02, 1.82) in the highest income quartile than in the lowest. The relative risk of ALS was significantly lower among blacks (RR = 0.57, 95% CI: 0.39, 0.83) and Asians (RR = 0.63, 95% CI: 0.41, 0.97) than among whites. Our findings suggest that ALS incidence in New Jersey appears to be associated with SES and race.

Original languageEnglish
Pages (from-to)512-519
Number of pages8
JournalAmerican Journal of Epidemiology
Volume182
Issue number6
DOIs
StatePublished - May 4 2015
Externally publishedYes

Keywords

  • Amyotrophic lateral sclerosis
  • disease mapping
  • spatial analysis

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