If you could look at a similar Geographic Information Systems (GIS) Map of New Jersey counties that charts Chlamydia infections, you would see intensive clusters centered in urban centers and around major hospitals and few infections in wealthy counties.
Chlamydia is a curable sexually transmitted infection (STI), which is caused by bacteria called Chlamydia trachomatis. You can get genital chlamydial infection during oral, vaginal, or anal sexual contact with an infected partner.
It can cause serious problems in men and women, such as penile discharge and infertility respectively, as well as in newborn babies of infected mothers. Chlamydia is one of the most widespread bacterial STIs in the United States. The Centers for Disease Control and Prevention (CDC) estimates that more than 3 million people are infected each year.
Why are Chlamydia infections clustered in poorer urban areas? Are poor people having more sex and using less protection? No. Why are Chlamydia infections less frequent in middle and upper income counties? Are rich people having less sex and using more protection? No. In New Jersey, Chlamydia infections are, by law, required to be reported.
When your doctor sends your genital swab to a lab and it is discovered you have Chlamydia, the lab must report your infection to the state so it can be logged and tracked in case of an Outbreak. Once your Chlamydia infection is reported to the state, you will get a home visit from state health officials in white van. That home visit will explain why Chlamydia is a notorious and dangerous infection that can have negative long-term effects if left lingering and untreated.
The difference between county Chlamydia infections in New Jersey isn’t about sex or having safe sex. The issue is one of reporting as well as the vast crevasse between those with money and power and influence and those without. People who live in urban areas are generally poorer than those who live in wealthier suburban counties.
The poor usually do not have a primary care physician or health insurance so they are forced seek routine healthcare in hospital emergency departments and when Chlamydia is confirmed, the entire neighborhood knows because the mandatory white van home visit is hard to hide.
If you have money and health insurance and a private doctor — and you shudder at the notion of having an embarrassing white van home visit for your Chlamydia infection — you and your doctor will know exactly what not to ask and what not to say and what not to test in order for that not to happen.
Most doctors, when they see a white discharge oozing from your genitalia, have a pretty good idea you probably have a Sexually Transmitted Infection and they know what medication to prescribe to make it, and any other similar infection you might have, and any subsequent home visit by a white van, go away.
If your doctor doesn’t swab your foaming genitals for lab analysis to confirm a suspicion, a white van cannot be dispatched for a visit. No law is broken because no test was done. The urban poor do not have that kind of inside access to manipulate the legal requirements of the reporting process. Remember when you see reported infections, especially those for Chlamydia and other STIs, you are seeing results skewed in favor of the wealthy and pressed against the poor.
Those manipulated reports are often used to advance public policy and to privately punish communities for being uneducated, immoral and undeserving. When we think about Race and Poverty and Power and Privilege in America we must look beyond skin and salary and wages and direct our attention instead to the prejudicial disparity between communities when it comes to Chlamydia and the white van.
Perhaps then we can begin to comprehend the hidden chasm between people and how even the law may not always do the right thing.