(P190) STAFFING AND BUDGET LEVELS FOR LOCAL STD PROGRAMS BY COUNTY-LEVEL SOCIODEMOGRAPHIC CHARACTERISTICS

Background:
While resource changes in sexually transmitted disease (STD) programs have occurred across the United States, it is unclear whether the changes differ in areas that serve populations facing socioeconomic disadvantage. Identifying whether certain population-level sociodemographic characteristics are correlated with changes in STD program resources may help inform STD program and policy decisions. We examined the relationship between STD program staffing and budget levels at local health departments and their county-level sociodemographic composition in 2020.

Methods:
Data from the 2021 STD Local Health Department (LHD) Infrastructure Survey and the 2020 CDC/ATSDR Social Vulnerability Index were used. The primary outcomes were whether a LHD had: 1) any staffing cuts to its STD program, and 2) any budget cuts to its STD program in 2020. County-level sociodemographic independent variables included two indicators for racial/ethnic minority status (non-Hispanic Black/African American, Hispanic/Latino), five indicators for socioeconomic status (poverty, unemployment, uninsurance, education, housing cost burden), and one indicator for household characteristics (single-parent household status). Covariates included region, jurisdiction size, and whether staff were diverted for the COVID-19 response. An adjusted logistic regression model assessed associations between STD program resource cuts and sociodemographic variables and covariates.

Results:
Higher percentage of Hispanic/Latino population (OR=1.1; 95% CI: 1.0, 1.2) and lower percentage of the population with no high school diploma (OR=0.68; 95% CI: 0.48, 0.97) within a jurisdiction were associated with STD program budget cuts at LHDs. No county-level sociodemographic characteristics were associated with STD program staffing cuts at LHDs.

Conclusion:
Understanding how STD program resources align with sociodemographic disparities can help identify factors to focus on when managing limited resources, particularly during public health emergencies such as the COVID-19 pandemic. This analysis provides a framework that LHDs may wish to consider on how resource allocation and emergency responses may impact community-level STD disparities.