A double major in biology and sociology, Melissa Lester has assembled extensive data on the social epidemiology of sepsis mortality in Philadelphia. Melissa presented her research findings at the 2011 McNair Scholars Conference in Atlanta, GA.
Abstract: Sepsis is a prevalent, life-threatening disease that has fallen under the radar of the majority of Americans even though it is the 10th leading cause of death in the U.S. Sepsis is a result of an overaggressive response to infection by the immune system potentially leading to death. When cytokines are released into the blood by B cells, vessel dilation and clots are promoted. This leads to organ impairment since blood flow is reduced which can quickly escalate to organ failure. Multiple organ failure results in death. Treatment includes antibiotics to treat infection and oxygen and fluids to restore blood pressure. The infection can be acquired in the community or in the hospital environment.
This research project stems from the ranking of Philadelphia as having the second highest rate of sepsis mortality of large cities. This ranking raises several questions considering Philadelphia is home to several top ranked hospitals. From a sociological perspective, questions including what are the medical factors, what are the social factors, and whether place plays a role were addressed in the study. The research is exploratory in nature and the goal is to determine underlying causes. The background literature was conceptualized as a web of causation of sepsis. The risk factors for sepsis directly were found and then traced back to secondary influences which included municipal laws, the social environment, and the physical environment.
The study design included comparing Philadelphia with another large city, Baltimore, that has a high rate of sepsis mortality and a large city with a low rate of sepsis mortality, San Francisco. Such a comparison would provide insight into the peculiarities of the population affected by sepsis in Philadelphia. The databases provided by the Centers for Disease Control and Prevention were utilized to gather data on the race, age, and sex distribution of sepsis deaths in each city.
The results of the comparison showed that were no large differences in the populations affected by sepsis in Baltimore and Philadelphia. The race, age, and sex distribution for each of the cities were in line with the literature, with older and male populations being most vulnerable. There are most likely several factors that are underlying the high rate of sepsis in Philadelphia. The social factors, however, were not uncovered in this study.
Click below to download her presentation slides and the mortality dataset she assembled.