Community-Level Patterns in Lyme Disease Incidence Among Medicare and Medicaid Beneficiaries

Despite Lyme disease’s (LD) status as the most common vector borne disease in the United States, relatively little attention has been paid to the demographic characteristics of LD patients or health disparities among them. Using administrative claims for Medicare and Medicaid, two large public health insurance programs, we calculate the incidence of LD within strata of a variety of social determinants of health (SDoH) among beneficiaries living in high incidence LD states. Our findings focus principally on two critical causes of disparities, socioeconomic status and racial residential segregation. We find that distinct patterns in LD incidence exist across these strata for both Medicare and Medicaid beneficiaries who had LD between 2016 and 2021. LD rates are highest in areas with low levels of socioeconomic inequality and racial residential segregation. When positioned against other data in the literature, we argue that these findings may reflect access to health care or inadequate recognition of LD symptoms for patients from particular communities.