Cases for three sexually transmitted diseases in Alabama are nearly double the national average.
The diseases are chlamydia, gonorrhea and syphilis.
According to the Alabama Department of Public Health, the statewide rate is about 1.8 times higher than the national rate.
Madison County Health Officer Lawrence Robey said it's often the poorer counties that suffer the most.
He said residents in poorer communities are at greater risk to contract and transmit STDs because of substandard public education and transportation. Robey also cited smaller tax bases to pay for medical centers and doctors.