Dataset Information

Racial and Ethnic Disparities in Influenza Vaccination among Adults with Chronic Medical Conditions Vary by Age in the United States.

ABSTRACT:

Background

People living with chronic health conditions exhibit higher risk for developing severe complications from influenza according to the Centers for Diseases Control and Prevention. Although racial and ethnic disparities in influenza vaccination have been documented, it has not been comprehensively determined whether similar disparities are present among the adult population with at least one such condition.

Objective

To study if racial and ethnic disparities in relation to influenza vaccination are present in adults suffering from at least one chronic condition and if such inequalities differ between age groups.

Methods

The Medical Expenditure Panel Survey (2011-2012) was used to study the adult population (age ?18) who had at least one chronic health condition. Baseline differences in population traits across racial and ethnic groups were identified using a chi-square test. This was conducted among various age groups. In addition, survey logistic regression was utilized to produce odds ratios of receiving influenza vaccination annually between racial and ethnic groups.

Results

The total sample consisted of 15,499 adults living with at least one chronic health condition. The numbers of non-Hispanic whites (whites), non-Hispanic blacks (blacks), and Hispanics were 8,658, 3,585, and 3,256, respectively. Whites (59.93%) were found to have a higher likelihood of self-reporting their receipt of the influenza vaccine in comparison to the black (48.54%) and Hispanic (48.65%) groups (P<0.001). When examining persons aged 50-64 years and ?65 years, it was noted that the black (54.99%, 62.72%) and Hispanic (53.54%, 64.48%) population had lower rates of influenza vaccine coverage than the white population (59.22%, 77.89) (both P<0.0001). No significant differences between whites and the blacks or Hispanics were found among the groups among adults between 18 and 49 inclusive (P>0.05). After controlling for patient characteristics, the difference in influenza vaccine coverage between whites and the minority groups were no longer significant for adults aged 50-64 years. However, the difference were still statistically significant for those aged ?65 years.

Conclusions

In the United States, there are significant disparities in influenza vaccination by race and ethnicity for adults over 65 years with at least one chronic health condition. Future research is needed to help develop more targeted interventions to address these issues and improve influenza vaccination rates.

SUBMITTER: Lu D

PROVIDER: S-EPMC5231366 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Racial and Ethnic Disparities in Influenza Vaccination among Adults with Chronic Medical Conditions Vary by Age in the United States.

Lu Degan D Qiao Yanru Y Brown Natalie E NE Wang Junling J

PloS one 20170112 1

<h4>Background</h4>People living with chronic health conditions exhibit higher risk for developing severe complications from influenza according to the Centers for Diseases Control and Prevention. Although racial and ethnic disparities in influenza vaccination have been documented, it has not been comprehensively determined whether similar disparities are present among the adult population with at least one such condition.<h4>Objective</h4>To study if racial and ethnic disparities in relation to ...[more]

PMID: 28081234

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Project description:BackgroundThere exist racial and ethnic disparities in the prevalence of chronic medical illnesses. However, it is unclear if the disparities arise from patients' self-reported estimates on these diseases and whether there is an association between healthcare utilization and diagnosis.ObjectiveTo estimate national racial/ethnic prevalence of undiagnosed hypertension, diabetes, high cholesterol, and kidney disease and identify characteristics associated with undiagnosed diseases.DesignRetrospective analysis of multi-year survey data.ParticipantsAdults 18 years and older who participated in the National Health and Nutrition Examination Survey during 2011-2014 (n = 10,403).Main outcomesUndiagnosed hypertension (SBP ≥ 140 or DBP ≥ 90 on physical examination with no history of hypertension), undiagnosed diabetes (hgba1c ≥ 6.5% with no history of diabetes), undiagnosed high cholesterol (LDL ≥ 160 mg/dL with no history of high cholesterol), and undiagnosed kidney disease (eGFR ≤ 30 with no history of kidney disease).ResultsThe study sample was categorized into Whites, Blacks, Hispanics, Asians, and Other. After adjusting for sociodemographic characteristics, Asians had increased odds of undiagnosed hypertension (OR = 1.41 [1.06-1.86]) and diabetes (OR = 6.16 [3.76-10.08]) compared to Whites. Blacks (OR = 2.53 [1.71-3.73]) and Hispanics (OR = 1.88 [1.19-2.99]) had increased odds of undiagnosed diabetes compared to Whites. Multivariate logistic regression analysis indicated that not having any health insurance was associated with increased odds of undiagnosed diabetes and hyperlipidemia (OR = 1.56 [1.00-2.44] and OR = 2.08 [1.44-3.00], respectively). A recent healthcare visit was associated with a lower likelihood of having undiagnosed hypertension (OR = 0.58 [0.41-0.83]) and diabetes (OR = 0.35 [0.18-0.69]).ConclusionsIn a nationally representative cohort, Asians had higher rates of undiagnosed hypertension and diabetes, and all minorities were more likely to have undiagnosed diabetes compared to Whites. Healthcare utilization was associated with undiagnosed medical conditions. Our study showed that reliance on self-reported data may systemically underestimate the prevalence of chronic illnesses among minorities and further research is needed to understand the significance of healthcare utilization in health outcomes.

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Dataset Information

Racial and Ethnic Disparities in Influenza Vaccination among Adults with Chronic Medical Conditions Vary by Age in the United States.

Background

Objective

Methods

Results

Conclusions

Publications

Racial and Ethnic Disparities in Influenza Vaccination among Adults with Chronic Medical Conditions Vary by Age in the United States.

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