Social determinants of influenza hospitalization in the United States.
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ABSTRACT: Background
Influenza hospitalizations result in substantial morbidity and mortality each year. Little is known about the association between influenza hospitalization and census tract-based socioeconomic determinants beyond the effect of individual factors.Objective
To evaluate whether census tract-based determinants such as poverty and household crowding would contribute significantly to the risk of influenza hospitalization above and beyond individual-level determinants.Methods
We analyzed 33 515 laboratory-confirmed influenza-associated hospitalizations that occurred during the 2009-2010 through 2013-2014 influenza seasons using a population-based surveillance system at 14 sites across the United States.Results
Using a multilevel regression model, we found that individual factors were associated with influenza hospitalization with the highest adjusted odds ratio (AOR) of 9.20 (95% CI 8.72-9.70) for those ?65 vs 5-17 years old. African Americans had an AOR of 1.67 (95% CI 1.60-1.73) compared to Whites, and Hispanics had an AOR of 1.21 (95% CI 1.16-1.26) compared to non-Hispanics. Among census tract-based determinants, those living in a tract with ?20% vs <5% of persons living below poverty had an AOR of 1.31 (95% CI 1.16-1.47), those living in a tract with ?5% vs <5% of persons living in crowded conditions had an AOR of 1.17 (95% CI 1.11-1.23), and those living in a tract with ?40% vs <5% female heads of household had an AOR of 1.32 (95% CI 1.25-1.40).Conclusion
Census tract-based determinants account for 11% of the variability in influenza hospitalization.
SUBMITTER: Chandrasekhar R
PROVIDER: S-EPMC5720587 | biostudies-literature | 2017 Nov
REPOSITORIES: biostudies-literature
Publications
Social determinants of influenza hospitalization in the United States.
Chandrasekhar Rameela R Sloan Chantel C Mitchel Edward E Ndi Danielle D Alden Nisha N Thomas Ann A Bennett Nancy M NM Kirley Pam D PD Hill Mary M Anderson Evan J EJ Lynfield Ruth R Yousey-Hindes Kimberly K Bargsten Marisa M Zansky Shelley M SM Lung Krista K Schroeder Monica M Monroe Maya M Eckel Seth S Markus Tiffanie M TM Cummings Charisse N CN Garg Shikha S Schaffner William W Lindegren Mary Lou ML
Influenza and other respiratory viruses 20171006 6
<h4>Background</h4>Influenza hospitalizations result in substantial morbidity and mortality each year. Little is known about the association between influenza hospitalization and census tract-based socioeconomic determinants beyond the effect of individual factors.<h4>Objective</h4>To evaluate whether census tract-based determinants such as poverty and household crowding would contribute significantly to the risk of influenza hospitalization above and beyond individual-level determinants.<h4>Met ...[more]
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