Racial and Ethnic Disparities in Influenza Vaccination among Adults with Chronic Medical Conditions Vary by Age in the United States.
Racial and Ethnic Disparities in Influenza Vaccination among Adults with Chronic Medical Conditions Vary by Age in the United States.
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美国患有慢性疾病的成年人在流感疫苗接种方面的种族和民族差异因年龄而异
DOI：
10.1371/journal.pone.0169679
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Wang J
中科院分区：
文献类型：
--
作者：
Lu D;Qiao Y;Brown NE;Wang J
根据疾病控制和预防中心的数据，患有慢性健康状况的人患流感严重并发症的风险更高。虽然流感疫苗接种的种族和民族差异已被记录在案，但尚未全面确定至少有一种此类疾病的成年人群中是否存在类似的差异。目的研究在患有至少一种慢性疾病的成年人中是否存在与流感疫苗接种相关的种族和民族差异，以及这种不平等在年龄组之间是否存在差异。方法采用2011-2012年医疗费用追踪调查方法，对至少患有一种慢性疾病的18岁以上成年人群进行调查。使用卡方检验确定不同种族和民族群体特征的基线差异。这是在不同年龄组中进行的。此外，调查逻辑回归用于产生种族和民族之间每年接受流感疫苗接种的比值比。总样本包括15，499名至少患有一种慢性健康状况的成年人。非西班牙裔白人（白人）、非西班牙裔黑人（黑人）和西班牙裔的人数分别为8，658、3，585和3，256。白人（59.93%）自我报告接种流感疫苗的可能性高于黑人（48.54%）和西班牙裔（48.65%）（P<0.001）。当检查50-64岁和≥65岁人群时，注意到黑人（54.99%，62.72%）和西班牙裔（53.54%，64.48%）人群的流感疫苗接种率低于白色人群（59.22%，77.89）（均P<0.0001）。在18 ~ 49岁成人组中，白人与黑人、西班牙裔之间无显著性差异（P>0.05）。在控制了患者特征后，白人和少数群体之间的流感疫苗覆盖率差异对于50-64岁的成年人不再显着。然而，对于年龄≥65岁的患者，差异仍具有统计学显著性。结论：在美国，65岁以上至少有一种慢性健康状况的成年人在流感疫苗接种方面存在明显的种族和民族差异。未来的研究需要帮助开发更有针对性的干预措施来解决这些问题并提高流感疫苗接种率。
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.