Influenza hospitalization rates are independently associated with neighborhood-level socioeconomic measures, suggesting that vaccination efforts in high-poverty areas might be effective, according to a study presented at IDWeek 2016.1

Rameela Chandrasekhar, PhD, assistant professor of biostatistics at the Vanderbilt University School of Medicine in Nashville, Tennessee, and colleagues analyzed data from 34,386 hospitalizations that occurred during the 2009-2010 through the 2013-2014 influenza seasons using the Influenza Hospitalization Surveillance Network. “Cases were geocoded, matched to census tracts (CT), and joined with the corresponding CT socioeconomic measures data from the American Community Survey,” the researchers noted. Influenza hospitalization rates and socioeconomic measures were evaluated by looking at people living below the poverty level, population density, female head of household, and household crowding, as well as individual age, race, gender, and ethnicity.

Except for population density, all socioeconomic measures were significantly associated with influenza hospitalizations.  Adults 65 years of age and older had the highest adjusted odds ratio (OR) of 9.3 (95% confidence interval [CI]: 8.8-9.7) vs children aged 5 to 17 years. Compared with whites, African Americans had an adjusted OR of 1.7 (95% CI: 1.6-1.72).

Residing in a community in which more than one-fifth of the population lives below the poverty level was associated with a greater risk of influenza hospitalization compared with those communities in which <5% of the population lives below the poverty level (adjusted OR, 1.3; 95% CI: 1.1-1.4). Those living in communities with >40% vs <20% of households being headed by a woman were also at greater risk (adjusted OR, 1.3; 95% CI: 1.2-1.4), as were those communities in which the average resident resided with >5 persons per room (adjusted OR, 1.2; 95% CI: 1.1-1.3).


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In order to reduce high morbidity and mortality due to influenza hospitalizations, “targeted vaccination efforts may be useful in high-poverty census tracts,” the researchers concluded.

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Reference

  1. Chandrasekhar R, Sloan C, Mitchel Jr E, et al. Social determinants of influenza hospitalization in the United States. Presented at: IDWeek 2016. New Orleans, LA; October 26-30, 2016. Abstract 1740.