Racial/Ethnic Disparities in Influenza Vaccination of Chronically Ill US Adults

Objective: Although research suggests racial/ethnic disparities in influenza vaccination and mortality rates, few studies have examined racial/ethnic trends among US adolescents. We used national cross-sectional data to determine (1) trends in influenza vaccination rates among non-Hispanic white (hereinafter, white), non-Hispanic black (hereinafter, black), and Hispanic adolescents over time and (2) whether influenza vaccination rates among adolescents varied by race/ethnicity. Methods: We analyzed provider-reported vaccination histories for 2010-2016 from the National Immunization Survey–Teen. We used binary logistic regression models to determine trends in influenza vaccination rates by race/ethnicity for 117 273 adolescents, adjusted for sex, age, health insurance, physician visit in the previous 12 months, vaccination facility type, poverty status, maternal education level, children in the household, maternal marital status, maternal age, and census region of residence. We calculated adjusted probabilities for influenza vaccination for each racial/ethnic group, adjusted for the same demographic characteristics. Results: Compared with white adolescents, Hispanic adolescents had higher odds (adjusted odds ratio [aOR] = 1.11; 95% confidence interval [CI], 1.06-1.16) and black adolescents had lower odds (aOR = 0.95; 95% CI, 0.90-1.00) of vaccination. Compared with white adolescents, Hispanic adolescents had significantly higher adjusted probabilities of vaccination for 2011-2013 (2011: 0.22, P < .001; 2012: 0.23, P < .001; 2013: 0.26, P < .001). Compared with white adolescents, black adolescents had significantly lower probabilities of vaccination for 2016 (2016: 0.21, P < .001). Conclusions: Targeted interventions are needed to improve adolescent influenza vaccination rates and reduce racial/ethnic disparities in adolescent vaccination coverage.

Download Full-text

Decomposing racial/ethnic disparities in influenza vaccination among the elderly

Vaccine ◽

10.1016/j.vaccine.2015.03.054 ◽

2015 ◽

Vol 33 (26) ◽

pp. 2997-3002 ◽

Cited By ~ 11

Author(s):

Byung-Kwang Yoo ◽

Takuya Hasebe ◽

Peter G. Szilagyi

Keyword(s):

Influenza Vaccination ◽

Ethnic Disparities ◽

The Elderly ◽

Racial Ethnic

Download Full-text

Trends in racial/ethnic disparities in influenza vaccination coverage among adults during the 2007-08 through 2011-12 seasons

American Journal of Infection Control ◽

10.1016/j.ajic.2014.03.021 ◽

2014 ◽

Vol 42 (7) ◽

pp. 763-769 ◽

Cited By ~ 36

Author(s):

Peng-Jun Lu ◽

Alissa O'Halloran ◽

Leah Bryan ◽

Erin D. Kennedy ◽

Helen Ding ◽

...

Keyword(s):

Influenza Vaccination ◽

Vaccination Coverage ◽

Ethnic Disparities ◽

Racial Ethnic

Download Full-text

#72-S racial/ethnic disparities in influenza vaccination in elderly adults

Annals of Epidemiology ◽

10.1016/s1047-2797(02)00360-5 ◽

2002 ◽

Vol 12 (7) ◽

pp. 516

Author(s):

MC Rangel ◽

VJ Schoenbach ◽

VK Hogan ◽

KA Weigle

Keyword(s):

Influenza Vaccination ◽

Ethnic Disparities ◽

Elderly Adults ◽

Racial Ethnic

Download Full-text

Study finds racial/ethnic disparities in depressive trajectories among middle-aged or older adults

PsycEXTRA Dataset ◽

10.1037/e531082012-003 ◽

2012 ◽

Author(s):

J. Liang ◽

X. Xu ◽

A. R. Quinones ◽

J. M. Bennett ◽

W. Ye

Keyword(s):

Older Adults ◽

Ethnic Disparities ◽

Middle Aged ◽

Racial Ethnic

Download Full-text

1489-P: Racial/Ethnic Disparities in Deaths Due to Diabetes, Diabetes Ketoacidosis, and Diabetic Coma among Those Aged 1-44 Years: 1999-2017, United States

Diabetes ◽

10.2337/db20-1489-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 1489-P

Author(s):

SHARON SHAYDAH ◽

GIUSEPPINA IMPERATORE ◽

CARLA MERCADO ◽

KAI M. BULLARD ◽

STEPHEN R. BENOIT

Keyword(s):

United States ◽

Ethnic Disparities ◽

Diabetic Coma ◽

Racial Ethnic

Download Full-text

Association Between Out-Of-Pocket Costs, Race/Ethnicity, and Adjuvant Endocrine Therapy Adherence Among Medicare Patients With Breast Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2016.68.2807 ◽

2017 ◽

Vol 35 (1) ◽

pp. 86-95 ◽

Cited By ~ 35

Author(s):

Albert J. Farias ◽

Xianglin L. Du

Keyword(s):

Breast Cancer ◽

Endocrine Therapy ◽

Ethnic Disparities ◽

Medication Possession Ratio ◽

Adjuvant Endocrine Therapy ◽

Hormone Receptor Positive ◽

Medication Costs ◽

Poverty Status ◽

Racial Ethnic ◽

Out Of Pocket Costs

Purpose Previous studies suggest that adherence to adjuvant endocrine therapy (AET) for patients with breast cancer is suboptimal, especially among minorities, and is associated with out-of-pocket medication costs. This study aimed to determine whether there are racial/ethnic differences in 1-year adherence to AET and whether out-of-pocket costs explain the racial/ethnic disparities in adherence. Methods This retrospective cohort study used the SEER-Medicare linked database to identify patients ≥ 65 years of age with hormone receptor–positive breast cancer who were enrolled in Medicare Part D from 2007 to 2009. The cohort included non-Hispanic whites, blacks, Hispanics, and Asians. Out-of-pocket costs for AET medications were standardized for a 30-day supply. Adherence to tamoxifen, aromatase inhibitors (AIs), and overall AET (tamoxifen or AIs) was assessed using the medication possession ratio (≥ 80%) during the 12-month period. Results Of 8,688 patients, 3,197 (36.8%) were nonadherent to AET. Out-of-pocket costs for AET medication were associated with lower adjusted odds of adherence for all four cost categories compared with the lowest category of ≤ $2.65 ( P < .01). In the univariable analysis, Hispanics had higher odds of adherence to any AET at initiation (OR, 1.30; 95% CI, 1.07 to 1.57), and blacks had higher odds of adherence to AIs at initiation (OR, 1.27; 95% CI, 1.04 to 1.54) compared with non-Hispanic whites. After adjusting for copayments, poverty status, and comorbidities, the association was no longer significant for Hispanics (OR, 0.95; 95% CI, 0.78 to 1.17) or blacks (OR, 0.96; 95% CI, 0.77 to 1.19). Blacks had significantly lower adjusted odds of adherence than non-Hispanic whites when they initiated AET therapy with tamoxifen (OR, 0.54; 95% CI, 0.31 to 0.93) after adjusting for socioeconomic, clinic, and prognostic factors. Conclusion Racial/ethnic disparities in AET adherence were largely explained by women's differences in socioeconomic status and out-of-pocket medication costs.

Download Full-text

Spatial association of racial/ethnic disparities between late-stage diagnosis and mortality for female breast cancer: where to intervene?

International Journal of Health Geographics ◽

10.1186/1476-072x-10-24 ◽

2011 ◽

Vol 10 (1) ◽

pp. 24 ◽

Cited By ~ 21

Author(s):

Nancy Tian ◽

J Gaines Wilson ◽

F Benjamin Zhan

Keyword(s):

Breast Cancer ◽

Late Stage ◽

Spatial Association ◽

Ethnic Disparities ◽

Female Breast Cancer ◽

Female Breast ◽

Late Stage Diagnosis ◽

Racial Ethnic

Download Full-text

Geographic Regional Variation in Patterns of Racial and Ethnic Disparities in Late-Life Depression

Innovation in Aging ◽

10.1093/geroni/igaa057.545 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 168-168

Author(s):

Chirag Vyas ◽

Charles Reynolds ◽

David Mischoulon ◽

Grace Chang ◽

Olivia Okereke

Keyword(s):

Native American ◽

Ethnic Differences ◽

Ethnic Disparities ◽

Late Life ◽

Geographic Region ◽

Omega 3 ◽

Late Life Depression ◽

Item Level ◽

Racial Ethnic ◽

Hispanic White

Abstract There is evidence of racial/ethnic disparities in late-life depression (LLD) burden and treatment in the US. Geographic region may be a novel social determinant; yet, limited data exist regarding the interplay of geographic region with racial/ethnic differences in LLD severity, item-level symptom burden and treatment. We conducted a cross-sectional study among 25,503 men aged 50+ years and women aged 55+ years in VITAL-DEP (VITamin D and OmegA-3 TriaL-Depression Endpoint Prevention), an ancillary study to the VITAL trial. Racial/ethnic groups included Non-Hispanic White, Black, Hispanic, Asian, and other groups (Native American/Alaskan Native and other/multiple/unspecified-race/ethnicity). We assessed depression status using: the Patient Health Questionnaire-8 (PHQ-8); self-reported clinician/physician diagnosis of depression; medication and/or counseling treatment for depression. In the full sample, Midwest region was significantly associated with 12% lower severity of LLD, compared to Northeast region (rate ratio (RR) (95% confidence interval (CI)): 0.88 (0.83-0.93)). However, racial/ethnic differences in LLD varied by region. For example, in the Midwest, Blacks and Hispanics had significantly higher depression severity compared to non-Hispanic Whites (RR (95% CI): for Black, 1.16 (1.02-1.31); for Hispanic, 2.03 (1.38-3.00)). Furthermore, in multivariable-adjusted logistic regression models, minority vs. non-Hispanic White adults had 2- to 3-fold significantly higher odds of several item-level symptoms across all regions, especially in the Midwest and Southwest. Finally, among those endorsing PHQ-8≥10, Blacks had 60-80% significantly lower odds of depression treatment, compared to non-Hispanic Whites, in all regions. In summary, we observed significant geographic variation in patterns of racial/ethnic disparities in LLD outcomes. This requires further longitudinal investigation.

Download Full-text