Sociodemographic disparities in the establishment of health records among 0.5 million migrants from 2014 to 2017 in China: a nationwide cross-sectional study

Background Migrants account for a large part of China’s population. Many policies and inventions have been taken to improve access to public health services and the health of migrants. China’s Basic Public Health Services(BPHS) are a series of public health services in this policy domain, which aims at promoting the access of public health sevices and improve health equity of residents. The establishment of health records is the fundamental service of BPHS. However, there is little known about the establishment of health records among migrants in China, which hinders the more efficient provision of health services for migrants, and health equity is difficult to achieve. Based on the research gap, this study aims at showing the sociodemographic disparities in the establishment rate of health records, and identifying priorities and recommendations for promoting health equity of migrants in China. Methods This study used national data from China Migrants Dynamic Survey (CMDS) from 2014 to 2017 to evaluate the sociodemographic disparities in the establishment rate of health records and utilization of relevant public health services. The study included 539,926 respondents. Following the descriptive statistics of migrants, we showed the establishment rate of health records by sociodemographic characteristics and migrating related characteristics. Multivariate analysis was conducted to explore the associations between sociodemographic charicteristics, migrating related charicteristics and the establishment of health records. Results The establishment rate of health records among migrants in the sampled years were 22.99, 38.44, 27.29% respectively, and 29.18% in general, and there existed heterogeneity in the establishment rate of health records by sociodemographic charicteristics and migrating related charicteristics. Female migrants who were older, from middle age, married or living with partner, with higher educational attainment, with urban household registration, migrated for longer time, migrated for the reason of studying or family issues, migrated in province were more likely to establish health records. Conclusion There existed sociodemographic disparities in the establishment rate of health records and inequalities in the utilization of health records services among migrants in China. Migrating related characteristics also had impact on the establishment status. Policies should take both supply side and demand side of health services to improve the health equity of migrants, which means that relative departments should continue to invest in primary healthcare centers to improve their ability to provide services as well as migrants’ health literacy.

24. An analysis of the National Institutes of Health All of Us Research Database: Sociodemographic Disparities Among Patients Who Received Vaccinations

Background The National Institutes of Health All of Us (AoU) research program is building a diversified database of 1 million+ adult subjects. With this database, we seek to describe the sociodemographic characteristics of those with documented vaccinations. Methods The AoU recruited subjects ≥ 18 years beginning in 2018. Eligible subjects were subsequently divided into five vaccine cohorts based on their vaccine history [influenza, hepatitis B (HepB), pneumococcal (Pneu) < 65, Pneu ≥ 65, human papillomavirus (HPV)]. The vaccine cohorts were compared to the general AoU cohort. Subjects in the influenza cohort had documented influenza vaccinations from 09/2017-05/2018. Other vaccine cohorts comprised subjects with ≥ 1 lifetime record(s) of vaccination by 12/2018. The Pneu < 65 and ≥ 65 cohorts comprised those who received pneumococcal vaccination before or after (inclusive) 65 years old, respectively. Descriptive statistics for all cohorts were generated using survey and electronic health record (EHR) data. Results We analyzed 315297 subjects in the AoU dataset R2020Q4R2. The cohort sizes were: influenza (n=15346), HepB (n=6323), HPV (n=2125), and Pneu (< 65 n=15217; ≥65 n=15100). For all vaccine cohorts, comparing the 95% confidence intervals (CIs), the proportions of whites and non-Hispanics/Latinos were statistically higher than the general AoU cohort, the largest being from the Pneu ≥ 65 cohort (Table 1). For educational attainment, the Pneu < 65 (36.5%) had the smallest proportion of college or advanced degree graduates while the largest was observed in the Pneu ≥ 65 cohort (59.0%). The proportions of subjects with < &10k in annual household income (AHI) were largest among Pneu < 65 (17.1%) and smallest among Pneu ≥ 65 (3.8%). In contrast, the largest proportion of subjects with ≥ &100k AHI was among Pneu ≥ 65 (25.3%) and the smallest among Pneu < 65 (15.8%). Table 1. Sociodemographic characteristics of subjects in the All of Us research program based on vaccine receipt Conclusion Racial and ethnic disparities in vaccinations were apparent. Pneumococcal vaccination at age 65 years and above was more prevalent among white, non-Hispanic/Latino subjects who were also more educated and affluent. Conversely, those receiving pneumococcal vaccination before age 65 years were less educated and had lower AHI. Disclosures All Authors: No reported disclosures

1139Predictors of Unintended Pregnancy among Indian women: An analysis from NFHS-IV Survey

Background Low levels of women’s decision-making over control of sexual intercourse, contraceptive use, domestic violence with intimate partners not only have impact on socioeconomic and cultural aspects but also on unintended pregnancies. Which create serious public health issues associated with physical, reproductive and mental health consequences. This study explores associations between domestic violence, maternity and sociodemographic characteristics with unintended pregnancies Methods Total 32428 married women aged between 15-49 years, who responded on current pregnancy wanted were observed in NFHS-IV (2015-16) survey data. Out of these, 3,842 found eligible for this study. Logistic regressions used for analysis using SPSS23 software. Results Mean age of 3,842 women respondents were 25.27 ± 4.97 years. 12.3% of them were unintended pregnancies. Women aged between 25-34 years (OR = 1.21, 95% CI: 0.99-1.48) and 35-49 years (OR = 1.50, 95% CI: 1.02-2.21) were more likely to have unintended pregnancy than 15–24 years. Working women were 7% (OR = 0.93, 95% CI: 0.73-1.18) less likely to have unintended pregnancy than not working. Women never used contraception were 1.4 times more likely to have unintended pregnancy. Ever face domestic violence were 1.71 times (OR = 1.71, 95% CI: 1.40-2.10) more likely to have unwanted pregnancy. Conclusions Sociodemographic disparities need to be addressed to promote reproductive health and welfare services. Preventing physical violence by intimate partners against women, could reduce unintended pregnancy. Key messages Improving women’s status through educational and occupational initiatives could contribute to reducing physical violence and incidence of unintended pregnancies