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Racial Inequities in Receipt of Influenza Vaccination among Nursing Home Residents in the United States, 2008-2009: A Pattern of Low Overall Coverage

tetano

Editor, Senior Moderator
J Am Med Dir Assoc. 2012 Mar 14. [Epub ahead of print]
Racial Inequities in Receipt of Influenza Vaccination among Nursing Home Residents in the United States, 2008-2009: A Pattern of Low Overall Coverage in Facilities in Which Most Residents are Black.
Bardenheier B, Wortley P, Shefer A, McCauley MM, Gravenstein S.
Source

Health Services Research and Evaluation Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (now with the National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention).
Abstract
OBJECTIVES:

Nationwide among nursing home residents, receipt of the influenza vaccine is 8 to 9 percentage points lower among blacks than among whites. The objective of this study was to determine if the national inequity in vaccination is because of the characteristics of facilities and/or residents.
DESIGN:

Cross-sectional study with multilevel modeling.
SETTING AND PARTICIPANTS:

States in which 1% or more of nursing home residents were black and the difference in influenza vaccination coverage between white and black nursing home residents was 1 percentage point or higher (n = 39 states and the District of Columbia). Data on residents (n = 2,359,321) were obtained from the Centers for Medicare & Medicaid Service's Minimum Data Set for October 1, 2008, through March 31, 2009.
MEASUREMENTS:

Residents' influenza vaccination status (vaccinated, refused vaccine, or not offered vaccination).
RESULTS:

States with higher overall influenza vaccination coverage among nursing home residents had smaller racial inequities. In nursing homes with higher proportions of black residents, vaccination coverage was lower for both blacks and whites. The most dramatic inequities existed between whites in nursing homes with 0% blacks (L1) and blacks in nursing homes with 50% or more blacks (L5) in states with overall racial inequities of 10 percentage points or more. In these states, more black nursing home residents lived in nursing homes with 50% or more blacks (L5); in general, the same homes with low overall coverage.
CONCLUSION:

Inequities in influenza vaccination coverage among nursing home residents are largely because of low vaccination coverage in nursing homes with a high proportion of black residents. Findings indicate that implementation of culturally appropriate interventions to increase vaccination in facilities with larger proportions of black residents may reduce the racial gap in influenza vaccination as well as increase overall state-level vaccination.

Copyright © 2012 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

PMID:
22420974
[PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/22420974
 
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