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Social Determinants of Influenza Hospitalization in the United States

tetano

Editor, Senior Moderator
Influenza Other Respir Viruses. 2017 Sep 5. doi: 10.1111/irv.12483. [Epub ahead of print]
[h=1]Social Determinants of Influenza Hospitalization in the United States.[/h] Chandrasekhar R[SUP]1[/SUP], Sloan C[SUP]2[/SUP], Mitchel E[SUP]1[/SUP], Ndi D[SUP]1[/SUP], Alden N[SUP]3[/SUP], Thomas A[SUP]4[/SUP], Bennett NM[SUP]5[/SUP], Kirley PD[SUP]6[/SUP], Hill M[SUP]7[/SUP], Anderson EJ[SUP]8[/SUP], Lynfield R[SUP]9[/SUP], Yousey-Hindes K[SUP]10[/SUP], Bargsten M[SUP]11[/SUP], Zansky SM[SUP]12[/SUP], Lung K[SUP]13[/SUP], Schroeder M[SUP]14[/SUP], Monroe M[SUP]15[/SUP], Eckel S[SUP]16[/SUP], Markus TM[SUP]1[/SUP], Cummings CN[SUP]17[/SUP], Garg S[SUP]17[/SUP], Schaffner W[SUP]1[/SUP], Lindegren ML[SUP]1[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Influenza hospitalizations result in substantial morbidity and mortality each year. Little is known about the association between influenza hospitalization and census tract-based socioeconomic determinants beyond the effect of individual factors.
[h=4]OBJECTIVE:[/h] To evaluate if census tract-based determinants such as poverty and household crowding would contribute significantly to the risk of influenza hospitalization above and beyond individual level determinants.
[h=4]METHODS:[/h] We analyzed 33,515 laboratory-confirmed influenza-associated hospitalizations that occurred during the 2009-2010 through 2013-2014 influenza seasons using a population-based surveillance system at 14 sites across the United States.
[h=4]RESULTS:[/h] Using a multilevel regression model, we found that individual factors were associated with influenza hospitalization with the highest adjusted odds ratio (AOR) of 9.20 (95% CI 8.72-9.70) for those >=65 versus 5-17 years old. African Americans had an AOR of 1.67 (95% CI 1.60-1.73) compared to Whites, and Hispanics had an AOR of 1.21 (95% CI 1.16-1.26) compared to non-Hispanics. Among census tract-based determinants, those living in a tract with >=20% versus <5% of persons living below poverty had an AOR of 1.31 (95% CI 1.16-1.47), those living in a tract with >=5% versus <5% of persons living in crowded conditions had an AOR of 1.17 (95% CI 1.11-1.23) and those living in a tract with >=40% versus <5% female heads of household had an AOR of 1.32 (95% CI 1.25-1.40).
[h=4]CONCLUSION:[/h] Census tract-based determinants account for 11% of the variability in influenza hospitalization. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.


[h=4]KEYWORDS:[/h] census tract-based determinants; disparities; geocoding; influenza hospitalization; multilevel modeling; socioeconomic determinants

PMID: 28872776 DOI: 10.1111/irv.12483
 
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