Disparities in influenza vaccination across the United States: Variability by minority group, Asian sub-populations, socio-economic status, and health insurance coverage

Budhwani, Henna; De, Prabal K.

doi:10.1016/j.puhe.2016.04.003

Cited by 27 publications

(38 citation statements)

References 19 publications

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“…English proficiency was associated with insurance among East Asians before adjusting for all health-related factors; other studies have found language to be an important barrier to utilizing the health care system and understanding necessary information about insurance [18, 17, 19]. However, speaking English very well was only significant among East Asians in model 1.…”

Section: Discussionmentioning

confidence: 85%

“…A nationally representative sample of US adults found that younger individuals were less likely to have health insurance [31]. Acculturation may also explain healthcare coverage [19], as more recent immigrants may be less likely to engage in healthcare due to factors such as immigrant status and language proficiency [18]. From our findings, individuals who had lived in the US for greater than 20 years (model 1 East Asians and South Asians; model 1 and fully adjusted model for Southeast Asians) were more likely to have insurance coverage than individuals living in the US for ≤5 years.…”

Section: Discussionmentioning

confidence: 99%

“…The study sample was collected through community-based convenience sampling in NYC, thus our sample is not generalizable to other Asian populations in NYC or elsewhere. Additionally, much of the published literature on insurance status among Asian Americans has focused on California [17, 37, 38, 23, 44, 40, 24] or national datasets [45, 41, 18, 46, 35, 6, 43, 39, 47, 32, 10, 12]; it is difficult to compare our findings to Asian groups in these studies. Similarly, health insurance guidelines are different outside of New York State, and immigrants in other locations often have a five-year waiting period for public insurance eligibility [15, 13].…”

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…breast, cervical, and colorectal) [18, 23–25]. The ACA aimed to increase access to care and improve health outcomes for disadvantaged populations, however disparities continue to persist [18, 17, 20]. The objective of this study is to identify factors associated with health insurance status in an Asian American population of NYC using cross-sectional survey data collected between 2013 and 2015, a key time when the ACA was being implemented across the US, while stratifying by Asian American ethnic subgroup.…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Health Insurance Status in an Asian American Population in New York City: Analysis of a Community-Based Survey

Tan

Wyatt

Kranick

et al. 2018

J. Racial and Ethnic Health Disparities

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Health Insurance Status in an Asian American Population in New York City: Analysis of a Community-Based Survey

Tan

Wyatt

Kranick

et al. 2018

J. Racial and Ethnic Health Disparities

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Disparities in H1N1 Vaccination Rates: a Systematic Review and Evidence Synthesis to Inform COVID-19 Vaccination Efforts

et al. 2021

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Background Data suggest that there were disparities in H1N1 vaccine uptake, and these may inform COVID-19 vaccination efforts. We conducted a systematic review to evaluate disparities in H1N1 vaccine uptake, factors contributing to disparities, and interventions to reduce them. Methods We searched English-language articles in MEDLINE ALL, PsycINFO, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from database inception through May 8, 2020. Observational studies examining H1N1 vaccine uptake by race/ethnicity, socioeconomic status, rurality, and disability status in US settings were included. Two reviewers independently assessed study eligibility. Single-reviewer data abstraction was confirmed by a second reviewer. We conducted independent dual quality assessment, and collective strength of evidence assessment. Results We included 21 studies. African American/Black, Latino, and low-socioeconomic status participants had disproportionately lower H1N1 vaccination rates ( low- to moderate-strength evidence ). However, Latinos were more likely than Whites to intend to be vaccinated, and African American/Blacks and participants with lower-socioeconomic status were just as likely to intend to be vaccinated as their White and higher-socioeconomic status counterparts ( low-strength evidence ). Vaccine uptake for other groups has been insufficiently studied. Factors potentially contributing to disparities in vaccine uptake included barriers to vaccine access, inadequate information, and concerns about vaccine safety and efficacy. Studies were largely cross-sectional. Many of the studies are a decade old and were conducted in the context of a different pandemic. The categorization of racial and ethnic groups was not consistent across studies and not all groups were well-studied. Discussion Efforts to avoid disparities in COVID-19 vaccination uptake should prioritize vaccine accessibility and convenience in African American/Black, Latino, and low-SES communities; engage trusted stakeholders to share vaccine information; and address concerns about vaccine safety and efficacy. Primary Funding Source Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development. Protocol Registration PROSPERO CRD42020187078 Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-06715-7.

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Influenza Vaccination Coverage Among English-Speaking Asian Americans

Srivastav

Williams

2018

American Journal of Preventive Medicine

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Introduction: English-speaking non-Hispanic Asians (Asians) in the U.S. include populations with multiple geographic origins and ethnicities (e.g., Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese). Health behaviors and outcomes can differ widely among Asian ethnicities, and highlight the importance of subgroup analysis. Aggregating Asians may mask differences in influenza vaccination across various ethnicities. Methods: Combined data from 2013 to 2015 Behavioral Risk Factor Surveillance System, a population-based, telephone survey of the non-institutionalized, U.S. population aged ≥ 18 years, were analyzed in 2017 to assess influenza vaccination among Asians. Weighted proportions were calculated. Multivariable logistic regression was used to determine independent associations between sociodemographic factors and receipt of influenza vaccination. Results: Influenza vaccination varied widely among Asian ethnicities, both nationally and by state. Overall, 42.1% of Asians reported having received an influenza vaccine, similar to vaccination among whites (42.4%). Coverage ranged from 36.1% among Koreans to 50.9% among Japanese. Factors independently associated with influenza vaccination among some or all Asian ethnicities included age (≥ 50 years), female, never married, high school or higher education, annual household income ≥ $75,000, possession of medical insurance and personal healthcare provider, routine checkup in the previous year, and presence of certain chronic conditions. Conclusions: Though Asians and whites had similar overall influenza vaccination coverage, differences existed between Asian ethnicities, both nationally and by state. This information may help community-based, state-level, and national-level public health agencies to support targeted approaches for outreach to these populations, such as improving cultural and linguistic access to care, to improve influenza vaccination.

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Disparities in influenza vaccination across the United States: Variability by minority group, Asian sub-populations, socio-economic status, and health insurance coverage

Cited by 27 publications

References 19 publications

Factors Associated with Health Insurance Status in an Asian American Population in New York City: Analysis of a Community-Based Survey

Factors Associated with Health Insurance Status in an Asian American Population in New York City: Analysis of a Community-Based Survey

Disparities in H1N1 Vaccination Rates: a Systematic Review and Evidence Synthesis to Inform COVID-19 Vaccination Efforts

Influenza Vaccination Coverage Among English-Speaking Asian Americans

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