Relationship between neighborhood census-tract level socioeconomic status and respiratory syncytial virus-associated hospitalizations in U.S. adults, 2015–2017

Abstract

Background Respiratory syncytial virus (RSV) infection causes substantial morbidity and mortality in children and adults. Socioeconomic status (SES) is known to influence many health outcomes, but there have been few studies of the relationship between RSV-associated illness and SES, particularly in adults. Understanding this association is important in order to identify and address disparities and to prioritize resources for prevention. Methods Adults hospitalized with a laboratory-confirmed RSV infection were identified through population-based surveillance at multiple sites in the U.S. The incidence of RSV-associated hospitalizations was calculated by census-tract (CT) poverty and crowding, adjusted for age. Log binomial regression was used to evaluate the association between Intensive Care Unit (ICU) admission or death and CT poverty and crowding. Results Among the 1713 cases, RSV-associated hospitalization correlated with increased CT level poverty and crowding. The incidence rate of RSV-associated hospitalization was 2.58 (CI 2.23, 2.98) times higher in CTs with the highest as compared to the lowest percentages of individuals living below the poverty level (≥ 20 and < 5%, respectively). The incidence rate of RSV-associated hospitalization was 1.52 (CI 1.33, 1.73) times higher in CTs with the highest as compared to the lowest levels of crowding (≥5 and < 1% of households with > 1 occupant/room, respectively). Neither CT level poverty nor crowding had a correlation with ICU admission or death. Conclusions Poverty and crowding at CT level were associated with increased incidence of RSV-associated hospitalization, but not with more severe RSV disease. Efforts to reduce the incidence of RSV disease should consider SES.

Estimated incidence of respiratory hospitalizations attributable to RSV infections across age and socioeconomic groups

“…Though the epidemic dynamics of RSV vary even within local geographic areas [5,6], little is known about how the burden of RSV varies between populations. Previous research has had mixed conclusions about the impact of socioeconomic status (SES) on the risk of RSV infections [7][8][9]. While some studies found lower rates of RSV infection in higher SES groups, others found no relationship.…”

From Forgotten Pathogen to Target for New Vaccines: What Clinicians Need to Know about Respiratory Syncytial Virus Infection in Older Adults

“…In the last four years, several systematic reviews and meta-analyses were published [ 15 , 16 , 17 , 25 , 27 , 29 , 31 , 32 , 41 ], most of them with the aim to define the disease burden of RSV in older adults and some of them with the active participation of pharma companies involved in RSV vaccine and drug development. Several clinical studies have been published over the years worldwide [ 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 ]. In Europe, what emerged together with the findings of few multicenter clinical studies [ 21 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ] was the need to harmonize and collaborate between the various laboratories in order to obtain shared diagnostic protocols with which to compare data...…”

Neighborhood infrastructure-related risk factors and non-communicable diseases: a systematic meta-review

“…There is broad consensus that, on average, residents from socially and economically deprived neighborhoods experience worse health outcomes than those from more prosperous areas [ 12 ]. Studies have found that residents of high-poverty areas suffer from higher rates of heart disease [ 13 ], respiratory ailments [ 14 ], cancer [ 15 ], and overall mortality [ 12 ]. A socially deprived neighborhood is often characterized by poor infrastructure and insufficient medical resources, which may be associated with serious adverse health outcomes for residents [ 16 ].…”