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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 in Facilities in Which Most Residents are Black
Filetype[PDF - 946.86 KB]


Details:
  • Pubmed ID:
    22420974
  • Pubmed Central ID:
    PMC4554484
  • Funding:
    CC999999/Intramural CDC HHS/United States
  • Document Type:
  • Collection(s):
  • Description:
    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.