1. Social determinants of influenza hospitalization in the United States.
- Author
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Chandrasekhar R, Sloan C, Mitchel E, Ndi D, Alden N, Thomas A, Bennett NM, Kirley PD, Hill M, Anderson EJ, Lynfield R, Yousey-Hindes K, Bargsten M, Zansky SM, Lung K, Schroeder M, Monroe M, Eckel S, Markus TM, Cummings CN, Garg S, Schaffner W, and Lindegren ML
- Subjects
- Adolescent, Adult, Black or African American statistics & numerical data, Aged, Child, Child, Preschool, Family Characteristics, Female, Hospitalization economics, Humans, Influenza, Human mortality, Influenza, Human virology, Male, Middle Aged, Odds Ratio, Poverty, Regression, Psychology, United States epidemiology, Young Adult, Censuses, Hospitalization statistics & numerical data, Influenza, Human epidemiology, Population Surveillance, Socioeconomic Factors
- Abstract
Background: 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., Objective: To evaluate whether 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., Methods: 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., Results: 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 vs 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% vs <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% vs <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% vs <5% female heads of household had an AOR of 1.32 (95% CI 1.25-1.40)., Conclusion: Census tract-based determinants account for 11% of the variability in influenza hospitalization., (© 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.)
- Published
- 2017
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