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Socio-economic disparities in the burden of seasonal influenza: the effect of social and material deprivation on rates of influenza infection.
- Source :
-
PloS one [PLoS One] 2011 Feb 17; Vol. 6 (2), pp. e17207. Date of Electronic Publication: 2011 Feb 17. - Publication Year :
- 2011
-
Abstract
- Background: There is little empirical evidence in support of a relationship between rates of influenza infection and level of material deprivation (i.e., lack of access to goods and services) and social deprivation (i.e. lack of social cohesion and support).<br />Method: Using validated population-level indices of material and social deprivation and medical billing claims for outpatient clinic and emergency department visits for influenza from 1996 to 2006, we assessed the relationship between neighbourhood rates of influenza and neighbourhood levels of deprivation using Bayesian ecological regression models. Then, by pooling data from neighbourhoods in the top decile (i.e., most deprived) and the bottom decile, we compared rates in the most deprived populations to the least deprived populations using age- and sex-standardized rate ratios.<br />Results: Deprivation scores ranged from one to five with five representing the highest level of deprivation. We found a 21% reduction in rates for every 1 unit increase in social deprivation score (rate ratio [RR] 0.79, 95% Credible Interval [CrI] 0.66, 0.97). There was little evidence of a meaningful linear relationship with material deprivation (RR 1.06, 95% CrI 0.93, 1.24). However, relative to neighbourhoods with deprivation scores in the bottom decile, those in the top decile (i.e., most materially deprived) had substantially higher rates (RR 2.02, 95% Confidence Interval 1.99, 2.05).<br />Conclusion: Though it is hypothesized that social and material deprivation increase risk of acute respiratory infection, we found decreasing healthcare utilization rates for influenza with increasing social deprivation. This finding may be explained by the fewer social contacts and, thus, fewer influenza exposure opportunities of the socially deprived. Though there was no evidence of a linear relationship with material deprivation, when comparing the least to the most materially deprived populations, we observed higher rates in the most materially deprived populations.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Healthcare Disparities statistics & numerical data
Humans
Incidence
Infant
Infant, Newborn
Influenza, Human etiology
Male
Middle Aged
Quebec epidemiology
Risk Factors
Seasons
Socioeconomic Factors
Young Adult
Cost of Illness
Health Status Disparities
Influenza, Human economics
Influenza, Human epidemiology
Psychosocial Deprivation
Social Class
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 6
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 21359150
- Full Text :
- https://doi.org/10.1371/journal.pone.0017207