Socioeconomic Disparities and Influenza Hospitalizations, Tennessee, USA.

Chantel Sloan,William Schaffner,Rameela Chandrasekhar,Edward Mitchel,Mary Lou Lindegren

doi:10.3201/eid2109.141861

Abstract

We examined population-based surveillance data from the Tennessee Emerging Infections Program to determine whether neighborhood socioeconomic status was associated with influenza hospitalization rates. Hospitalization data collected during October 2007-April 2014 were geocoded (N = 1,743) and linked to neighborhood socioeconomic data. We calculated age-standardized annual incidence rates, relative index of inequality, and concentration curves for socioeconomic variables. Influenza hospitalizations increased with increased percentages of persons who lived in poverty, had female-headed households, lived in crowded households, and lived in population-dense areas. Influenza hospitalizations decreased with increased percentages of persons who were college educated, were employed, and had health insurance. Higher incidence of influenza hospitalization was also associated with lower neighborhood socioeconomic status when data were stratified by race.

Highlights

We examined population-based surveillance data from the Tennessee Emerging Infections Program to determine whether neighborhood socioeconomic status was associated with influenza hospitalization rates
We analyzed population-based influenza hospitalization surveillance data from the Tennessee Emerging Infections Program (EIP) [8,9] to identify potential disparities in influenza hospitalization rates in Middle Tennessee according to neighborhood-level measures of socioeconomic status (SES)
The observed frequency of influenza hospitalizations was in accordance with those reported by other surveillance sites

Summary

Introduction

We examined population-based surveillance data from the Tennessee Emerging Infections Program to determine whether neighborhood socioeconomic status was associated with influenza hospitalization rates. Higher incidence of influenza hospitalization was associated with lower neighborhood socioeconomic status when data were stratified by race. Geographic-based measures include physical, social, and economic characteristics of neighborhoods, such as poverty level, education, residential segregation, psychosocial stress, unemployment, inadequate transportation, social networks, distance to medical facilities, access to prevention and treatment services, insurance status, Author affiliations: Brigham Young University, Provo, Utah, USA We analyzed population-based influenza hospitalization surveillance data from the Tennessee Emerging Infections Program (EIP) [8,9] to identify potential disparities in influenza hospitalization rates in Middle Tennessee according to neighborhood-level measures of socioeconomic status (SES). Understanding disparities in influenza hospitalization rates is a priority for the EIP as necessary to reduce illness and death from annual influenza epidemics

Methods

Results

Conclusion