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Health Services Research & Development

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2005 HSR&D National Meeting Abstract

1019 — Factors Related to Racial Disparities in Influenza Immunization Among Veterans Aged >50

Author List:
Straits-Troster KA (VA NCP)
Orelein JG (VA NCP)
Kahwati LC (VA NCP)
Kinsinger LS (VA NCP)
Burdick MB (VA NCP)
Ciesco E (VA NCP)
Lewis SK (VA NCP)
Strickland R (VA NCP)
Yevich SJ (VA NCP)

To determine racial/ethnic disparities and characterize factors related to receipt of influenza immunization for older veterans.

A random sample of outpatients seen in VA October 2003-February 2004 completed the mailed Survey of Health Experiences of Patients (SHEP). Participants aged 50 or older (N=159,142) provided self-identified race/ethnicity: Hispanics (N=5400), non-Hispanic whites (N=100,944), non-Hispanic blacks (N=7499), American Indian/Alaskan (N=2819) and Asian/Pacific Islanders (N=971). The associations between race, source of vaccination (VA versus non-VA), reminders and barriers to vaccination were examined.

Unadjusted odds ratios indicated racial disparities: Hispanics (79% vaccinated; OR=0.85 [95% CI=0.8, 0.9]), non-Hispanic blacks (72%; OR=0.55 [0.2, 0.6]) and American Indians (76%; OR=0.67 [0.6, 0.7]) were less likely to be vaccinated compared to non-Hispanic whites (83%). However, after adjusting for socioeconomic variables, only non-Hispanic blacks (OR=0.75 [0.71, 0.8]) were less likely to receive influenza vaccination. Factors associated with increased likelihood of vaccination included higher income, older age, being married, higher education and having a primary care provider (PCP). Among Non-Whites, reminder by a VA clinician was the most endorsed influence upon decision to be immunized (49%). Non-Whites were also more likely to rely upon VA for flu vaccination: Hispanics (80%), non Hispanic blacks (83%), American Indian (75%), and Asians/Pacific Islanders (70%) compared to Whites (59%) and Non-Whites were more likely to report that they did not know they needed a flu shot.

Hispanics, Blacks and Native Americans were less likely to receive the influenza vaccine compared to Whites and Asian/Pacific Islanders. Non-whites relied upon VA for influenza immunization more frequently than Whites, reported reminders from VA clinicians to be the most helpful in deciding to be immunized, and more frequently reported not knowing they needed to be immunized.

People of color depend upon the VA for flu vaccination and report VA clinician reminders are helpful in deciding to be immunized. Targeted educational efforts may improve understanding of need for flu vaccination rates among Non-Whites. More research is need to clarify identified racial disparities and to determine reasons why many individuals regardless of race do not want to be immunized.

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