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Socioeconomic status influences influenza hospitalization rates
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Socioeconomic status, particularly living in poverty, increased the rate of influenza hospitalizations, according to surveillance data from Tennessee.
“Area-based measures of disparities in [socioeconomic status (SES)] were strongly associated with incidence of influenza hospitalization in Middle Tennessee,” researchers, including Infectious Disease News Editorial Board member William Schaffner, MD, of Vanderbilt University School of Medicine, wrote in Emerging Infectious Diseases.
William Schaffner
Schaffner and colleagues analyzed population-based data on influenza hospitalizations from the Tennessee Emerging Infections Program (EIP) Influenza Hospitalization Surveillance Network for the 2007-2008 through 2013-2014 influenza seasons. The EIP includes eight counties in Tennessee and covers approximately 1.5 million residents.
Based on physician discretion, patients were tested for influenza using reverse transcription PCR, viral culture, direct or indirect fluorescent antibody staining or rapid antigen staining.
In all, 1,743 people were hospitalized in the catchment area due to influenza during the study period. Hospitalizations ranged from 61 during the 2011-2012 season to 590 during the 2013-2014 season, the researchers wrote.
SES and influenza hospitalization rates were linked, with people living in poverty being the most likely to be hospitalized due to influenza. In areas with the highest percentage of people living in poverty, for example, the incident rate for influenza hospitalizations was 25.7 per 100,000 population (95% CI, 23.7-27.8), while the incidence rate of influenza hospitalization was 11.5 per 100,000 population (95% CI, 10.1-13) for census tracts with the lowest percentage of people living below the poverty level.
Influenza hospitalization rates also were higher when women were the heads of households and when people lived in densely populated areas and in crowded homes.
Hospitalization rates decreased with increasing rates of health insurance, college education and employment, according to the researchers.
“These population-based data from Tennessee reinforce the association of area-based measures of SES with incidence of influenza hospitalization and emphasize the important role that neighborhood socioeconomics play in explaining rates described here,” Schaffner and colleagues wrote. “The study also suggests that, because neighborhood characteristics are strongly associated with hospitalization rates, they should be considered when designing targeted prevention strategies such as vaccination programs.”– by Colleen Owens
Disclosure: The researchers report no relevant financial disclosures.
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