Skip to main content

Advertisement

Log in

Health Disparities And Prevention: Racial/ethnic Barriers To Flu Vaccinations

Journal of Community Health Aims and scope Submit manuscript

Abstract

To address the widening disparity between Whites and non-Whites for influenza vaccination rates, this study employed the Health Belief Model to examine these rates in five racial ethnic groups (White, Latino, African American, Filipino American, and Japanese American) to identify modifiable determinants of vaccination by race/ethnicity. A 2004 telephone survey of parishioners of faith-based congregations aged 50–75 years in Los Angeles and Honolulu assessed influenza vaccination rate, perceived susceptibility to influenza, perceived severity of illness, and the self-reported main barrier to influenza vaccination. Logistic regression models for each race/ethnic group predicting vaccination dependent upon perceived susceptibility to influenza, perceived severity of illness, and sociodemographic characteristics were estimated. Model parameters were used to generate standardized predictions of vaccination rates by race/ethnic group. In the multivariate models, Whites and African Americans who were very concerned about getting the flu were significantly more likely to be vaccinated (96% and 91%, respectively), compared with those who were not concerned (45% and 33%). However, vaccination rates among Latinos who were very concerned about getting the flu (54%), although significantly higher than Latinos who were not concerned (34%), were lower than for Whites and African Americans. Examination of the main barriers to vaccination revealed that Latinos were more likely to report access and cost barriers, while African Americans were more likely to raise issues of mistrust such as concern that the vaccine causes influenza. Distinct barriers to influenza vaccination exist among racial/ethnic groups. Vaccination programs may benefit from addressing these specific and unique concerns.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Monto AS 1996 The clinical efficacy of influenza vaccination Pharmacoeconomics. 9(Suppl 3):16–22; discussion 23–15

    PubMed  Google Scholar 

  2. Voordouw BC, van der Linden PD, Simonian S, et al Influenza vaccination in community-dwelling elderly: impact on mortality and influenza-associated morbidity Arch Intern Med. 2003;163:1089–1094

    Article  PubMed  Google Scholar 

  3. Wang CS, Wang ST, Chou P Efficacy and cost-effectiveness of influenza vaccination of the elderly in a densely populated and unvaccinated community Vaccine. 2002;20:2494–2499

    Article  PubMed  Google Scholar 

  4. Vu T, Farish S, Jenkins M, Kelly H A meta-analysis of effectiveness of influenza vaccine in persons aged 65 years and over living in the community Vaccine. 2002;20:1831–1836

    Article  PubMed  Google Scholar 

  5. Thompson WW, Shay DK, Weintraub E, et al Mortality associated with influenza and respiratory syncytial virus in the United States JAMA. 2003;289:179–186

    Article  PubMed  Google Scholar 

  6. Bridges CB, Winquist AG, Fukuda K, et al Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Recomm Rep. 2000;49:1–38; quiz CE31–37

    PubMed  CAS  Google Scholar 

  7. Mendez-Luck CA, Yu H, Meng YY, et al Many uninsured children qualify for Medi-Cal or Health Families Policy Brief UCLA Cent Health Policy Res. 2004:1–8

  8. From the Centers for Disease Control, Prevention 2002 Influenza and pneumococcal vaccination levels among persons aged > or = 65 years–United States, 2001 JAMA. 288:2815–2817

    Article  Google Scholar 

  9. Egede LE, Zheng D Racial/ethnic differences in influenza vaccination coverage in high-risk adults Am J Public Health. 2003;93:2074–2078

    PubMed  Google Scholar 

  10. Bonito AJ, Lenfestey NF, Eicheldinger C, et al Disparities in immunizations among elderly Medicare beneficiaries, 2000 to 2002 Am J Prev Med. 2004;27:153–160

    Article  PubMed  Google Scholar 

  11. Egede LE, Zheng D Racial/ethnic differences in adult vaccination among individuals with diabetes Am J Public Health. 2003;93:324–329

    PubMed  Google Scholar 

  12. Racial/ethnic disparities in influenza and pneumococcal vaccination levels among persons aged > or =65 years–United States, 1989–2001. MMWR Morb Mortal Wkly Rep. 2003;52:958–962

  13. Glanz K, Rimer B, Lewis F 2002 Health Behavior and Health Education. Jossey-Bass, San Francisco, pp. 45–66

    Google Scholar 

  14. Rosenstock IM Historical Origins of the Health Belief Model Health Education Monographs. 1974;2:328–335

    Google Scholar 

  15. Janz NK, Becker MH The Health Belief Model: a decade later Health Educ Q. Spring 1984;11:1–47

    CAS  Google Scholar 

  16. Mark TL, Paramore LC Pneumococcal pneumonia and influenza vaccination: access to and use by US Hispanic Medicare beneficiaries Am J Public Health. 1996;86:1545–1550

    Article  PubMed  CAS  Google Scholar 

  17. Influenza vaccination and self-reported reasons for not receiving influenza vaccination among Medicare beneficiaries aged > or =65 years–United States, 1991–2002. MMWR Morb Mortal Wkly Rep. 2004;53:1012–1015

  18. Hebert PL, Frick KD, Kane RL, et al The causes of racial and ethnic differences in influenza vaccination rates among elderly Medicare beneficiaries Health Serv Res. 2005;40:517–537

    Article  PubMed  Google Scholar 

  19. Bogart LM, Thorburn S Are HIV/AIDS conspiracy beliefs a barrier to HIV prevention among African Americans? J Acquir Immune Defic Syndr. 2005;38:213–218

    Article  PubMed  Google Scholar 

  20. Boulware LE, Cooper LA, Ratner LE, et al Race and trust in the health care system Public Health Rep. 2003;118:358–365

    PubMed  Google Scholar 

  21. Wolff M, Bates T, Beck B, et al Cancer prevention in underserved African American communities: barriers and effective strategies–a review of the literature WMJ. 2003;102:36–40

    PubMed  Google Scholar 

  22. Vaccination levels among Hispanics and non-Hispanic whites aged > or =65 years – Los Angeles County, California, 1996. MMWR Morb Mortal Wkly Rep. 1997;46:1165–1168

Download references

Acknowledgments

This material was supported by the National Institute of Health, National Cancer Institute, award 2 R01 CA65880, and the Robert Wood Johnson Foundation.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Judy Y. Chen MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chen, J.Y., Fox, S.A., Cantrell, C.H. et al. Health Disparities And Prevention: Racial/ethnic Barriers To Flu Vaccinations. J Community Health 32, 5–20 (2007). https://doi.org/10.1007/s10900-006-9031-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-006-9031-7

Keywords

Navigation