Americans who live in poorer neighborhoods are more likely to be hospitalized with complications from influenza, according to a recent CDC study.
Factors such as low vaccination rates, crowded housing and less access to regular healthcare could be behind the increased risk, lead researcher James Hadler, MD, said in an article written by Steven Reinberg for HealthDay.
“As the neighborhood gets poorer, the rate of hospitalizations from influenza increases,” Hadler said in the article. He is a clinical professor of epidemiology and public health at Yale School of Public Health’s Connecticut Emerging Infections Program in New Haven.
The poorest have double the risk of being hospitalized, compared with the richest, Hadler said in the article, adding the findings are not influenced by the person’s race. Findings were published Feb. 12 in the CDC’s Morbidity and Mortality Weekly Report.
For the study, researchers used data on 27 million people from 14 states collected during two influenza seasons, 2010-11 and 2011-12. The team used U.S. Census data to categorize areas based on the percentage of residents who lived below the federal poverty level (less than 5%, 5%-9%, 10%-19% and 20% or more). Neighborhoods were considered high poverty areas if 20% or more of the residents lived below the federal poverty level, and low poverty areas if fewer than 5% of residents lived below the federal poverty level, according to the report.
Researchers were able to determine the census tract for 7,936 (96%) of the total 8,304 influenza hospitalizations reported during the study period. Once the results were adjusted for age, investigators found people in high poverty neighborhoods had nearly double the rate of influenza hospitalizations compared with people in low poverty neighborhoods.
Findings also showed the rate of influenza hospitalizations increased as the level of poverty increased, in all age groups, all racial and ethnic groups and during both flu seasons. Researchers also found the association persisted for all age-adjusted groups for hospitalizations requiring ICU treatment, mechanical ventilation and for deaths during or within 30 days of hospitalization.
“People in these neighborhoods do have lower vaccination rates than people living in wealthier areas, but that doesn’t explain all the differences in hospitalizations,” Hadler said in the HealthDay article, also noting poorer neighborhoods tend to be more crowded, so people have closer contact with each other and are at a higher risk of getting influenza.
The article also pointed out people in high-poverty areas are more likely to have other medical conditions such as asthma, which can lead to more severe cases of flu, and they have less access to regular healthcare. According to Hadler, the lack of regular care leads to lower vaccination rates and also results in people waiting to seek care until their illness is so severe a trip to the hospital is needed.
“They only seek care when there’s a crisis,” he said in the article, even though earlier treatment with antiviral drugs could help reduce complications.
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