1 / 15

The Impact of Racial and Ethnic Disparities in Influenza Vaccination on Minority Deaths

The Impact of Racial and Ethnic Disparities in Influenza Vaccination on Minority Deaths. Kevin Fiscella, MD, MPH Departments of Family Medicine Community & Preventive Medicine University of Rochester School of Medicine & Dentistry. Goals of Study.

hilary-walls
Download Presentation

The Impact of Racial and Ethnic Disparities in Influenza Vaccination on Minority Deaths

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The Impact of Racial and Ethnic Disparities in Influenza Vaccination on Minority Deaths Kevin Fiscella, MD, MPH Departments of Family Medicine Community & Preventive Medicine University of Rochester School of Medicine & Dentistry

  2. Goals of Study • Estimate the impact of racial and ethnic disparity in flu shots on elderly, minority deaths and lives saved by achievement of HP 2010 vaccination rates. • Illustrate a method for quantifying the impact of health care disparities on disparities in health.

  3. Annual All-Cause Deaths among Elderly from Influenza • 46,000 (range 23,000-64,000) –CDC, 2003 • Racial and ethnic disparities in influenza vaccination are striking (W 67%, B 46%, H 55%) • Impact of disparities in vaccination on elderly minority deaths is not known

  4. Methods • Estimate the number of influenza associated all-cause deaths attributable to influenza among elderly minority patients (both vaccinated and unvaccinated). • Simulate the number of influenza associated all-cause deaths assuming equivalence between white, non-Hispanic and minority rates.

  5. Influenza Vaccination Rates (MCBS, 2002)

  6. Estimate of Reduction in All-Cause Mortality from Flu Shots • Meta-analysis of cohort studies show a 68% reduction in all-cause mortality (not just flu related!) among elderly vaccinated patients. • Estimate is improbably high – vastly exceeds the number of deaths CDC attributes to influenza. • Selection bias confounds estimates.

  7. Comparison of Deaths During Influenza and Non-influenza Season among Vaccinated and Unvaccinated(Armstrong et al 2004) • Minimizes selection bias • Vaccination reduces influenza attributable risk percent from 13.4% to 2.2%

  8. Estimating deaths deaths in age, gender, race/ethnicity subgroup = annual deaths x PAR x number in subgroup x #months flu/12 Estimating deaths under varying flu shot rates

  9. Validation in U.S. Applying these estimates to 1998-1999 US data approximates CDC estimates of elderly flu deaths (60,230 v. 58,820)

  10. Total and influenza associated deaths among elderly minorities, 2002

  11. Minority lives saved from increases in vaccination rates v. deaths from 10th leading cause

  12. Minority Years of Life Saved

  13. Limitations of findings • Uncertainty regarding impact of influenza vaccination on mortality • Uncertainty as comparable attributable risk of influenza among different groups or comparable benefit of vaccine.

  14. Conclusions • Racial and ethnic disparities in flu shot contribute appreciably to minority deaths. • Achievement of 90% vaccination coverage for minorities would save more minority lives than elimination of the 10th leading cause of deaths. • Deaths resulting from disparities in health care represent one means for quantifying the impact of health care disparities on minority health.

  15. Acknowledgments • Richard Dressler, MD, MPH • Kathleen Holt, PhD • RWJF for support

More Related