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Decomposing racial/ethnic disparities in influenza vaccination among the elderly.
Vaccine. 2015 Jun 12; 33(26):2997-3002.V

Abstract

While persistent racial/ethnic disparities in influenza vaccination have been reported among the elderly, characteristics contributing to disparities are poorly understood. This study aimed to assess characteristics associated with racial/ethnic disparities in influenza vaccination using a nonlinear Oaxaca-Blinder decomposition method. We performed cross-sectional multivariable logistic regression analyses for which the dependent variable was self-reported receipt of influenza vaccine during the 2010-2011 season among community dwelling non-Hispanic African-American (AA), non-Hispanic White (W), English-speaking Hispanic (EH) and Spanish-speaking Hispanic (SH) elderly, enrolled in the 2011 Medicare Current Beneficiary Survey (MCBS) (un-weighted/weighted N=6,095/19.2 million). Using the nonlinear Oaxaca-Blinder decomposition method, we assessed the relative contribution of seventeen covariates - including socio-demographic characteristics, health status, insurance, access, preference regarding healthcare, and geographic regions - to disparities in influenza vaccination. Unadjusted racial/ethnic disparities in influenza vaccination were 14.1 percentage points (pp) (W-AA disparity, p<0.001), 25.7 pp (W-SH disparity, p<0.001) and 0.6 pp (W-EH disparity, p>.8). The Oaxaca-Blinder decomposition method estimated that the unadjusted W-AA and W-SH disparities in vaccination could be reduced by only 45% even if AA and SH groups become equivalent to Whites in all covariates in multivariable regression models. The remaining 55% of disparities were attributed to (a) racial/ethnic differences in the estimated coefficients (e.g., odds ratios) in the regression models and (b) characteristics not included in the regression models. Our analysis found that only about 45% of racial/ethnic disparities in influenza vaccination among the elderly could be reduced by equalizing recognized characteristics among racial/ethnic groups. Future studies are needed to identify additional modifiable characteristics causing disparities in influenza vaccination.

Authors+Show Affiliations

Department of Public Health Sciences, University of California Davis School of Medicine, One Shields Ave. Medical Sciences 1C, Davis, CA 95616, USA. Electronic address: byoo@ucdavis.edu.Department of Public Health Sciences, University of California Davis School of Medicine, One Shields Ave. Medical Sciences 1C, Davis, CA 95616, USA; Faculty of Liberal Arts, Sophia University, 7-1 Kioi-cho, Chiyoda-ku, Tokyo 102-8554, Japan. Electronic address: thasebe@sophia.ac.jp.Department of Pediatrics, University of California Los Angeles (UCLA), LeConte Avenue, Los Angeles, CA 10833, USA. Electronic address: pszilagyi@mednet.ucla.edu.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

25900133

Citation

Yoo, Byung-Kwang, et al. "Decomposing Racial/ethnic Disparities in Influenza Vaccination Among the Elderly." Vaccine, vol. 33, no. 26, 2015, pp. 2997-3002.
Yoo BK, Hasebe T, Szilagyi PG. Decomposing racial/ethnic disparities in influenza vaccination among the elderly. Vaccine. 2015;33(26):2997-3002.
Yoo, B. K., Hasebe, T., & Szilagyi, P. G. (2015). Decomposing racial/ethnic disparities in influenza vaccination among the elderly. Vaccine, 33(26), 2997-3002. https://doi.org/10.1016/j.vaccine.2015.03.054
Yoo BK, Hasebe T, Szilagyi PG. Decomposing Racial/ethnic Disparities in Influenza Vaccination Among the Elderly. Vaccine. 2015 Jun 12;33(26):2997-3002. PubMed PMID: 25900133.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decomposing racial/ethnic disparities in influenza vaccination among the elderly. AU - Yoo,Byung-Kwang, AU - Hasebe,Takuya, AU - Szilagyi,Peter G, Y1 - 2015/04/18/ PY - 2014/07/17/received PY - 2015/03/07/revised PY - 2015/03/18/accepted PY - 2015/4/23/entrez PY - 2015/4/23/pubmed PY - 2016/2/26/medline KW - Elderly population KW - Influenza vaccination KW - Non-linear Oaxaca–Blinder decomposition method KW - Racial/ethnic disparities SP - 2997 EP - 3002 JF - Vaccine JO - Vaccine VL - 33 IS - 26 N2 - While persistent racial/ethnic disparities in influenza vaccination have been reported among the elderly, characteristics contributing to disparities are poorly understood. This study aimed to assess characteristics associated with racial/ethnic disparities in influenza vaccination using a nonlinear Oaxaca-Blinder decomposition method. We performed cross-sectional multivariable logistic regression analyses for which the dependent variable was self-reported receipt of influenza vaccine during the 2010-2011 season among community dwelling non-Hispanic African-American (AA), non-Hispanic White (W), English-speaking Hispanic (EH) and Spanish-speaking Hispanic (SH) elderly, enrolled in the 2011 Medicare Current Beneficiary Survey (MCBS) (un-weighted/weighted N=6,095/19.2 million). Using the nonlinear Oaxaca-Blinder decomposition method, we assessed the relative contribution of seventeen covariates - including socio-demographic characteristics, health status, insurance, access, preference regarding healthcare, and geographic regions - to disparities in influenza vaccination. Unadjusted racial/ethnic disparities in influenza vaccination were 14.1 percentage points (pp) (W-AA disparity, p<0.001), 25.7 pp (W-SH disparity, p<0.001) and 0.6 pp (W-EH disparity, p>.8). The Oaxaca-Blinder decomposition method estimated that the unadjusted W-AA and W-SH disparities in vaccination could be reduced by only 45% even if AA and SH groups become equivalent to Whites in all covariates in multivariable regression models. The remaining 55% of disparities were attributed to (a) racial/ethnic differences in the estimated coefficients (e.g., odds ratios) in the regression models and (b) characteristics not included in the regression models. Our analysis found that only about 45% of racial/ethnic disparities in influenza vaccination among the elderly could be reduced by equalizing recognized characteristics among racial/ethnic groups. Future studies are needed to identify additional modifiable characteristics causing disparities in influenza vaccination. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/25900133/Decomposing_racial/ethnic_disparities_in_influenza_vaccination_among_the_elderly_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(15)00362-X DB - PRIME DP - Unbound Medicine ER -