Influenza Vaccination among Underserved African-American Older Adults

• Published in: BioMed research international 2020, Vol.2020 (2020), p.1-9
• Main Authors: Assari, Shervin, Santana, Delia, Ameli, Hoorolnesa, Adinkrah, Edward, Wisseh, Cheryl, Bazargan, Mohsen, Cobb, Sharon
• Format: Article
• Language: English
• Subjects: Accessibility; Adults; African American aged; African Americans; Age; Aged; Aged, 80 and over; Availability; Bivariate analysis; Black or African American - statistics & numerical data; Care and treatment; Chronic illnesses; Chronic obstructive pulmonary disease; Continuity; Coronaviruses; COVID-19; Cross-Sectional Studies; Demographic aspects; Disability; Educational attainment; Female; Health care; Health care disparities; Health Personnel; Health services; Humans; Immunization; Influenza; Influenza Vaccines; Influenza, Human - prevention & control; Logistic Models; Los Angeles; Lung diseases; Male; Medical personnel; Medically Underserved Area; Mental depression; Mental health; Obstructive lung disease; Older people; Patient Acceptance of Health Care; Patient Satisfaction; Public health; Pulmonary Disease, Chronic Obstructive - epidemiology; Race factors; Regression analysis; Signs and symptoms; Sociodemographics; Socioeconomic Factors; Socioeconomics; Statistics; Vaccination; Vaccination - psychology; Vaccination - statistics & numerical data; Vaccines
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2020/2160894

Background. Racial disparities in influenza vaccination among underserved minority older adults are a public health problem. Understanding the factors that impact influenza vaccination behaviors among underserved older African-Americans could lead to more effective communication and delivery strategies. Aims. We aimed to investigate rate and factors associated with seasonal influenza vaccination among underserved African-American older adults. We were particularly interested in the roles of demographic factors, socioeconomic status, and continuity and patient satisfaction with medical care, as well as physical and mental health status. Methods. This community-based cross-sectional study recruited 620 African-American older adults residing in South Los Angeles, one of the most under-resources areas within Los Angeles County, with a population of over one million. Bivariate and multiple regression analyses were performed to document independent correlates of influenza vaccination. Results. One out of three underserved African-American older adults aged 65 years and older residing in South Los Angeles had never been vaccinated against the influenza. Only 49% of participants reported being vaccinated within the 12 months prior to the interview. One out of five participants admitted that their health care provider recommended influenza vaccination. However, only 45% followed their provider’s recommendations. Multivariate logistic regression shows that old-old (≥75 years), participants who lived alone, those with a lower level of continuity of care and satisfaction with the accessibility, availability, and quality of care, and participants with a higher number of depression symptoms were less likely to be vaccinated. As expected, participants who indicated that their physician had advised them to obtain a flu vaccination were more likely to be vaccinated. Our data shows that only gender was associated with self-report of being advised to have a flu shot. Discussion. One of the most striking aspects of this study is that no association between influenza vaccination and being diagnosed with chronic obstructive pulmonary disease or other major chronic condition was detected. Our study confirmed that both continuity of care and satisfaction with access, availability, and quality of medical care are strongly associated with current influenza vaccinations. We documented that participants with a higher number of depression symptoms were less likely to be vaccinated. Co