Comparisons of immunisation accessibility between non-US born and US-born children in New York City.
BACKGROUND
New York City (NYC) has the second highest immigrant population in the USA; with many migrants from countries outside the USA being inadequately immunised. To assess the immunisation status of this population, the NYC Department of Health's Family Health Services Division designed and implemented a study in order to examine how accessible the immunisation service was to immigrant families who wished to have their children immunised.


METHODS
A one time cross-sectional design was used in this study and data was collected, by means of a survey, in the NYC Department of Health's Immunisation Clinics. These were the major walk-in and free of charge immunisation facilities for children in NYC. Descriptive and Chi square statistics were used to analyse the data from this survey.


RESULTS
Of 270 children surveyed, 211 (78%) were born outside the US; of these, 116 (55%) reported that apart from the NYC Department of Health's Immunisation Clinics they had no other access to immunisation services. There was a significant difference in the accessibility to immunisation services between non-US-born and US-born children. The factors that influenced the accessibility by non-US-born children compared with US-born children included health insurance, family income, primary language and years of residence in the US. How they came to hear about immunisation services and general knowledge regarding immunisation were not significantly different between these two groups and these were not significant factors which affected accessibility to immunisation services among children.


CONCLUSIONS
Major steps have been taken in NYC to help increase access to immunisation services by using free public health immunisation programs. Such programs should be expanded to target non-US-born children and their parents. Such educational and outreach programs need to be culturally sensitive.
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New York City Department of Health, Brooklyn, NY 11219, USA.
Sangweni
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B
Butts
G
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Merlino
M
M
D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000592:standards*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D007114:Immunization / Q000592:standards*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009519:New York City; D012111:Residence Characteristics / Q000706:statistics & numerical data*