title: Racial disparities in exposure, susceptibility, and access to health care in the US H1N1 influenza pandemic.
abstract: OBJECTIVE
  We conducted the first empirical examination of disparities in H1N1 exposure, susceptibility to H1N1 complications, and access to health care during the H1N1 influenza pandemic.
  
  
  METHODS
  We conducted a nationally representative survey among a sample drawn from more than 60,000 US households. We analyzed responses from 1479 adults, including significant numbers of Blacks and Hispanics. The survey asked respondents about their ability to impose social distance in response to public health recommendations, their chronic health conditions, and their access to health care.
  
  
  RESULTS
  Risk of exposure to H1N1 was significantly related to race and ethnicity. Spanish-speaking Hispanics were at greatest risk of exposure but were less susceptible to complications from H1N1. Disparities in access to health care remained significant for Spanish-speaking Hispanics after controlling for other demographic factors. We used measures based on prevalence of chronic conditions to determine that Blacks were the most susceptible to complications from H1N1.
  
  
  CONCLUSIONS
  We found significant race/ethnicity-related disparities in potential risk from H1N1 flu. Disparities in the risks of exposure, susceptibility (particularly to severe disease), and access to health care may interact to exacerbate existing health inequalities and contribute to increased morbidity and mortality in these populations.
authors.affiliation: Department of Family Science, School of Public Health, University of Maryland, 2242CC SPH Building #255, College Park, MD 20742-2611, USA. scquinn@umd.edu
authors.forename: Sandra Crouse
authors.initials: SC
authors.lastname: Quinn
authors.forename: Supriya
authors.initials: S
authors.lastname: Kumar
authors.forename: Vicki S
authors.initials: VS
authors.lastname: Freimuth
authors.forename: Donald
authors.initials: D
authors.lastname: Musa
authors.forename: Nestor
authors.initials: N
authors.lastname: Casteneda-Angarita
authors.forename: Kelley
authors.initials: K
authors.lastname: Kidwell
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D058873:Pandemics; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult