title: The determinants of health-seeking behaviour during the A/H1N1 influenza pandemic: an ecological study.
abstract: BACKGROUND
  This is an ecological study that examines the relationship between antiviral drug collection during the 2009/2010 A/H1N1 influenza pandemic, and area-level ethnicity, socioeconomic deprivation and distance from an antiviral collection point (ACP).
  
  
  METHODS
  Age-standardized antiviral collection rates (ACR) were calculated for each super output area (geographic areas representing a population of ∼1500) in Sandwell, UK for all residents who received an antiviral drug for influenza-like illness between 23 July 2009 and 7 February 2010. Multivariable regression was used to examine the relationship between ACR and ethnicity (percentage population non-white), socioeconomic deprivation (index of multiple deprivation, IMD) and distance from an ACP.
  
  
  RESULTS
  Socioeconomic deprivation, ethnicity and distance from an ACP were independently associated with a reduction in ACR. Each one-point increase in the IMD score was associated with a drop in the ACR of 15.7 prescriptions per 100 000 population (P= 0.013).
  
  
  CONCLUSIONS
  Socioeconomic deprivation, ethnicity and distance from an ACP may have influenced health-seeking behaviour during the 2009/2010 influenza pandemic. This suggests possible inequalities in access to antivirals during the most recent influenza pandemic. Qualitative research is needed to examine the reasons for this. Individual-level data on ethnicity should be routinely collected in the event of a future pandemic.
authors: Department of Public Health, Sandwell Primary Care Trust, Kingston House, 438 High Street, West Bromwich, West Midlands B70 9LD, UK. shamil.haroon@nhs.net
authors: Shamil M M
authors: SM
authors: Haroon
authors: Gregory P
authors: GP
authors: Barbosa
authors: Patrick J
authors: PJ
authors: Saunders
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004739:England / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006297:Health Services Accessibility; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000472:pathogenicity*; D007251:Influenza, Human / Q000208:ethnology / Q000517:prevention & control*; D008297:Male; D058873:Pandemics / Q000517:prevention & control*; D012959:Socioeconomic Factors
chemical_list: D000998:Antiviral Agents