title: Racial and ethnic disparities in hospitalizations and deaths associated with 2009 pandemic Influenza A (H1N1) virus infections in the United States.
abstract: OBJECTIVE
  Concerns have been raised regarding possible racial-ethnic disparities in 2009 pandemic influenza A (H1N1) (pH1N1) illness severity and health consequences for U.S. minority populations.
  
  
  METHODS
  Using data from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System, Emerging Infections Program Influenza-Associated Hospitalization Surveillance, and Influenza-Associated Pediatric Mortality Surveillance, we calculated race-ethnicity-specific, age-adjusted rates of self-reported influenza-like illness (ILI) and pH1N1-associated hospitalizations. We used χ(2) tests to evaluate racial-ethnic disparities in ILI-associated health care-seeking behavior and pH1N1 hospitalization. To evaluate pediatric deaths, we compared racial-ethnic proportions of deaths against U.S. population distributions.
  
  
  RESULTS
  Prevalence of self-reported ILI was lower among Hispanics (6.5%), higher among American Indians/Alaska Natives (16.2%), and similar among non-Hispanic blacks (7.7%) compared with non-Hispanic whites (8.5%). No racial-ethnic differences were identified in ILI-associated health care-seeking behavior. Age-adjusted pH1N1-associated Emerging Infections Program hospitalization rates were higher among all minority populations (range: 8.1-10.9/100,000 population) compared with non-Hispanic whites (3.0/100,000). The proportion of pH1N1-associated pediatric deaths was higher than expected among Hispanics (31%) and lower than expected among non-Hispanic whites (45%) given the proportions of the U.S. population they comprise (22% and 58%, respectively).
  
  
  CONCLUSIONS
  Racial-ethnic disparities in pH1N1-associated hospitalizations and pediatric deaths were identified. Vaccination remains the primary intervention for preventing influenza.
authors: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. ddee@cdc.gov
authors: Deborah L
authors: DL
authors: Dee
authors: Diana M
authors: DM
authors: Bensyl
authors: Jacqueline
authors: J
authors: Gindler
authors: Benedict I
authors: BI
authors: Truman
authors: Barbara G
authors: BG
authors: Allen
authors: Tiffany
authors: T
authors: D'Mello
authors: Alejandro
authors: A
authors: Pérez
authors: Laurie
authors: L
authors: Kamimoto
authors: Matthew
authors: M
authors: Biggerstaff
authors: Lenee
authors: L
authors: Blanton
authors: Ashley
authors: A
authors: Fowlkes
authors: Maleeka J
authors: MJ
authors: Glover
authors: David L
authors: DL
authors: Swerdlow
authors: Lyn
authors: L
authors: Finelli
mesh_terms: D000293:Adolescent; D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D005006:Ethnicity / Q000706:statistics & numerical data; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000208:ethnology* / Q000401:mortality* / Q000517:prevention & control; D008875:Middle Aged; D058873:Pandemics / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult