title: The impact of workplace policies and other social factors on self-reported influenza-like illness incidence during the 2009 H1N1 pandemic.
abstract: OBJECTIVE
  We assessed the impact of social determinants of potential exposure to H1N1--which are unequally distributed by race/ethnicity in the United States--on incidence of influenza-like illness (ILI) during the 2009 H1N1 pandemic.
  
  
  METHODS
  In January 2010 we surveyed a nationally representative sample (n = 2079) of US adults from the Knowledge Networks online research panel, with Hispanic and African American oversamples. The completion rate was 56%.
  
  
  RESULTS
  Path analysis examining ILI incidence, race, and social determinants of potential exposure to H1N1 demonstrated that higher ILI incidence was related to workplace policies, such as lack of access to sick leave, and structural factors, such as number of children in the household. Hispanic ethnicity was related to a greater risk of ILI attributable to these social determinants, even after we controlled for income and education.
  
  
  CONCLUSIONS
  The absence of certain workplace policies, such as paid sick leave, confers a population-attributable risk of 5 million additional cases of ILI in the general population and 1.2 million cases among Hispanics. Federal mandates for sick leave could have significant health impacts by reducing morbidity from ILI, especially in Hispanics.
authors.affiliation: Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. supriya@pitt.edu
authors.forename: Supriya
authors.initials: S
authors.lastname: Kumar
authors.forename: Sandra Crouse
authors.initials: SC
authors.lastname: Quinn
authors.forename: Kevin H
authors.initials: KH
authors.lastname: Kim
authors.forename: Laura H
authors.initials: LH
authors.lastname: Daniel
authors.forename: Vicki S
authors.initials: VS
authors.lastname: Freimuth
mesh_terms: D000328:Adult; D003625:Data Collection; D005260:Female; D006801:Humans; D015994:Incidence; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D058873:Pandemics / Q000517:prevention & control / Q000706:statistics & numerical data*; D010559:Personnel Management / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D017132:Workplace / Q000458:organization & administration*
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