Disparities among 2009 pandemic influenza A (H1N1) hospital admissions: a mixed methods analysis--Illinois, April-December 2009.
During late April 2009, the first cases of 2009 pandemic influenza A (H1N1) (pH1N1) in Illinois were reported. On-going, sustained local transmission resulted in an estimated 500,000 infected persons. We conducted a mixed method analysis using both quantitative (surveillance) and qualitative (interview) data; surveillance data was used to analyze demographic distribution of hospitalized cases and follow-up interview data was used to assess health seeking behavior. Invitations to participate in a telephone interview were sent to 120 randomly selected Illinois residents that were hospitalized during April-December 2009. During April-December 2009, 2,824 pH1N1 hospitalizations occurred in Illinois hospitals; median age (interquartile range) at admission was 24 (range: 6-49) years. Hospitalization rates/100,000 persons for blacks and Hispanics, regardless of age or sex were 2-3 times greater than for whites (blacks, 36/100,000 (95% Confidence Interval ([95% CI], 33-39)); Hispanics, 35/100,000 [95%CI,32-37] (; whites, 13/100,000[95%CI, 12-14); p<0.001). Mortality rates were higher for blacks (0.9/100,000; p<0.09) and Hispanics (1/100,000; p<0.04) when compared with the mortality rates for whites (0.6/100,000). Of 33 interview respondents, 31 (94%) stated that they had heard of pH1N1 before being hospitalized, and 24 (73%) did not believed they were at risk for pH1N1. On average, respondents reported experiencing symptoms for 2 days (range: 1-7) before seeking medical care. When asked how to prevent pH1N1 infection in the future, the most common responses were getting vaccinated and practicing hand hygiene. Blacks and Hispanics in Illinois experienced disproportionate pH1N1 hospitalization and mortality rates. Public health education and outreach efforts in preparation for future influenza pandemics should include prevention messaging focused on perception of risk, and ensure community wide access to prevention messages and practices.
Office of Health Protection, Division of Infectious Diseases, Illinois Department of Public Health, Chicago, Illinois, United States of America.
Kenneth
K
Soyemi
Office of Health Protection, Division of Infectious Diseases, Illinois Department of Public Health, Chicago, Illinois, United States of America; Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Andrew
A
Medina-Marino
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Ronda
R
Sinkowitz-Cochran
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Amy
A
Schneider
Office of Non communicable Diseases, Injury and Environmental Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Rashid
R
Njai
Office of Health Disparities, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Marian
M
McDonald
Office of Director, Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Maleeka
M
Glover
University of Miami, Miller School of Medicine, Obstetrics and Gynecology Department, Miami, Florida, United States of America.
Jocelyn
J
Garcia
University of Michigan, School of Public Health, Ann Arbor, Michigan, United States of America.
Allison E
AE
Aiello
D000293:Adolescent; D000328:Adult; D044383:Black People / Q000706:statistics & numerical data; D002648:Child; D062665:Epidemiological Monitoring; D005260:Female; D015438:Health Behavior; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D053118:Influenza A Virus, H1N1 Subtype / Q000502:physiology*; D007251:Influenza, Human / Q000453:epidemiology* / Q000628:therapy*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D058873:Pandemics / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult; D001741:Black or African American