title: Influenza vaccination in patients with diabetes: disparities in prevalence between African Americans and Whites.
abstract: BACKGROUND
  Patients with diabetes who contract influenza are at higher risk of complications, such as hospitalization and death. Patients with diabetes are three times more likely to die from influenza complications than those without diabetes. Racial disparities among patients with diabetes in preventive health services have not been extensively studied.
  
  
  OBJECTIVE
  To compare influenza vaccination rates among African Americans and Whites patients with diabetes and investigate factors that might have an impact on racial disparities in the receipt of influenza vaccinations.
  
  
  METHODS
  A secondary data analysis of 47,283 (unweighted) patients with diabetes from the 2011 Behavioral Risk Factor Surveillance System survey (BRFSS) (15,902,478 weighted) was performed. The survey respondents were asked whether they received an influenza vaccination in the last twelve months. We used logistic regression to estimate the odds of receiving the influenza vaccine based on race.
  
  
  RESULTS
  The results indicated a significantly lower proportion of African Americans respondents (50%) reported receiving the influenza vaccination in the last year when compared with Whites respondents (61%). Age, gender, education, health care coverage, health care cost, and employment status were found to significantly modify the effect of race on receiving the influenza vaccination.
  
  
  CONCLUSIONS
  This study found a significant racial disparity in influenza vaccination rates in adults with diabetes with higher rates in Whites compared to African Americans individuals. The public health policies that target diabetes patients in general and specifically African Americans in the 65+ age group, women, and homemakers, may be necessary to diminish the racial disparity in influenza vaccination rates between African Americans and Whites diabetics.
authors.affiliation: Institute of Community Health, University of Houston, Texas Medical Center. Houston, TX ( United States ). lathamne@uh.edu.
authors.forename: Liqa N
authors.initials: LN
authors.lastname: Athamneh
authors.affiliation: Institute of Community Health, University of Houston, Texas Medical Center. Houston, TX ( United States ). ssansgiry@uh.edu.
authors.forename: Sujit S
authors.initials: SS
authors.lastname: Sansgiry
keywords: Diabetes Mellitus; Ethnic Groups; Health Care Surveys; Health Promotion; Healthcare Disparities; Influenza Vaccines; United States; Vaccination