Researchers find White-Hispanic disparities in receiving immunization against flu, pneumonia

Seniors of Hispanic descent are far less likely to become immunized against the flu or pneumonia compared to similar White seniors, according to a new RAND Corporation study.

Researchers found that Hispanic seniors who prefer speaking Spanish and live in linguistically isolated communities such as the Southeast that are newer immigrant destinations are least likely to be immunized. The findings suggest that such groups should be targeted with special education efforts in the future.

"All Hispanic seniors are less likely to become immunized, and we found the problem seems to be the worst in new immigrant communities where Spanish is the predominant language," said Amelia M. Haviland, the study's lead author and a statistician at RAND, a nonprofit research organization. "These findings suggest new strategies may be needed to target an important problem."

RAND researchers say that increasing immunization rates among all groups helps cut disease incidence and reduces the spread of dangerous communicable diseases to all age groups. The findings are published in the Jan. 24 edition of the Archives of Internal Medicine.

The study analyzed information from more than 244,000 seniors surveyed in 2008 as a part of the Medicare Consumer Assessment of Healthcare Providers and Systems, a federal project that regularly polls a large number of American seniors about a variety of health care issues.

Researchers found lifetime immunization rates for pneumonia were substantially lower among both Spanish-speaking and English-speaking Hispanics when compared to Whites of the same age. While 74 percent of White seniors had received the pneumonia vaccine, just 56 percent of English-speaking Hispanic seniors and 40 percent of Spanish-speaking Hispanic seniors had done so.

Findings for getting the annual flu vaccine were a bit less dramatic. While 76 percent of White seniors had been inoculated against the flu, just 68 percent of English-speaking Hispanic seniors and 64 percent of Spanish-speaking Hispanics seniors had done so.

Researchers found that the disparities did not appear to be related to differences in health status and were explained only partly by socio-demographic differences between the groups. Communities where there was a longstanding Hispanic population had significantly smaller disparities in influenza vaccination rates, regardless of language preference.

In addition, researchers found that Hispanic seniors enrolled in Medicare Advantage Plans (a type of health maintenance organization) had higher pneumonia immunization rates and experienced lower White-Hispanic disparities than those in traditional fee-for-service Medicare plans, regardless of language preference.

Haviland said the findings suggest that further efforts are needed to improve cultural and linguistic access to care for Hispanic seniors.

Geographic targeting of the subgroups at risk for not being vaccinated and related efforts such as health literacy mapping also may help improve outreach and targeting of vaccine resources. Such efforts would result in more outreach in new destination areas such as agricultural regions of the Southeast, where the immunization rates of Hispanic seniors are particularly low.