Social Vulnerability and Outcomes in Adults Hospitalized With Influenza
Author Information
Author(s): Katherine Adams MPH, Kimberly Yousey-Hindes MPH, Catherine H. Bozio PhD, MPH, Seema Jain MD, Pam Daily Kirley MPH, Isaac Armistead MD, MPH, Nisha B. Alden MPH, Kyle P. Openo DrPH, Lucy S. Witt MD, MPH, MSc, Maya L. Monroe MPH, Sue Kim MPH, Anna Falkowski MS, Ruth Lynfield MD, Melissa McMahon MPH, Marisa R. Hoffman MPH, Yomei P. Shaw MPP, PhD, Nancy L. Spina MPH, Adam Rowe BA, Christina B. Felsen MPH, Erin Licherdell MPH, Krista Lung MPH, Eli Shiltz MPH, Ann Thomas MD, MPH, H. Keipp Talbot MD, William Schaffner MD, Melanie T. Crossland MPH, Kristen P. Olsen BS, Larry W. Chang MD, MPH, Charisse N. Cummings MPH, Mark W. Tenforde MD, PhD, Shikha Garg MD, MPH, James L. Hadler MD, MPH, Alissa O’Halloran MSPH
Primary Institution: Centers for Disease Control and Prevention
Hypothesis
Is social vulnerability associated with outcomes and interventions among patients hospitalized with influenza?
Conclusion
Social vulnerability was associated with a modestly increased prevalence of invasive mechanical ventilation and/or extracorporeal membrane oxygenation support among patients hospitalized with influenza.
Supporting Evidence
- High social vulnerability was associated with higher prevalence of invasive mechanical ventilation.
- Vaccination status and underlying medical conditions partially mediated significant associations.
- The proportion of patients receiving seasonal influenza vaccination declined as social vulnerability increased.
Takeaway
People living in areas with more social challenges are more likely to need help breathing when they get the flu.
Methodology
This was a retrospective repeated cross-sectional study using data from a population-based surveillance network of counties within 13 states.
Potential Biases
Testing may be influenced by care-seeking behavior and access to care.
Limitations
The study did not capture individual-level variables that may provide additional context, and selection bias may have been introduced.
Participant Demographics
Median age was 71 years; 55.5% were female; 64.6% were White; 18.3% were Black or African American; and 6.6% were Hispanic or Latino.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI, 1.13–1.39
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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