Comments on rangel et al., 'Racial and ethnic disparities in influenza vaccination-'

Autor: Philip S. Mehler, Alicia Appel
Rok vydání: 2006
Předmět:
Zdroj: Journal of General Internal Medicine. 21:101-101
ISSN: 1525-1497
0884-8734
DOI: 10.1111/j.1525-1497.2005.00271_1.x
Popis: To the Editor:— The article in the May issue entitled “Racial and Ethnic Disparities in Influenza Vaccination among Elderly Adults” described decreased immunization rates among Hispanic and non-Hispanic black patients. Rangel et al.1 used NHIS data to investigate factors impacting access to care and found that, even after controlling for access to care and socioeconomic factors, racial/ethnic disparities remained. The authors hypothesized that there may be attitudes and perceptions specific to African Americans, which affect their willingness to be vaccinated. A recent study done at our institution had very different results. Denver Health is a vertically and horizontally integrated system of an urban public hospital and 11 community health centers. We analyzed rates of immunization for pneumococcus and influenza among our patients who are 66 years of age and older and who are regular users of our system. Hispanic and African-American patients had rates of immunization equal to or higher than our Caucasian patients. This remained true after controlling for insurance status, medical comorbidities, age and site of greatest uses. Language was also not found to be a barrier for our monolingual Spanish-Speaking Hispanic patients. There are a few possible reasons that explain why ethnic minorities have equal rates of immunization when compared to Caucasians at Denver Health. Personnel who staff our community health centers are hired from within the communities, which access care at a particular clinic site. This leads to a great deal of racial concordance between staff and patients and establishes a sense of trust in the community with regards to the medical care the center offers. Many of our providers also speak Spanish and there is a significant amount of language concordance between the provider and their patients. All immunization data sheets are in both Spanish and English and interpreter services are readily available for those providers not proficient in Spanish. Furthermore, all providers and staff undergo cultural sensitivity training. Thus, while it is clear that racial disparities continue to exist in health care, additional efforts should be focused on analytical work that helps to understand those disparities and on the implementation of interventions to reduce them.
Databáze: OpenAIRE
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