Disparities/Minority Health

Lower flu vaccination rates for black nursing home residents a cause for concern

The average flu vaccination rate among nursing home residents nationwide was 72 percent during the 2005-2006 flu season. This was well below the Healthy People 2010 goal of 90 percent. A new study found that black nursing home residents have lower flu vaccination rates than their white counterparts. It found that over three consecutive flu seasons (2006-07, 2007-08, and 2008-09), the odds of being vaccinated were 14-16 percent lower for blacks than for whites within the same facility. This difference persisted even after excluding residents who were either offered but declined vaccination, or were vaccinated outside the facility.

The Brown University researchers also found that nursing homes with high proportions of black residents had lower vaccination rates for both blacks and whites than did facilities with lower proportions of black residents. These facilities generally have a high proportion of Medicaid residents. Therefore, they have less revenue and fewer opportunities to cross-subsidize care with income from more profitable Medicare and private-pay patients.

The researchers suggest that low revenue, insufficient staffing, and poor-quality performance may all contribute to the lower vaccination rates in these facilities. They also point out that blacks are consistently more likely than whites to refuse flu vaccinations when offered. To completely eliminate racial differences in flu vaccination rates, educational programs that focus on elderly blacks and their families may be necessary, suggest the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS16094).

See "Despite small improvement, black nursing home residents remain less likely than whites to receive flu vaccine" by Shubing Cai, Ph.D., Zhanlian Feng, Ph.D., Mary L. Fennell, Ph.D., and Vincent Mor, Ph.D., in Health Affairs 30(10), pp. 1939-1946, 2011.