Social Vulnerability, Intervention Utilization, and Outcomes in US Adults Hospitalized With Influenza

Area of Science:

• Public Health
• Epidemiology
• Health Disparities

Background:

• Seasonal influenza significantly impacts public health, causing substantial disease burden.
• The influence of social vulnerability on clinical outcomes for influenza patients is not well understood.

Purpose of the Study:

• To examine the association between social vulnerability and outcomes in hospitalized influenza patients.
• To assess patterns of influenza vaccination and antiviral use across different levels of social vulnerability.

Main Methods:

• Retrospective, repeated cross-sectional study of adults with laboratory-confirmed influenza hospitalizations (2014-2019).
• Utilized data from a population-based surveillance network across 13 states.
• Employed modified Poisson regression to estimate associations between social vulnerability and influenza outcomes.

Main Results:

• High social vulnerability correlated with increased prevalence of invasive mechanical ventilation/extracorporeal membrane oxygenation support (aPR, 1.25).
• Socioeconomic status and household composition/disability were key drivers of this association.
• Influenza vaccination rates declined as social vulnerability increased; prehospital and early in-hospital antiviral receipt also decreased.

Conclusions:

• Social vulnerability is associated with a modest increase in severe outcomes for hospitalized influenza patients.
• Factors contributing to disparities include poorer baseline health and reduced access to preventive and treatment interventions.
• Addressing social determinants of health is crucial for mitigating influenza-related inequities.