Local Labor Market Condition and Influenza Vaccination
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Influenza vaccination is a cost-effective preventive service, but its utilization rate is below the recommended level. Many studies have explored possible predictors and causes for low vaccination rates. Despite a large volume of studies in this area, there is limited research on how local economic conditions can affect individual influenza vaccination. This study explores this topic by merging the 2008–2012 individual-level data from the Behavioral Risk Factor Surveillance System (BRFSS) with the Area Health Resources Files (AHRF), and the Bureau of Labor Statistics Local Area Unemployment Statistics (LAUS). Using county-level unemployment rates as a measurement of local economic conditions, we used multivariate probit models to examine its relationship with individual flu vaccination while controlling for individual socioeconomic and demographic factors and contextual characteristics. We found that county-level unemployment rates were significantly and negatively associated with individual influenza vaccination, especially for people who were employed or living in metropolitan counties. Our results support public health interventions to improve flu vaccination during economic recessions.
KeywordsFlu vaccination Labor market conditions Behavioral risk factor Surveillance system Area health resources Files Bureau of labor statistics local area unemployment statistics Multivariate Probit models
- Bureau of Labor Statistics (BLS). (2016). Local area unemployment statistics. County Data, 2008–2012 https://www.bls.gov/lau/tables.htm. Accessed Jan 2017.
- Centers for Disease Control and Prevention (CDC). (2013). Flu Vaccination Coverage, United States, 2012–13 Influenza Season http://www.cdc.gov/flu/fluvaxview/coverage-1213estimates.htm. Accessed Jan 2017.
- Centers for Disease Control and Prevention (CDC). (2014). Behavioral Risk Factor Surveillance System, Weighting BRFSS Data. https://www.cdc.gov/brfss/annual_data/2013/pdf/weighting_data.pdf. Accessed Jan 2017.
- Centers for Disease Control and Prevention (CDC). (2016). Behavioral risk factor Surveillance system. Annual Survey Data, 2008–2012 https://www.cdc.gov/brfss/annual_data/annual_data.htm. Accessed Jan 2017.
- U.S. Department of Health and Human Services (HHS). (2016). The Area Health Resources Files data 2016. https://datawarehouse.hrsa.gov/data/datadownload.aspx#MainContent_ctl00_gvDD_lbl_dd_topic_ttl_0. Accessed Jan 2017.
- Zimmerman, R. K., Nowalk, M. P., Tabbarah, M., Hart, J. A., Fox, D. E., Raymund, M., & FM Pitt-Net Primary Care Research Network. (2009). Understanding adult vaccination in urban, lower-socioeconomic settings: Influence of physician and prevention systems. The Annals of Family Medicine, 7(6), 534–541.CrossRefGoogle Scholar