Atlantic Economic Journal

, Volume 45, Issue 2, pp 181–199 | Cite as

Local Labor Market Condition and Influenza Vaccination

  • Yunwei Gai
  • Li Feng
  • Jing Hao


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.


Flu vaccination Labor market conditions Behavioral risk factor Surveillance system Area health resources Files Bureau of labor statistics local area unemployment statistics Multivariate Probit models 


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The authors would like to thank the editor and an anonymous referee for their valuable suggestions and comments. Initial findings of paper were presented at the International Health Economics Association 11th World Congress, Milan, Italy, July 2015, and the 82nd International Atlantic Economic Conference in Washington, D.C., October 15-18, 2016.


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Copyright information

© International Atlantic Economic Society 2017

Authors and Affiliations

  1. 1.Economics DivisionBabson CollegeBabson ParkUSA
  2. 2.Department of Finance and EconomicsTexas State UniversitySan MarcosUSA
  3. 3.Department of Epidemiology and Health Services ResearchGeisinger Health SystemDanvilleUSA

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