Atlantic Economic Journal

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

Local Labor Market Condition and Influenza Vaccination

Article

Abstract

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.

Keywords

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 

JEL

I12 I18 

References

  1. Benjamins, M. R., Kirby, J. B., & Huie, S. A. B. (2004). County characteristics and racial and ethnic disparities in the use of preventive services. Preventive Medicine, 39(4), 704–712.CrossRefGoogle Scholar
  2. Bureau of Labor Statistics (BLS). (2016). Local area unemployment statistics. County Data, 2008–2012 https://www.bls.gov/lau/tables.htm. Accessed Jan 2017.
  3. 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.
  4. 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.
  5. 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.
  6. Charles, K. K., & DeCicca, P. (2008). Local labor market fluctuations and health: Is there a connection and for whom? Journal of Health Economics, 27(6), 1532–1550.CrossRefGoogle Scholar
  7. Colman, G., & Dave, D. (2013). Exercise, physical activity, and exertion over the business cycle. Social Science and Medicine, 93, 11–20.CrossRefGoogle Scholar
  8. Cornwell, B. (2012). Unemployment and widespread influenza in America, 1999–2010. Influenza and Other Respiratory Viruses, 6(1), 63–70.CrossRefGoogle Scholar
  9. Coughlin, S. S., Leadbetter, S., Richards, T., & Sabatino, S. A. (2008). Contextual analysis of breast and cervical cancer screening and factors associated with health care access among United States women, 2002. Social Science and Medicine, 66(2), 260–275.CrossRefGoogle Scholar
  10. Maciosek, M. V., Leif, I. S., Ashley, B. C., Nichol, M. E., & Michael, J. G. (2006). Influenza vaccination: Health impact and cost effectiveness among adults aged 50 to 64 and 65 and older. American Journal of Preventive Medicine, 31(1), 72–79.CrossRefGoogle Scholar
  11. Markowitz, S., Nesson, E., & Robinson, J. (2010). Are pink slips better than flu shots? The effects of employment on influenza rates. In Working papers w15796. National Bureau of Economic: Research http://www.nber.org/papers/w15796. Accessed Jan 2017.Google Scholar
  12. Maurer, J. (2009). Who has a clue to preventing the flu? Unravelling supply and demand effects on the take-up of influenza vaccinations. Journal of Health Economics, 28(3), 704–717.CrossRefGoogle Scholar
  13. McInerney, M., & Mellor, J. M. (2012). Recessions and seniors’ health, health behaviors, and healthcare use: Analysis of the Medicare current beneficiary survey. Journal of Health Economics, 31(5), 744–751.CrossRefGoogle Scholar
  14. Ruhm, C. J. (2005). Healthy living in hard times. Journal of Health Economics, 24(2), 341–363.CrossRefGoogle Scholar
  15. Tefft, N., & Kageleiry, A. (2014). State-level unemployment and the utilization of preventive medical services. Health Services Research, 49(1), 186–205.CrossRefGoogle Scholar
  16. Tsutsui, Y., Benzion, U., Shahrabani, S., & Din, G. Y. (2010). A policy to promote influenza vaccination: A behavioral economic approach. Health Policy, 97(2), 238–249.CrossRefGoogle Scholar
  17. 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.
  18. Wells, B. L., & Horm, J. W. (1998). Targeting the underserved for breast and cervical cancer screening: The utility of ecological analysis using the National Health Interview Survey. American Journal of Public Health, 88(10), 1484–1489.CrossRefGoogle Scholar
  19. Wu, S. (2003). Sickness and preventive medical behavior. Journal of Health Economics, 22(4), 675–689.CrossRefGoogle Scholar
  20. 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

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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