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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Matilde Irigoyen, MD1, Sally Findley, PhD2, Marian D. Chitu, MD1, Shaofu Chen, PhD1, and Pamela Sternfels, ScM2. (1) Division of General Pediatrics, Columbia University, 622 W. 168th St., VC4-402, New York, NY 10032, 212-305-6227, mi5@columbia.edu, (2) Northern Manhattan Start Right Coalition, Columbia University, 60 Haven Avenue, Heilbrunn Center for Population and Family Health, New York, NY 10032
Background: In 1996 an immunization program was launched in two low-income minority communities in New York City (NYC) to reduce disparities in coverage rates relative to the city and the nation. Methods: From 1996-2000, we conducted semi-annual audits of 3,568 randomly selected children ages 12-23 months at 8 inner city practices implementing immunization programs in the communities of Harlem and Washington Heights, NYC. Practice coverage rates were assessed for DTaP, Polio, MMR, and Hib (4:3:1:3). The levels and changes in coverage in these communities were compared to published US and NYC population-based rates. Results: Coverage rates in Harlem/Washington Heights were significantly lower than the citywide and national rates at all time periods. In 1996, the community-city coverage gap was 12.2% and community-nation gap was 20.3%. In 2000, these gaps were reduced to 8.4% and 15.8%, respectively. The communities' coverage rate increased 2-times faster than citywide and national coverage rates (1.4% vs. 0.7% and 0.5%, respectively). Coverage increased everywhere 1996-1998, then diverged. Citywide and national coverage began dropping in 1998, while coverage in the communities began dropping in 1999. There were no significant differences between the rates of change in the communities and citywide and national rates of change. Conclusions: The immunization program launched in 1996 reduced coverage disparities in these two low-income minority communities, relative to citywide and national levels. However, following the nation and city, Harlem/Washington Heights experienced a drop in coverage after 1999. Factors affecting adverse trends in coverage at citywide and national levels also impacted these communities.
Learning Objectives:
Keywords: Immunizations, Minorities
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.