Online Program

Race/ethnic disparities in discharges from all US community, non-rehabilitation hospitals for respiratory syncytial virus among children one year or younger and the possible role of healthcare access

Monday, November 4, 2013

Vanessa Perez, Ph.D., M.S., Center for Epidemiology, Biostatistics, and Computational Biology, Exponent, Inc., Chicago, IL
Introduction: According to the Centers for Disease Control and Prevention, respiratory syncytial virus (RSV) is the most prevalent cause of bronchiolitis and pneumonia in children younger than one year in the US, with 75,000-125,000 hospitalizations estimated annually in this population. Research has shown that infants of ethnic minority status are more vulnerable to severe RSV disease compared to non-ethnic minorities. Methods: The 2006 Kids' Inpatient Database (KID) was used to quantify racial disparities for RSV hospitalization risk among children one year of age or younger at the time of admission. Discharge records for infants with an International Classification of Diseases, Ninth Revision, Clinical Modification code of 079.6 (RSV), 466.11 (RSV acute bronchiolitis), and 480.1 (RSV pneumonia) in any diagnosis field were analyzed. Findings were weighted to produce national estimates and associations were evaluated using PROC SURVEYLOGISTIC. Results: Controlling for seasonality, Native American infants were at increased risk for RSV-attributable hospitalization compared to non-Hispanic white infants (odds ratio [OR] and 95% confidence interval [CI] 1.50 (95% CI: 1.23-1.83)). In contrast, Asian/Pacific Islander infants had a 53% reduced odds of RSV hospitalization than did white infants (OR: 0.47 (95% CI: 0.40-0.55)). No significant differences between black, Hispanic, and white infants were observed. Further control for primary payer source (e.g. Medicare, Medicaid) weakened the findings. Discussion: The odds of RSV hospitalization in 2006 were highest among Native American infants and lowest among Asian/Pacific Islander infants in this study. Partial confounding by payer type suggests that health care access likely contributes to the race/ethnic disparities observed.

Learning Areas:


Learning Objectives:
Identify the risk of RSV-related hospitalization associated with race/ethnic minority status in the US among children aged 0 to 1 year. Assess if access to healthcare, as defined by primary payer type, explains the association between race/ethnicity and the risk of RSV-attributed hospitalization among children aged 0 to 1 year in the US.

Keyword(s): Infant Health, Risk Factors

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Ph.D. level epidemiologist with an interest in social epidemiology, health disparities, and population health. My dissertation work focused on risk factors for the severity of influenza among university students and I am currently preparing a systematic review for publication on health disparities in RSV outcomes among children to assist in future surveillance, clinical diagnosis, and treatment. I received my Ph.D. in Epidemiology (2010) from the University of Michigan at Ann Arbor.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.