Flu Vaccinations in Asian Indians: A Case for Improving Health Insurance Coverage

Purpose:The purpose of this study was to investigate differences in flu vaccination rates among racial and ethnic minorities, specifically focusing on Asian Indians and the effects of various contextual factors, such as health insurance coverage and nativity.

Methods: We examined the association between race and ethnicity, separating Asian Indians from Asians, insurance coverage, and socio-economic status with flu vaccination uptake The National Health Interview Survey (NHIS), conducted by the National Center for Health Statistics for 2013. The NHIS uses multistage probability sampling to select approximately 41,000 households and 107,000 individuals each year. Multivariable regression models were used to compute estimates and 95% confidence intervals (CI).

Results: Of all racial and ethnic groups, Asian Indians had one of the highest odds of flu vaccine uptake; race was a statistically significant predictor, with Blacks being less likely to vaccinate and Asians and Asian Indians to be more likely to vaccine as compared to Whites. For example, when only demographic variables are controlled for, Asian Indians are 69% more likely to get flu vaccine (OR= 1.69, t-stat = 4.28). However, the effects of race were ameliorated to the point at which being Asian Indian was no longer significant (t-stat = 0.43) with the introduction of binary measures of income (high vs. low) and insurance coverage (insured vs. uninsured) after adjusting for confounders.

Conclusion: Historic disparities research has often addressed Asians as a homogenous mass; however, the availability of sub-group data has allowed us to parse effects which has resulted in informative findings and begs the question: when targeting Asian Indians with health interventions, does race matter or are there other mainstream indicators which provide my valuable insight?