Assessment

The health disparity being examined is the hospital admissions for influenza among older, non-Hispanic white individuals in Virginia. The elderly population is at a higher risk for severe illness and death from the flu, and Virginia has a large gap to reach the benchmark for this disparity. Economic stability, education, health and healthcare, neighborhood and built environment, and social and community context are all social determinants that contribute to this disparity. Improving economic stability and education can help reduce the disparity. The health disparity I examined was hospital admissions for immunization-preventable influenza among the older, non-Hispanic white population age 65 and over in Virginia. Hospitalization can occur when individuals are not vaccinated against the flu leading to complications like pneumonia or bronchitis. Influenza can cause severe illness and even death, especially in the elderly population with an estimated death toll of 300,000 to 650,000 deaths being attributed to the flu annually, 1,009, 2021. In Virginia, the far distance to benchmark for this disparity is an estimated 254.3 based on a 53.3 benchmark resulting in a whopping 377% distance to benchmark, meaning Virginia has a lot of work to do in reaching the benchmark. The first social determinant of health that contributes to this disparity is economic stability. The health poverty trap is a term that has been assigned to describe the negative health effects that negative economic stability variables like poverty, housing instability, and unemployment have by increasing the risk for illness and injury. Sims, et al., 2023. Economic stability contributes to the disparity by impacting their access to healthcare services and preventative measures such as vaccination. Economic instability can result in unstable housing or reduced access to healthy food and clean water, leading to weakened immune systems making them more susceptible to infection. The second social determinant of health that contributes to the disparity is education. Education is a significant factor in a person's income because it greatly determines the kind of work individuals are eligible to obtain. There is well-documented incremental improvement in health as education levels resulting in completed degrees increases, which shows the economic rewards that generally accompany education. Braveman, 2023. Older adults with higher levels of education may be more knowledgeable about the importance of vaccination and more likely to seek out and achieve vaccination, leading to lower rates of infection and hospitalization, and they may be more likely to have healthier lifestyle regimes, such as regular exercise, healthy eating, and not smoking or drinking alcohol, which can help boost the immune system and reduce the risk of infection. Greater education generally means better insurance, better access to health services, and transportation, which can help facilitate vaccination and other preventative measures. The third social determinant of health that contributes to the disparity is health and healthcare. Unreliable access to healthcare services affects access to preventative care like flu vaccination. Older adults who have limited access to healthcare services or who are without health insurance have difficulty accessing flu vaccines, leading to lower rates of vaccination and increased risk of infection and hospitalization. Also, the quality of the healthcare can impact the effectiveness of the preventative measures, such as vaccination. Older adults who receive care from lower-quality healthcare providers and or facilities may receive an insufficient number of vaccines, leading to an increased risk of flu infection and hospitalization. Generally, older adults are less likely to receive healthcare services than their younger counterparts, with the percentage of recommended care received declining with increasing age with up to a 50% reduction for those 65 and older, Williams, 2007. The fourth social determinant of health that contributes to the disparity is neighborhood and built environment by enabling the elderly to be physically active and independent. This is an important characteristic in supporting or hindering physical activity, which can affect their health, Ma et al., 2015. Areas in Virginia with poor air quality or exposure to environmental pollutants may induce weakened immune systems, which would disproportionately affect those 65 and over, making the population more susceptible to infection. Neighborhood and built environment can affect the economic vitality of Virginia and contribute to the risk of infection and hospitalization by having limited access to healthy food options and safe outdoor spaces for physical activity. The fifth social determinant of health that contributes to disparity is social and community context. Older adults who have strong social networks and support may be more likely to receive flu immunizations due to variables like social norms, peer pressure, or support from family members and friends. Individuals who lack social support may feel isolated and unable to advocate for their healthcare. They may not have anyone to help them navigate the healthcare system, or they may lack the support necessary to make informed decisions about their care. The following is the correlation between network size and health outcomes with the primary negative effects coming from social isolation. Knapp and Hall, 2018. Two social determinants of health that could be addressed which would result in reducing the disparity are economic stability and education. Income inequality is a major contributor to economic instability and can be addressed by increased taxes, increased minimum wage, and expanding social services like Medicaid. Education can help reduce this health disparity by establishing education or job training programs to help this population develop the skills and knowledge they need when they are younger to secure stable employment and achieve economic stability when they are older, thus promoting healthy behaviors like flu immunization.