Racial disparities in human papillomavirus vaccination

Does access matter?

Amanda Gelman, Elizabeth Miller, Eleanor Schwarz, Aletha Y. Akers, Kwonho Jeong, Sonya Borrero

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Purpose To examine the association between race/ethnicity and human papillomavirus (HPV) vaccine initiation and to determine how access to health care influences this relationship. Methods We used nationally representative data from the National Survey of Family Growth to assess HPV vaccine initiation in 2,168 females aged 15-24 years. A series of regression analyses were performed to determine the independent effect of race/ethnicity on HPV vaccine initiation after controlling for sociodemographic variables and health care access measures. Age-stratified regression analyses were also performed to assess whether the relationship between race/ethnicity and HPV vaccine initiation differed among females aged 15-18 and 19-24 years. Results There were significant racial/ethnic disparities in HPV vaccination; United States (US)-born Hispanics, foreign-born Hispanics, and African-Americans were less likely to have initiated vaccination than were whites (p <.001). Adjusting for sociodemographic characteristics attenuated the disparity for both US-born and foreign-born Hispanics (adjusted odds ratio [AOR],.76; 95% confidence interval [CI],.50-1.16; and AOR,.67; 95% CI,.37-1.19) but not for African-Americans (AOR,.47, 95% CI,.33-.66). Adding health care access measures further attenuated the disparity for US-born and foreign-born Hispanics (AOR,.85, 95% CI,.54-1.34; and AOR,.84, 95% CI,.45-1.55). However, African-Americans remained less likely than whites to have initiated vaccination (AOR,.49, 95% CI,.36-.68). These racial/ethnic trends were similar for females aged 15-18 and 19-24 years. Conclusions Lower rates of HPV vaccination among African-American females do not appear to be explained by differential access to health care. More research is necessary to elucidate factors contributing to HPV vaccination in this population.

Original languageEnglish (US)
Pages (from-to)756-762
Number of pages7
JournalJournal of Adolescent Health
Volume53
Issue number6
DOIs
StatePublished - Dec 2013
Externally publishedYes

Fingerprint

Papillomavirus Vaccines
Vaccination
Odds Ratio
Confidence Intervals
Hispanic Americans
African Americans
Health Services Accessibility
Regression Analysis
Delivery of Health Care
Growth
Research
Population

Keywords

  • Disparities
  • Human papillomavirus
  • National Survey of Family Growth
  • Race/ethnicity
  • Vaccination

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health
  • Public Health, Environmental and Occupational Health

Cite this

Racial disparities in human papillomavirus vaccination : Does access matter? / Gelman, Amanda; Miller, Elizabeth; Schwarz, Eleanor; Akers, Aletha Y.; Jeong, Kwonho; Borrero, Sonya.

In: Journal of Adolescent Health, Vol. 53, No. 6, 12.2013, p. 756-762.

Research output: Contribution to journalArticle

Gelman, Amanda ; Miller, Elizabeth ; Schwarz, Eleanor ; Akers, Aletha Y. ; Jeong, Kwonho ; Borrero, Sonya. / Racial disparities in human papillomavirus vaccination : Does access matter?. In: Journal of Adolescent Health. 2013 ; Vol. 53, No. 6. pp. 756-762.
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abstract = "Purpose To examine the association between race/ethnicity and human papillomavirus (HPV) vaccine initiation and to determine how access to health care influences this relationship. Methods We used nationally representative data from the National Survey of Family Growth to assess HPV vaccine initiation in 2,168 females aged 15-24 years. A series of regression analyses were performed to determine the independent effect of race/ethnicity on HPV vaccine initiation after controlling for sociodemographic variables and health care access measures. Age-stratified regression analyses were also performed to assess whether the relationship between race/ethnicity and HPV vaccine initiation differed among females aged 15-18 and 19-24 years. Results There were significant racial/ethnic disparities in HPV vaccination; United States (US)-born Hispanics, foreign-born Hispanics, and African-Americans were less likely to have initiated vaccination than were whites (p <.001). Adjusting for sociodemographic characteristics attenuated the disparity for both US-born and foreign-born Hispanics (adjusted odds ratio [AOR],.76; 95{\%} confidence interval [CI],.50-1.16; and AOR,.67; 95{\%} CI,.37-1.19) but not for African-Americans (AOR,.47, 95{\%} CI,.33-.66). Adding health care access measures further attenuated the disparity for US-born and foreign-born Hispanics (AOR,.85, 95{\%} CI,.54-1.34; and AOR,.84, 95{\%} CI,.45-1.55). However, African-Americans remained less likely than whites to have initiated vaccination (AOR,.49, 95{\%} CI,.36-.68). These racial/ethnic trends were similar for females aged 15-18 and 19-24 years. Conclusions Lower rates of HPV vaccination among African-American females do not appear to be explained by differential access to health care. More research is necessary to elucidate factors contributing to HPV vaccination in this population.",
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N2 - Purpose To examine the association between race/ethnicity and human papillomavirus (HPV) vaccine initiation and to determine how access to health care influences this relationship. Methods We used nationally representative data from the National Survey of Family Growth to assess HPV vaccine initiation in 2,168 females aged 15-24 years. A series of regression analyses were performed to determine the independent effect of race/ethnicity on HPV vaccine initiation after controlling for sociodemographic variables and health care access measures. Age-stratified regression analyses were also performed to assess whether the relationship between race/ethnicity and HPV vaccine initiation differed among females aged 15-18 and 19-24 years. Results There were significant racial/ethnic disparities in HPV vaccination; United States (US)-born Hispanics, foreign-born Hispanics, and African-Americans were less likely to have initiated vaccination than were whites (p <.001). Adjusting for sociodemographic characteristics attenuated the disparity for both US-born and foreign-born Hispanics (adjusted odds ratio [AOR],.76; 95% confidence interval [CI],.50-1.16; and AOR,.67; 95% CI,.37-1.19) but not for African-Americans (AOR,.47, 95% CI,.33-.66). Adding health care access measures further attenuated the disparity for US-born and foreign-born Hispanics (AOR,.85, 95% CI,.54-1.34; and AOR,.84, 95% CI,.45-1.55). However, African-Americans remained less likely than whites to have initiated vaccination (AOR,.49, 95% CI,.36-.68). These racial/ethnic trends were similar for females aged 15-18 and 19-24 years. Conclusions Lower rates of HPV vaccination among African-American females do not appear to be explained by differential access to health care. More research is necessary to elucidate factors contributing to HPV vaccination in this population.

AB - Purpose To examine the association between race/ethnicity and human papillomavirus (HPV) vaccine initiation and to determine how access to health care influences this relationship. Methods We used nationally representative data from the National Survey of Family Growth to assess HPV vaccine initiation in 2,168 females aged 15-24 years. A series of regression analyses were performed to determine the independent effect of race/ethnicity on HPV vaccine initiation after controlling for sociodemographic variables and health care access measures. Age-stratified regression analyses were also performed to assess whether the relationship between race/ethnicity and HPV vaccine initiation differed among females aged 15-18 and 19-24 years. Results There were significant racial/ethnic disparities in HPV vaccination; United States (US)-born Hispanics, foreign-born Hispanics, and African-Americans were less likely to have initiated vaccination than were whites (p <.001). Adjusting for sociodemographic characteristics attenuated the disparity for both US-born and foreign-born Hispanics (adjusted odds ratio [AOR],.76; 95% confidence interval [CI],.50-1.16; and AOR,.67; 95% CI,.37-1.19) but not for African-Americans (AOR,.47, 95% CI,.33-.66). Adding health care access measures further attenuated the disparity for US-born and foreign-born Hispanics (AOR,.85, 95% CI,.54-1.34; and AOR,.84, 95% CI,.45-1.55). However, African-Americans remained less likely than whites to have initiated vaccination (AOR,.49, 95% CI,.36-.68). These racial/ethnic trends were similar for females aged 15-18 and 19-24 years. Conclusions Lower rates of HPV vaccination among African-American females do not appear to be explained by differential access to health care. More research is necessary to elucidate factors contributing to HPV vaccination in this population.

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