Relationship between neighborhood census-tract level socioeconomic status and respiratory syncytial virus-associated hospitalizations in US adults, 2015-2017

• Authors: Evan Anderson, Emory University; Jenna E Holmen, UCSF Benioff Children’s Hospital; Lindsay Kim, Centers for Disease Control and Prevention (CDC), Atlanta; Bryanna Cikesh, Centers for Disease Control and Prevention (CDC), Atlanta; Pam D Kirley, California Emerging Infections Program; Shua J Chai, Centers for Disease Control and Prevention (CDC), Atlanta; Nancy M Bennett, University of Rochester; Christina B Felsen, University of Rochester; Patricia Ryan, Maryland Department of Health; Maya Monroe, Maryland Department of Health; Kyle P Openo, Georgia Department of Health, Atlanta; Kathryn Como-Sabetti, Minnesota Department of Health; Erica Bye, Minnesota Department of Health; Keipp H Talbot, Vanderbilt University; William Schaffner, Vanderbilt University; Alison Muse, New York State Department of Health; Grant R Barney, New York State Department of Health; Michael Whitaker, Centers for Disease Control and Prevention (CDC), Atlanta; Jennifer Ahern, University of California Berkeley; Christopher Rowe, University of California Berkeley; Gayle Langley, Centers for Disease Control and Prevention (CDC), Atlanta; Art Reingold, University of California Berkeley
• Journal Title: BMC INFECTIOUS DISEASES
• Volume: Volume 21, Number 1
• Publisher: BMC | 2021-03-23, Pages 293-293
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1186/s12879-021-05989-w
• Subjects: Health Sciences, Epidemiology; Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Infectious Diseases; RSV; Socioeconomic status; NEW-HAVEN COUNTY; RISK-FACTORS; INFLUENZA; DISPARITIES; INFECTION; HEALTH; CHILDREN; EPIDEMIOLOGY; SURVEILLANCE; INEQUALITIES

Abstract

Background: Respiratory syncytial virus (RSV) infection causes substantial morbidity and mortality in children and adults. Socioeconomic status (SES) is known to influence many health outcomes, but there have been few studies of the relationship between RSV-associated illness and SES, particularly in adults. Understanding this association is important in order to identify and address disparities and to prioritize resources for prevention. Methods: Adults hospitalized with a laboratory-confirmed RSV infection were identified through population-based surveillance at multiple sites in the U.S. The incidence of RSV-associated hospitalizations was calculated by census-tract (CT) poverty and crowding, adjusted for age. Log binomial regression was used to evaluate the association between Intensive Care Unit (ICU) admission or death and CT poverty and crowding. Results: Among the 1713 cases, RSV-associated hospitalization correlated with increased CT level poverty and crowding. The incidence rate of RSV-associated hospitalization was 2.58 (CI 2.23, 2.98) times higher in CTs with the highest as compared to the lowest percentages of individuals living below the poverty level (≥ 20 and < 5%, respectively). The incidence rate of RSV-associated hospitalization was 1.52 (CI 1.33, 1.73) times higher in CTs with the highest as compared to the lowest levels of crowding (≥5 and < 1% of households with > 1 occupant/room, respectively). Neither CT level poverty nor crowding had a correlation with ICU admission or death. Conclusions: Poverty and crowding at CT level were associated with increased incidence of RSV-associated hospitalization, but not with more severe RSV disease. Efforts to reduce the incidence of RSV disease should consider SES.