Community Coalition Launches Program to Eliminate Disparities in Older Adult Immunizations
Rochester One of Five Sites Selected to Create National Model
December 12, 2002
Just 39 percent of African Americans in Monroe County over the age of 65 receive a flu shot, compared with 71 percent of Whites, even though the flu is a serious illness that kills more than 20,000 people nationwide each year. Today, the Monroe County Department of Health and the University of Rochester Medical Center announced that Rochester is one of five sites selected by the Centers for Disease Control and Prevention (CDC) to develop a model program to eliminate disparity in older adult immunizations.
The program is part of CDC’s Racial and Ethnic Adult Disparities in Immunization Initiative (READII). Five areas around the country (Chicago, Illinois; Milwaukee, Wisconsin; San Antonio, Texas; rural counties in Mississippi, and Rochester) were chosen to research, develop and test two-year programs to reduce racial and ethnic disparities in adult flu and pneumococcal vaccinations for adults 65 years of age and older. Their successes will then be used to guide efforts across the country, with the ultimate goal of eliminating older adult vaccination disparities nationwide.
According to Nancy M. Bennett, M.D., deputy director of the Monroe County Department of Health and principal investigator for READII Rochester, Rochester was awarded the two-year $800,000 grant due to its successful track record in adult and childhood immunizations. A Community Advisory Board comprised of 33 organizations representing public health professionals, physician practices and neighborhood health clinics, health systems, insurers, and social service agencies was formed to identify and implement strategies to increase immunization levels.
“Over the past decade, our community has developed novel approaches that have boosted adult immunization rates overall, and eliminated the disparity gap in childhood immunizations,” Bennett said. “However, there is still much work to do with the older adult minority community. With this grant, we plan to build on our successes and develop a program to help our African American seniors understand the importance of flu and pneumococcal vaccinations, and provide them ways to quickly and easily obtain these lifesaving shots.”
University of Rochester Medical Center CEO Jay Stein, M.D. noted that READII Rochester is consistent with the University’s commitment to improving the health of Rochester.
“If we are to make Rochester a healthier community, we must address the health status of our African American and Latino populations, which exhibit startling disparities not only in immunization rates, but in several other health areas such as diabetes, infant mortality and heart disease,” Stein said. “We are honored to help lead this local effort that will positively impact the health of our community’s African American seniors.”
READII Rochester will combine community outreach and education with a comprehensive on-site intervention at medical clinics and physician offices. This primary care practice intervention is the foundation of READII Rochester, and is modeled after a similar approach that was successfully used in Monroe County to eliminate childhood vaccination disparities in the 1990s.
Most of Monroe County’s 7,000 African American seniors live in the city of Rochester and obtain medical care at neighborhood health centers, hospital-based clinics and a half-dozen group practices located in the inner city. READII Rochester outreach workers will be placed in these sites to work with staff to identify unvaccinated seniors. Once identified, a system of physician prompts, personalized letters, and phone calls will be used to motivate older adults to obtain flu and pneumococcal vaccines. Home visits and access to transportation will be provided as necessary.
The following eight locations are participating in this effort, effectively targeting approximately 80 percent of Rochester’s African American seniors:
- Anthony Jordan Health Center
- Culver Medical Group
- Downtown Healthcare
- Genesee Health Services
- Highland Hospital Family Medicine
- Rochester General Hospital Outpatient
- Department Strong Memorial Hospital Medical Clinic
- Westside Health Services
Mark Brown, M.D., medical director of Westside Health Services, said that the area’s disparity in older adult immunizations is a result of many factors including misinformation about vaccines and lack of healthcare access.
“We know immunizations work, yet too many of our elderly—especially African Americans—are not getting the shots that can prevent flu and pneumonia,” Brown said. “Our job is to intensely educate our African American seniors about the benefits of the vaccines, and motivate them to get up to date on their immunizations.”
In addition to the primary care practice intervention, community outreach and education, spearheaded by members of the READII Rochester Community Advisory Board will occur during the two-year grant cycle. Many of the organizations will deliver the READII Rochester message utilizing their existing programs and networks, while others will create a special program targeted at African Americans.
Primary categories of outreach and education include:
- Public Flu Clinics: Increase number of public flu clinics held in inner city areas
- Community Awareness: Educational advertising and PSA campaign on benefits of flu vaccine
- Physician Education: Efforts aimed at physicians and their office staff to boost physician-based flu clinics
- Grass-roots Activities: Carried out in a variety of forms, will include everything from neighborhood canvassing to church-based outreach
Focus on the Flu
READII Rochester is already underway with a proactive campaign to increase 2002-2003 flu vaccination rates. Brown noted that the flu has yet to reach Monroe County this season, so the flu vaccine is still highly effective.
“Getting the flu shots save lives—especially for people ages 65 and older,” Brown said. “Flu is the fourth leading cause of death among those 65 years of age and older in Monroe County, and nationwide about 20,000 persons die each year from complications of illness due to the flu virus. It’s our hope that we can greatly reduce hospitalization and death rates in Rochester by convincing our African American seniors to get the flu shot.”
Upcoming events to promote the flu vaccine to African American seniors include: ·
- Special public clinics will be held at the Rochester Public Market on Thursday, December 12 and Saturday, December 14 in the Market Office Foyer from 10 a.m. to 1 p.m.
- Targeted advertising campaign on WDKX and WWWG radio stations and PSAs running on all major cable and network television stations
- Active outreach with the inner city African American churches, culminating in on-site flu clinics.
Flu and Pneumonia Background Information
Annual epidemics of influenza impose an enormous health and economic burden on society. Every year, the U.S. spends $10 billion treating adults for vaccine-preventable diseases. On average, more than 20,000 deaths and 114,000 hospitalizations occur every year due to influenza, and most of the deaths from the flu occur in the elderly.
There are approximately 60,000 cases of invasive pneumococcal disease in the U.S. every year and about 20,000—or one-third—are in people age 65 and older. More than half of the estimated 6,000-7,000 annual deaths from invasive pneumococal disease occur in the elderly.
In the combined 1999 and 2001 Behavioral Risk Factor Surveillance System surveys, 68 percent of older whites received influenza vaccination, compared to only 48 percent and 57 percent of older African-Americans and Hispanics, respectively. Disparities for pneumococcal vaccination coverage were even wider, with 60 percent for whites, 38 percent for African Americans and 38 percent for Hispanics.
In Monroe County, 71 percent of older whites received influenza vaccination, compared to only 39 percent of older African-Americans. For pneumococcal vaccination coverage, 75 percent of older whites received the vaccine versus 42 percent of older African Americans.
The HHS READII project is being implemented by CDC, with support from the Centers for Medicare and Medicaid Services (CMS), the Health Resources and Services Administration (HRSA) and other federal agencies.