Date of Award:

8-2018

Document Type:

Dissertation

Degree Name:

Doctor of Philosophy (PhD)

Department:

Sociology, Social Work, and Anthropology

Advisor/Chair:

Eric Reither

Abstract

On June 11, 2009 the World Health Organization announced that a novel strain of H1N1 influenza was being classified a Phase 6 pandemic, the highest level of alarm indicating that the disease was present worldwide and its spread was inevitable. While seasonal influenza epidemics occur annually, the 2009 H1N1 strain was the first novel pandemic influenza since the 1968 Hong Kong flu. The 2009 H1N1 pandemic provides a case study of how the U.S. population responded to an emergent and potentially lethal infectious disease. The richness and variety of public health data presents an opportunity to examine predictors of vaccination among men and women from different racial/ethnic groups. Because vaccination is often the most effective way to prevent influenza, it is important to understand the predictors of low vaccination uptake during the H1N1 pandemic to better prepare for future novel outbreaks of influenza.

Through a series of three research papers, my dissertation provides a comprehensive examination of the ways that race, ethnicity and gender affected H1N1 vaccination behavior. Paper 1 explores the diversity of the U.S. Hispanic population by estimating H1N1 vaccination uptake among U.S-born and foreign-born Hispanics. In Paper 2, I shift my focus to H1N1 vaccination disparities between non-Hispanic whites and non-Hispanic blacks in the U.S. This paper further explores racial disparities in vaccination by examining intersections with gender and analyzing the influence of attitudes and beliefs about the H1N1 vaccine. In Paper 3, I provide a more detailed account of the socioeconomic and attitudinal mechanisms through which race, ethnicity and gender influence H1N1 vaccination. My research confirms large racial/ethnic disparities in H1N1 vaccination and identifies mechanisms amenable to policy change that could reduce the disease burden of a future influenza pandemic.

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