Social determinants, including the lack of paid sick leave, contributed to higher risk of exposure to the influenza A (H1N1) virus among Hispanics in the U.S. during the 2009 H1N1 pandemic, according to a study led by Sandra Crouse Quinn, professor of family science and senior associate director of the Maryland Center for Health Equity at the University of Maryland School of Public Health.
The findings are published online ahead of print in the American Journal of Public Health, November 17, 2011.
Several other studies from the pandemic found that H1N1 disease had a disproportionate impact on minorities, but the factors contributing to this disparity were not clear.
Dr. Quinn’s team, which included lead author, Dr. Supriya Kumar, and other researchers from the University of Pittsburgh and the University of Georgia, investigated how social determinants, such as workplace policies and household size, contributed to the incidence of influenza-like illness during the pandemic.
By surveying a nationally representative sample of 2,079 U.S. adults in January 2010, the research team discovered that incidence of influenza-like illness was strongly associated with workplace policies, such as lack of access to sick leave, and structural factors, such as having more children and crowding in the household. Even after controlling for income and education, the researchers found that Hispanic ethnicity was related to a greater risk of influenza-like illness attributable to these social determinants.
The study analysis also suggests that the absence of such sick leave policies could contribute to 5 million additional cases of influenza in the general population and 1.2 million additional cases among Hispanics during a subsequent pandemic.