Los Angeles County Department of Public Health, CA 90005, USA.
J Public Health Manag Pract. 2011 Jan-Feb;17(1):20-7. doi: 10.1097/PHH.0b013e3181ff2ad7.
Pandemic preparedness and response (as with all public health actions) occur within a social, cultural, and historical context of preexisting health disparities and, in some populations, underlying mistrust in government. Almost 200,000 people received H1N1 vaccine at 109 free, public mass vaccination clinics operated by the Los Angeles County Department of Public Health between October 23, 2009, and December 8, 2009. Wide racial/ethnic disparities in vaccination rates were observed with African Americans having the lowest rate followed by whites.
METHODOLOGY/PRINCIPAL FINDINGS: Demographic information, including race/ethnicity, was obtained for 163 087 of the Los Angeles County residents who received vaccine. This information was compared with estimates of the Los Angeles County population distribution by race/ethnicity. Rate ratios of vaccination were as follows: white, reference; African American, 0.5; Asian, 3.2; Hispanic, 1.5; Native American, 1.9; and Pacific Islander, 4.3.
Significant political challenges and media coverage focused on equity in vaccination access specifically in the African American population. An important challenge was community-level informal messaging that ran counter to the "official" messages. Finally, we present a partnership strategy, developed in response to the challenges, to improve outreach and build trust and engagement with African Americans in Los Angeles County.
大流行的防备和应对（与所有公共卫生行动一样）发生在存在先前存在的健康差距的社会、文化和历史背景下，在某些人群中，对政府的信任度较低。在 2009 年 10 月 23 日至 12 月 8 日期间，洛杉矶县公共卫生部在 109 个免费的公共大规模疫苗接种诊所中为近 20 万人接种了 H1N1 疫苗。接种率存在广泛的种族/族裔差异，非裔美国人的接种率最低，其次是白人。
方法/主要发现：为在洛杉矶县接种疫苗的 163087 名居民获得了人口统计信息，包括种族/族裔。将这些信息与按种族/族裔估计的洛杉矶县人口分布进行了比较。接种疫苗的比率比为：白人，参考；非裔美国人，0.5；亚裔，3.2；西班牙裔，1.5；美洲原住民，1.9；和太平洋岛民，4.3。
在接种疫苗方面的公平性，特别是在非裔美国人中，面临着重大的政治挑战和媒体报道。一个重要的挑战是社区层面的非正式信息传递，这与“官方”信息背道而驰。最后，我们提出了一种合作伙伴关系策略，旨在应对挑战，以改善与洛杉矶县非裔美国人的外联工作，并建立信任和参与。
