Vukovic V, Lillini R, Asta F, Chini F, DE Waure C
Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, Italy.
J Prev Med Hyg. 2019 Feb 28;59(4 Suppl 2):E31-E37. doi: 10.15167/2421-4248/jpmh2018.59.4s2.1142. eCollection 2018 Dec.
Elderly people are more likely to develop influenza-related complications. However, despite the recommendations, the optimal vaccination coverage is not reached. The use of deprivation indexes can help to identify subgroups with lower vaccination uptake. We analyzed vaccination coverage among elderly subjects living in the city of Rome on the basis of their socioeconomic characteristics by using a local deprivation index.
We focused on the population aged ≥ 65 years living in the city of Rome from 2009 to 2013. Information on vaccination coverage was collected from general practitioners. A combination of multivariate techniques, including multiple linear regression, factor and cluster analysis, was used to construct a composite area-based Index of Socio-Economic and Health Deprivation (SEHDI). The index was calculated for each census tract on the basis of data from the 2001 Italian census.
The majority of elderly subjects living in Rome belonged to the medium (40.4%) and medium-high (24%) deprivation groups; only 4.5% of the population was in the low-deprivation group. An inverse relationship was found between influenza vaccination coverage and the deprivation index: elderly subjects in the low-deprivation group displayed lower coverage (55.45%) than those in the high-deprivation group (57.59%). Specifically, vaccination coverage decreased with the increase of replacement index, employment rate and the percentage of: single and divorced individuals; university and high-school graduates; employees, entrepreneurs and freelancers, family assistants, students; foreigners and stateless persons residing in Italy; families consisting of one person.
Our results show an inverse relationship between deprivation and vaccination coverage and may help to identify subgroups that could benefit from targeted initiatives to increase vaccination coverage.
老年人更容易出现与流感相关的并发症。然而，尽管有相关建议，但仍未达到最佳的疫苗接种覆盖率。使用贫困指数有助于识别疫苗接种率较低的亚组。我们通过使用当地贫困指数，根据社会经济特征分析了居住在罗马市的老年人的疫苗接种覆盖率。
我们关注的是2009年至2013年居住在罗马市的65岁及以上人群。疫苗接种覆盖率信息从全科医生处收集。采用包括多元线性回归、因子分析和聚类分析在内的多种多元技术组合，构建了一个基于区域的综合社会经济和健康贫困指数（SEHDI）。该指数是根据2001年意大利人口普查数据为每个普查区计算的。
居住在罗马的大多数老年人属于中等贫困组（40.4%）和中高贫困组（24%）；只有4.5%的人口属于低贫困组。流感疫苗接种覆盖率与贫困指数之间存在反比关系：低贫困组的老年受试者的接种覆盖率（55.45%）低于高贫困组（57.59%）。具体而言，接种覆盖率随着替代指数、就业率以及以下人群百分比的增加而降低：单身和离异人士；大学和高中毕业生；员工、企业家和自由职业者、家庭助理、学生；居住在意大利的外国人及无国籍人士；单人家庭。
我们的结果显示贫困与疫苗接种覆盖率之间存在反比关系，可能有助于识别那些可以从旨在提高疫苗接种覆盖率的针对性举措中受益的亚组。
