DePaul University Newsline > Sections > Ask an Expert > Racial disparities in flu mortality persist in many large U.S. cities
By Kristin Claes Mathews /
October 22, 2021 /
Posted in: ASK AN EXPERT /
Lippert is a DePaul fellow with Sinai Urban Health Institute,
as part of a collaboration on education, research projects and development of programs that address social and health equity challenges. In this Q&A, she discusses her latest research with her colleagues published in the
Journal of Racial and Ethnic Health Disparities, analyzing racial inequities in flu mortality across the 30 biggest U.S. cities.
Influenza and pneumonia are consistently within the top ten leading causes of death in the United States. We set out to assess racial inequities in mortality in the 30 biggest U.S. cities from 2009-17. Public health researchers have established that many structural issues and social determinants of health contribute to the racial inequities in influenza and pneumonia mortality. Many of the same factors, including access to care, contributed to the racial health disparities we are seeing in COVID-19 mortality.
How are U.S. cities faring in addressing flu and pneumonia across racial demographics?
Influenza and pneumonia mortality have decreased over time nationally and significantly in 13 of the 30 cities we studied, including Chicago. While we didn't study this directly, progress can be attributed in large part to vaccination efforts. Nonetheless, there is a racial inequity in influenza and pneumonia mortality with significantly higher Black mortality rates in one third of the 30 largest U.S. cities.
For example, in Chicago, Black people are 18% more likely to die from pneumonia and influenza than white people. This racial inequity is decreasing in over half of the cities we studied, but only slightly. There are cities where this inequity remains largely the same or has increased over time. Chicago decreased in racial disparity but it was not statistically significant, meaning we have more work to do.
What can these findings, plus the learnings from the pandemic, teach us? What are the barriers to flu or COVID vaccination, as well as initiatives that work?
Both the successes and failures of the COVID-19 pandemic as well as flu vaccination are linked to access to care. Having employers give you the day off so you can be vaccinated can reduce barriers. We have seen successful efforts to reduce vaccine hesitancy in the Black population, such as campaigns from the NAACP.
As we’ve seen with COVID-19 vaccination efforts, often a mobilized response targeting people where they are can be most effective. Populations are not homogenous and that is why the city of Chicago has to offer a range of opportunities and resources, from educational outreach to bigger structural changes that make people’s default decision a healthy one. Requiring vaccinations — both for COVID-19 and the flu — can make a big difference.
Kristin Claes Mathews