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Biosecurity News in Brief
Study Calls Attention to the Importance of Minimizing Disparities in Pandemic PlanningBy Brooke Courtney, April 4, 2008 A new study published by Emerging Infectious Diseases describes the specific “ways in which different socioeconomic and racial/ethnic groups might fare differently in an influenza pandemic on the basis of current knowledge of social factors that shape exposure and vulnerability to influenza virus and that influence the timeliness and adequacy of treatment among those who become ill.” The article also considers how “policy decisions, made either before or during a pandemic…might differentially affect risk for illness or death” for certain groups of individuals. The authors note that pandemic plans often do not adequately address disparities, and they call upon pandemic planners to develop “[e]xplicit, systematic, and detailed plans for overcoming the social barriers that are predicted to result in socioeconomic and racial/ethnic disparities in pandemic influenza illness and death.”1 According to the article, the purposes of the study were two-fold: (1) to “call attention to potentially major and avoidable social disparities in suffering and death during an influenza pandemic,” and (2) to “highlight the importance of including in pandemic preparedness plans targeted strategies for minimizing or avoiding” such disparities. The authors adapted a previously published conceptual framework and used published population-based data to systematically evaluate possible sources of disparities during a pandemic.1 Specifically, the authors analyzed differences in certain socioeconomic groups’ likelihood of being exposed to the influenza virus, contracting influenza disease, and receiving timely and effective treatment after contracting the disease. The authors report that crowding (e.g., within residences and as a result of greater reliance on public transportation and emergency departments and clinics for medical care) and occupational factors (e.g., not being able to stay at home from work) can increase the likelihood of exposure to the influenza virus and may be more common among certain population groups. In addition, patterns of annual influenza and other diseases indicate that “socially disadvantaged groups are likely to be at higher risk for [contracting] influenza disease, particularly severe disease,” and may be less likely to seek or accept vaccines in response to a pandemic. The study also found that, “given long-standing and persistent disparities in access to medical care,” the likelihood of access-to-care disparities based on socioeconomic status, race/ethnicity, ability to speak English, and legal status after contracting the disease would be high.1 The authors offer policy recommendations and propose that certain disparities can be minimized through careful planning that addresses vulnerability at each level (exposure, susceptibility, and treatment). For example, planners “should consider likely differences in influenza exposure and identify potential strategies for mitigating such disparities” and take into account how certain strategies, such as limiting public gatherings and implementing quarantines, could differentially affect disadvantaged groups. Additionally, planners should address issues such as accessibility of vaccination and treatment, development of vaccine and medication distribution plans to limit crowding, and involvement of community-based providers and organizations that have familiarity with vulnerable groups in preparedness planning.1 References
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