NEWS

Ohio State Flu Shot Initiative Addresses Racial Inequities In Health Care

masked doctor talking to masked patient

The Ohio State University Wexner Medical Center

Key Takeaways

  • The Ohio State University Wexner Medical Center hopes to combat racial inequities in health care by taking steps to make flu shots more accessible to underserved communities.
  • The medical center has taken several steps, including purchasing more flu shot doses and doing community outreach, to ensure that at-risk people have access to the vaccine.
  • The initiative is now in its second year, and the medical center plans to continue it annually until there is no longer a need.

The Ohio State University Wexner Medical Center has launched an influenza vaccine initiative to try to address racial inequities in health care and improve access to flu shots in at-risk communities.

Aaron Clark, DO, a family medicine physician at The Ohio State University Wexner Medical Center and medical director of the Ohio State Health Accountable Care Organization, tells Verywell that the initiative came from the center's Anti-Racism Action Plan committee.

“They recommended a top-of-house corporate scorecard level health equity initiative be implemented,” Clark says. “After discussion and input from a diverse group of clinical and operational leaders, we settled on reducing influenza immunization disparities between our Black and non-Black patient populations.”

Clark says the goal of the Ohio State initiative, which began in August 2020, is to "eliminate the disparity in rates of influenza immunization between the Black and non-Black patients" at the medical center.

Racial Disparities and The Flu

A 10-year analysis from the Centers for Disease Control and Prevention (CDC) found that there are racial disparities in the rates of hospitalization, intensive care unit (IUC) admissions, and in-hospital deaths related to flu illnesses.

The data showed that the rate of flu-related hospitalization is:

  • Highest for non-Hispanic Black people (69 per 100,000, compared to 38 per 100,00 in non-Hispanic white people)
  • Second-highest for non-Hispanic American Indian or Alaska Native people (49 per 100,000)
  • Third-highest for people who are Hispanic or Latino (45 per 100,000)
  • Lowest for non-Hispanic Asian people (32 per 100,000)

The disparities start young: children under the age of five who belong to a racial or ethnic minority group are 1.3 to 4.4 times more likely to be hospitalized, enter the ICU, or die in the hospital of the flu than non-Hispanic white children of the same age.

The data also showed that racial disparities related to the flu go beyond hospitalizations. The rate of flu-related ICU admissions is:

  • Highest for Non-Hispanic Black people (12 per 100,000)
  • Second-highest for Non-Hispanic American Indian or Alaska Native people (9 per 100,000)
  • Third-highest for Hispanic or Latino and non-Hispanic white people (7 per 100,000)
  • Lowest for non-Hispanic Asian people (6 per 100,000)

Deaths in the hospital from the flu are also the highest in non-Hispanic Black people, who are 1.1 times more likely to die from the flu than other racial populations.

Addressing the Disparities

The first step for the Ohio State team to increase the number of flu vaccines purchased. It also created new clinical procedures to offer flu vaccines in its emergency departments, pharmacies, primary care offices, specialty clinics, and inpatient units.

By March 2021, the medical center had given 10 times the number of flu shots to non-white patients in its emergency room than it had during the entire 2019-2020 flu season.

Targeted outreach was also implemented to help make sure that flu vaccines were accessible to at-risk populations. For example, a team of nurses called patients in specific zip codes to encourage them to get the flu shot, and also listened to patients' concerns. Other efforts to help get flu shots to underserved communities included drive-through programs, pop-up clinics, and a mobile health unit.

Aaron Clark, DO

It takes unrelenting determination and willingness to be transparent on outcomes and make changes when strategies are not working as intended.

— Aaron Clark, DO

Next Steps

Now in its second year, Clark says that community groups have been receptive to the initiative, but he also acknowledges that “it was a challenge to add influenza immunizations to the scope of community needs while the COVID pandemic was still such a disruptive force."

Clark admits that, “solving disparities is hard" and that "it takes unrelenting determination and willingness to be transparent on outcomes and make changes when strategies are not working as intended."

When the initiative was created in the summer of 2020, Clark says that there was a real concern about what it would be like to experience flu season on top of the COVID-19 pandemic. Even though there have been challenges, there have also been successes.

For example, Clark says that the medical center has been able to "enhance access to influenza immunizations in areas such as walk-in pharmacies, our emergency departments, all ambulatory care settings, and our community care coach.”

According to Clark, the initiative will continue yearly “until the need for this work is no longer present.” 

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  1. Centers for Disease Control and Prevention. Flu disparities among racial and ethnic minority groups. Updated September 3, 2021.