The determinants of health-seeking behaviour during the A/H1N1 influenza pandemic: an ecological study

J Public Health (Oxf). 2011 Dec;33(4):503-10. doi: 10.1093/pubmed/fdr029. Epub 2011 Apr 2.

Abstract

Background: This is an ecological study that examines the relationship between antiviral drug collection during the 2009/2010 A/H1N1 influenza pandemic, and area-level ethnicity, socioeconomic deprivation and distance from an antiviral collection point (ACP).

Methods: Age-standardized antiviral collection rates (ACR) were calculated for each super output area (geographic areas representing a population of ∼1500) in Sandwell, UK for all residents who received an antiviral drug for influenza-like illness between 23 July 2009 and 7 February 2010. Multivariable regression was used to examine the relationship between ACR and ethnicity (percentage population non-white), socioeconomic deprivation (index of multiple deprivation, IMD) and distance from an ACP.

Results: Socioeconomic deprivation, ethnicity and distance from an ACP were independently associated with a reduction in ACR. Each one-point increase in the IMD score was associated with a drop in the ACR of 15.7 prescriptions per 100 000 population (P= 0.013).

Conclusions: Socioeconomic deprivation, ethnicity and distance from an ACP may have influenced health-seeking behaviour during the 2009/2010 influenza pandemic. This suggests possible inequalities in access to antivirals during the most recent influenza pandemic. Qualitative research is needed to examine the reasons for this. Individual-level data on ethnicity should be routinely collected in the event of a future pandemic.

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • England / epidemiology
  • Ethnicity
  • Female
  • Health Behavior / ethnology*
  • Health Services Accessibility*
  • Humans
  • Influenza A Virus, H1N1 Subtype / pathogenicity*
  • Influenza, Human / ethnology
  • Influenza, Human / prevention & control*
  • Male
  • Pandemics / prevention & control*
  • Socioeconomic Factors

Substances

  • Antiviral Agents