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LETTER |
The authors are with the University of North Carolina, Chapel Hill. Sohini Sengupta and Giselle Corbie-Smith are with the Department of Social Medicine, Ronald P. Strauss is with the Department of Dental Ecology, and Angela Thrasher is with the Department of Health Behavior and Health Education.
Correspondence: Requests for reprints should be sent to Sohini Sengupta, PhD, MPH, Department of Social Medicine, Wing D Medical School, CB 7164, University of North Carolina, Chapel Hill, NC 27599-7164 (e-mail: sengups{at}med.unc.edu).
In their article "Racial/Ethnic Differences in Influenza Vaccination Coverage," Egede and Zheng highlighted the fact that, even though flu vaccine use has improved over time, racial/ethnic inequalities continue to persist. Blacks are less likely than Whites to be vaccinated, particularly in the age group 65 years and older.1 Furthermore, the authors emphasized greater patient–provider communication to improve vaccination rates among Black Americans, as physicians’ recommendations can influence flu vaccine use. Since we have not yet seen an end to this year’s flu epidemic, and the flu vaccine is in short supply and may not be as effective as in previous years,2 we are left to ponder additional strategies for protecting high-risk populations.
In a pilot qualitative study we conducted in Durham, NC, we asked a sample of 28 elderly Black Americans what other types of flu-preventive health behaviors they practice in addition to, or in lieu of, getting vaccinated. Seventeen flu prevention behaviors were identified, and they can be collapsed into 3 main categories. The first category focuses on keeping the body and immune system healthy, such as eating properly (n = 19), drinking fluids (n = 11), taking vitamins such as vitamin C (n = 7), exercising (n = 6), taking home remedies such as cod liver oil (n = 4), and getting plenty of rest (n = 3). The second category reflects various methods to "keep clean," such as washing hands (n = 3), using disinfectants to sterilize hands or surface areas (n = 3), and having antibacterial wipes handy (n = 2). The last category focuses on avoiding perceived high-risk contexts for getting the flu, such as staying indoors in the winter (n = 15), avoiding sick people (n = 9), and staying away from crowds (n = 2).
Egede and Zheng concluded with the need to implement "effective strategies to increase vacination rates" in health care settings.1 While we support such efforts, we feel that increasing vaccination rates is only a piece of the puzzle and that any targeted intervention developed for elderly African Americans would need to acknowledge the range of flu-preventive behaviors practiced as complementary to getting an annual flu vaccination.
Acknowledgments
The pilot study was funded by the UNC/North Carolina Central University Center for Minority Aging (NR04716-HL04039) and the Robert Wood Johnson Minority Medical Faculty Development Program.
References
1. Egede LE, Zheng D. Racial/ethnic differences in influenza vaccination coverage in high-risk adults. Am J Public Health. 2003;93:2074–2078.
2. More to come from the flu this year, experts say. New York Times. December 17, 2003. Available at: http://www.nytimes.com/2003/12/17/health/17FLU.html. Accessed December 17, 2003.
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