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Blacks Slow to Opt for HPV Vaccination – racial profiling?

[preamble]In a continuation of racial profiling, if you read this article, it is VERY specific about blacks and their deficiencies. Hence is this not racial profiling? Why is it OK for this type of profiling and not for the police when the statistics state the same deficiencies?

I again postulate that “meaningful use” questions and their usage is discriminatory and racial profiling hence unconstitutional[backtopost]
Published: Aug 28, 2013 | Updated: Aug 29, 2013

By Charles Bankhead, Staff Writer, MedPage Today

Reviewed by F. Perry Wilson, MD, MSCE; Instructor of Medicine, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse

Uptake of human papillomavirus (HPV) vaccine has lagged considerably in African Americans as compared with other racial/ethnic groups for reasons that remain unclear, a review of a national database showed.

Young African-American women were about half as likely to report HPV vaccination as compared with whites. Hispanic women also had lower vaccination rates, but the difference did not reach statistical significance.

Adjustment for differences in access to healthcare further attenuated differences between whites and Hispanics, whereas vaccination rates in African-American women remained about 50% below the rate of white women, as reported online in the Journal of Adolescent Health.

“This disparity persisted among both younger (15 to 18) and older (19 to 24) African Americans,” Sonya Borrero, MD, of the University of Pittsburgh, and co-authors said of their findings. “Disparities in HPV vaccination for Hispanics, on the other hand, were fully attenuated after adjusting for sociodemographic and healthcare access variables.”

“Research is needed to further elucidate the reasons for undervaccination among African-American adolescents and young women and identify ways in which providers and healthcare systems may improve HPV vaccine uptake for this vulnerable population,” they added.

Evidence supporting the safety and efficacy of HPV vaccination has so far proven insufficient to persuade a majority of female adolescents and young women to initiate the vaccine series. An estimated 53% of girls 13 to 17 and 21% of women 19 to 26 have reported initiating HPV vaccination, and vaccinations rates have slowed after a period of increasing uptake.

Cervical cancer occurs more often and causes more deaths in Hispanic and African-American women than in white women. The disparity emphasizes the importance of understanding barriers to HPV vaccination in these populations, the authors noted in their introduction.

Previous attempts to quantify vaccine uptake by race/ethnicity have yielded inconsistent results. However, the results have been based primarily on data collected prior to 2008, the authors continued.

To provide more current estimates of vaccine uptake, Borrero and colleagues searched the National Survey of Family Growth for females 15 to 24 who participated in the 2006 to 2010 surveys. Beginning with the 2008 survey, a question about access to a healthcare provider was added, affording an opportunity to examine the impact of access on outcomes of interest.

The study sample comprised 2,168 adolescent females and young women who participated in the surveys from the study period. Whites accounted for 63.6% of the sample, U.S.-born Hispanics for 13.8%, foreign-born Hispanics for 5.3%, and African Americans for 17.2%.

The four racial/ethnic groups differed substantially with respect to sociodemographic characteristics: Hispanics were more likely to be uninsured than whites were. African-American participants were more likely than whites to have public insurance. Hispanics and African Americans were less likely to have a usual source of healthcare.

Overall, 28.4% of participants had received at least one dose of HPV vaccine, including 33.1% of whites, 24.2% of U.S.-born Hispanics, 18.2% of African Americans, and 16.2% of foreign-born Hispanics. All three minority groups had significantly lower vaccination rates as compared with whites: U.S.-born Hispanics, OR 0.35, 95% CI 0.44-0.95; foreign-born Hispanics, OR 0.39, 95% CI 0.23-0.68; and African Americans, OR 0.45, 95% CI 0.33-0.62.

After adjustment for sociodemographic variables, the odds of HPV vaccine initiation for both groups of Hispanics increased and were no longer significantly different from those of whites (U.S.-born, OR 0.76, 95% CI 0.50-1.16; foreign born, OR 0.67, 95% CI 0.37-1.19). In contrast, the odds ratio for African Americans remained significantly different from that of whites (OR 0.47, 95% CI 0.33-0.66).

Further adjustment for access to a usual healthcare provider increased the odds for Hispanics to 0.84-0.85, but did not change the disparity between African Americans and whites (OR 0.49, 0.36-0.68).

Analysis by age groups showed similar results for the younger (15 to 18) and older (19 to 24) survey participants.

The finding that disparities in vaccination rates exist does not come as a surprise, as disparities between whites and other racial/ethnic groups have been demonstrated for nearly all aspects of healthcare, said Leslie Randall, MD, of the University of California Irvine. Given the inconsistency of previous studies of vaccine uptake, the study “sheds light on the fact that these differences probably do, in fact, exist.”

“It is important for practicing physicians to have an awareness of these differences so they can focus extra effort on targeting specific people who might not be taking advantage of the HPV vaccine, which is a safe and effective way of preventing a life-threatening illness,” Randall, who is a spokesperson for the Society of Gynecologic Oncology, told MedPage Today via email.