Evaluation of rates of laboratory-confirmed influenza hospitalization in rural and urban census tracts over eight influenza seasons

Christopher A Czaja; Myles G Cockburn; Kathryn Colborn; Lisa Miller; Deborah S K Thomas; Rachel K Herlihy; Nisha Alden; Eric A F Simões

doi:10.1016/j.ypmed.2020.106184

Evaluation of rates of laboratory-confirmed influenza hospitalization in rural and urban census tracts over eight influenza seasons

Prev Med. 2020 Oct:139:106184. doi: 10.1016/j.ypmed.2020.106184. Epub 2020 Jun 29.

Authors

Christopher A Czaja¹, Myles G Cockburn², Kathryn Colborn³, Lisa Miller³, Deborah S K Thomas⁴, Rachel K Herlihy⁵, Nisha Alden⁵, Eric A F Simões⁶

Affiliations

¹ Colorado Department of Public Health and Environment, 4300 Cherry Creek Drive S., Denver, CO 80246, USA; Colorado School of Public Health, Aurora, CO 80045, USA; University of Colorado School of Medicine, 13001 E. 17th Pl., Aurora, CO 80045, USA. Electronic address: [email protected].
² University of Southern California, 3616 Trousdale Pkwy., Los Angeles, CA 90089, USA.
³ Colorado School of Public Health, Aurora, CO 80045, USA.
⁴ University of North Carolina, 9201 University City Blvd, Charlotte, NC 28223, USA.
⁵ Colorado Department of Public Health and Environment, 4300 Cherry Creek Drive S., Denver, CO 80246, USA.
⁶ Colorado School of Public Health, Aurora, CO 80045, USA; University of Colorado School of Medicine, 13001 E. 17th Pl., Aurora, CO 80045, USA.

PMID: 32615128
DOI: 10.1016/j.ypmed.2020.106184

Abstract

The burden of influenza in rural areas is largely unstudied. Rural populations may be vulnerable yet isolated from circulating virus. Laboratory-confirmed influenza hospitalizations in rural Colorado census tracts over eight influenza seasons were inconsistently distributed across seasons. Rural rates were, on average, lower than urban rates. Race, ethnicity, poverty, health insurance coverage, and distance from a hospital accounted for rate differences. Our interpretation is: 1) influenza regularly circulates in urban areas and inconsistently spreads to rural areas, 2) demographic and socioeconomic factors drive morbidity in exposed populations, and 3) public health interventions targeting high-risk urban census tracts may be beneficial.

Keywords: Human; Influenza; Rural population; Spatial analysis.

Publication types

Research Support, U.S. Gov't, P.H.S.

MeSH terms

Censuses
Colorado / epidemiology
Hospitalization
Humans
Influenza, Human* / diagnosis
Influenza, Human* / epidemiology
Laboratories
Rural Population*
Seasons
Urban Population