New Study Identifies Racial and Ethnic Disparities in Severe Flu Outcomes

August 24, 2021 – A new CDC study published today identified racial and ethnic disparities in severe flu-related outcomes across 10 flu seasons from 2009-10 through 2018-19. The study is the largest of its kind to examine and analyze racial and ethnic differences in three categories of severe flu outcomes, including: rates of flu-associated hospitalization, ICU admission, and in-hospital death. The study found that rates of all 3 of these severe flu-related outcomes were higher for several racial and ethnic minority groups when compared to non-Hispanic White persons. These findings underscore the importance of ongoing efforts to improve vaccination rates among racial and ethnic minorities.

Overall, adjusting for age, Black persons had the highest flu-associated hospitalization rates across all 10 seasons, followed by American Indian or Alaska Native persons and Hispanic persons, with similar trends for ICU admission rates. More specifically, the study found that disparities were greatest in the youngest age groups, with rates of severe outcomes being up to 4 times higher among racial and ethnic minority children ages 0-4 years compared with non-Hispanic White children:

• Among non-Hispanic American Indian or Alaska Native children, rates were 3.0-3.5 times higher for all three 3 severe flu-related outcomes
• Among non-Hispanic Black children, rates were 2.2-3.4 times higher for all 3 severe flu-related outcomes
• Among Hispanic children, rates were 1.9-3.0 times higher for all 3 severe flu-related outcomes
• Among non-Hispanic Asian or Pacific Islander (A/PI) children, rates were 1.3-4.4 times higher for all 3 severe flu-related outcomes

The differences in rates of hospitalization, ICU admission, and in-hospital deaths decreased with increasing age. There were few differences in rates of severe flu-related outcomes in adults 75 years and older across racial/ethnic groups.

These findings are similar to prior CDC studies that have identified racial and ethnic disparities in flu outcomes:

• A CDC study published in 2016 showed that during the 2010-11 and 2011-12 flu seasons, non-Hispanic Black persons in every age group and Hispanic or Latino persons five years and older were more likely to be hospitalized with flu than non-Hispanic White persons. This study also showed that people living in high poverty areas were at higher risk for severe outcomes from flu, suggesting that socioeconomic status may be a factor contributing to higher flu-related hospitalization rates among these groups.
• A 2011 study found that Hispanic or Latino persons were more likely than non-Hispanic White persons to be exposed to flu viruses because of their jobs, which often involved  public interaction, or because of crowded living conditions that often involved living with extended family.

CDC is working to address racial and ethnic inequalities in a number of ways. One of these is through the agency’s new Partnering for Vaccine Equity grant program. The program provides nearly $95 million in funding and support to national, state, local, and community-level partners working on increasing vaccine confidence and access among racial and ethnic minority groups. As of May 2021, the program is supporting a total of 19 direct grantees, representing national organizations, medical and professional associations, CDC programs and immunization partners, and other health entities. These efforts also involve continuing to collect data to better understand how communities of color are disproportionately impacted by flu-related outcomes.

For more information on how CDC is working to address flu disparities among racial and ethnic minority groups, visit https://www.cdc.gov/flu/highrisk/disparities-racial-ethnic-minority-groups.html.