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Health inequities in influenza transmission and surveillance
Shweta Bansal
Casey M Zipfel
Novel Coronavirus
Acceso Abierto
The lower an individual's socio-economic position, the higher their risk of poor health in low-, middle-, and high-income settings alike. As health inequities grow, it is imperative that we develop an empirically-driven mechanistic understanding of the determinants of health disparities, and capture disease burden in at-risk populations to prevent exacerbation of disparities. Past work has been limited in data or scope and has thus fallen short of generating generalizable insights. Here, we integrate empirical data from observational studies and large-scale healthcare data with models to characterize the dynamics and spatial heterogeneity of health disparities in an infectious disease case study: influenza. We find that variation in social, behavioral, and physiological determinants exacerbates influenza epidemics, and that low SES individuals disproportionately bear the burden of infection. We also identify geographical hotspots of disproportionate influenza burden in low SES populations, and find that these differences are most predicted by variation in healthcare utilization and susceptibility. The negative association between health and socio-economic prosperity has a long history in the epidemiological literature. Addressing health inequities in respiratory infectious disease burden is an important step towards social justice in public health, and ignoring them promises to pose a serious threat to the entire population. Our results highlight that the effect of overlapping behavioral social, and physiological factors is synergistic and that reducing this intersectionality can significantly reduce inequities. Additionally, health disparities are expressed geographically, as targeting public health efforts spatially may be an efficient use of resources to abate inequities. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Research reported in this publication was supported by the National Institute Of General Medical Sciences of the National Institutes of Health under Award Number R01GM123007. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. We also acknowledge support from the PhRMA Foundation and the Chateaubriand Fellowship Program. ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data will be made available. <> <> <> <>
Cold Spring Harbor Laboratory Press
Appears in Collections:Artículos científicos

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