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Community-Based Strategies to Reduce Childhood Immunization Disparities

Mailman School of Public Health, Columbia University and Columbia University Medical Center in New York City, New York

Matilde Irigoyen, MD

College of Physicians and Surgeons and Mailman School of Public Health, Columbia University and General Pediatrics Group Practice, Columbia University Medical Center in New York City, New York

Martha Sanchez, MA

Northern Manhattan Start Right Coalition at the Mailman School of Public Health, Columbia University in New York City, New York

Letty Guzman, BA

Northern Manhattan Start Right Coalition at Alianza Domincana, Inc. in New York City, New York

Miriam Mejia, BA

Alianza Dominicana, Inc. in New York City, New York

Michelle Sajous, BA

Health and Wellness Strategies Division at Harlem Congregations for Community Improvement in New York City, New York

Deborah A. Levine, MSW

Health and Wellness Strategies Division at Harlem Congregations for Community Improvement in New York City, New York

Shaofu Chen, MD, PhD

Start Right Coalition, Columbia University Medical Center in New York City, New York

Frank Chimkin, MBA, MSW

Start Right Coalition, based at the Columbia University Medical Center in New York City, New York

This study demonstrates how community-based immunization promotion reduced immunization disparities. In 2002 to 2004, the coalition enrolled 3,748 children younger than 5, with 1,502 aged 19 to 35 months in April 2004. Disparity reduction was assessed by comparing coalition immunization coverage rates (4:3:1:3:3) to the National Immunization Survey 2003 rates. Logistic regression was used to assess factors contributing to up-to-date immunizations. Coverage increased from 46.0% at enrollment to 80.5%, matching nationwide rates for all (t = 0.87) or White (t = 1.99) children. The 78% for African Americans was higher than 73% for U.S. African American children (t = 2.90); 84% for Latinos was higher than 77% for U.S. Latinos (t = 2.32). Being current with age-appropriate immunizations at enrollment (OR = 9.8), being Latino (OR = 1.6), and participating through child health insurance enrollment (OR = 4.9), Women, Infants, and Children (OR = 3.1), or child care or parenting (OR = 1.9) programs increased immunization coverage. Embedding immunization promotion into existing community programs was successful in eliminating immunization disparities. Most effective programs were those with direct linkages to health care systems or that targeted young children.

Key Words: community based • child health promotion • childhood immunization • health disparities

This version was published on July 1, 2006

Health Promotion Practice, Vol. 7, No. 3 suppl, 191S-200S (2006)
DOI: 10.1177/1524839906288692


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