Community-Based Strategies to Reduce Childhood Immunization Disparities

¹ professor of clinical population and family health (in pediatrics) at the Mailman School of Public Health, Columbia University and Columbia University Medical Center in New York City, New York.
² professor of clinical pediatrics and population and family health at College of Physicians and Surgeons and Mailman School of Public Health, Columbia University and is director of the General Pediatrics Group Practice, Columbia University Medical Center in New York City, New York.
³ program director for the Northern Manhattan Start Right Coalition at the Mailman School of Public Health, Columbia University in New York City, New York.
⁴ coordinator for the Northern Manhattan Start Right Coalition at Alianza Domincana, Inc. in New York City, New York.
⁵ deputy director for Alianza Dominicana, Inc. in New York City, New York.
⁶ special project coordinator for the Health and Wellness Strategies Division at Harlem Congregations for Community Improvement in New York City, New York.
⁷ vice president for the Health and Wellness Strategies Division at Harlem Congregations for Community Improvement in New York City, New York.
⁸ an associate research scientist with the Start Right Coalition, based at the Columbia University Medical Center in New York City, New York.
⁹ data analyst for the Start Right Coalition, based at the Columbia University Medical Center in New York City, New York.

^* To whom correspondence should be addressed.

	Abstract

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

First published on June 7, 2006, doi:10.1177/1524839906288692

Health Promotion Practice 2006;7:191S.

A more recent version of this article appeared on July 1, 2006


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