H1N1 death rates higher for some ethnic and racial groups in California


California Latinos have been nearly twice as likely as whites to die of H1N1 flu since the pandemic began last spring, according to statewide figures released Thursday by the California Department of Public Health.

Over the same months, blacks in the state have been 50% more likely to die of H1N1 flu than whites, the report said.

“Not everybody has been impacted equally” by H1N1, said state epidemiologist Dr. Gilberto Chavez, who added that statistics have shown “very important racial disparities” in H1N1 mortality and hospitalization rates.

Chavez said blacks were three times as likely as whites to be hospitalized with H1N1 flu, and Latinos twice as likely. Native Americans, who make up most of the “other” category in state H1N1 data, are also more likely to be hospitalized and die of H1N1 flu than whites, he said.

The new statewide figures came out less than a week after Los Angeles County health officials released data showing H1N1, also known as swine flu, had disproportionately struck the young and minorities in the county.

There are several reasons for the higher mortality and hospitalization rates among some minorities, Chavez said. Blacks and Latinos have high rates of chronic health conditions, such as diabetes and obesity, that studies by the Centers for Disease Control and Prevention indicate put them at greater risk for flu, he said. They also tend to have less access to healthcare and wait longer to seek help, he said, which reduces the chances for successful treatment with antiviral medication.

“For cultural reasons, they may be waiting too long to seek care,” Chavez said. “This gives us an idea of who we need to target for outreach and immunizations.”

More difficult to explain, Chavez said, is why Asians were more likely than whites to be hospitalized with H1N1, yet are less likely to die of it.

Chavez said state officials are still compiling an ethnic breakdown of those vaccinated against H1N1 flu and trying to determine whether there is a connection between vaccinations and lower mortality or hospitalization rates.

About 55% of patients hospitalized with H1N1 flu in L.A. County were Latino, 130 of 237 patients as of Aug. 3, the most recent data available from the county Department of Public Health. Of the total, 17% were white, 8% black, 4% Asian, 2% other and 14% unknown (meaning hospital staff failed to determine and report a patient’s ethnicity to the county), records show.

The “unknowns” were probably distributed evenly among ethnicities and did not skew the other ethnic percentages, according to Elizabeth Bancroft, the department’s medical epidemiologist.

Those hospitalizations occurred before the county sponsored 109 public vaccination clinics in the fall. Of those vaccinated at the clinics, 29% were Asian, 44% Latino, 3% black and 19% white as of Nov. 25, the most recent information available, county health officials said.

Los Angeles County is 47% Latino, 29% white, 13% Asian and 8% black, according to the most recent census figures.

Dr. Jonathan E. Fielding, director of the county’s Public Health Department, said the H1N1 figures were not surprising given the county’s large Latino population, which skews younger.

Statewide, 8,400 people have been hospitalized with H1N1 flu and 479 have died, Chavez said. The number of deaths and hospitalizations has decreased markedly since October, Chavez said, but half the state population is still considered susceptible.

“We leave ourselves vulnerable if we do not vaccinate more people,” he said.

On Monday, state public health officials announced a targeting youths. The program allows individuals to text “No Flu” and their ZIP Code to 30644 and receive a text message with flu-related information, including alerts and the nearest clinic, pharmacy or other provider that has the H1N1 vaccine.

As of Tuesday, Los Angeles International Airport and began offering H1N1 flu shots for $22.50 and seasonal flu shots for $35 at most terminals from 7 a.m. to 7 p.m. Mondays through Fridays; 8 a.m. to 1 p.m. Saturdays; and 11 a.m. to 7 p.m. Sundays. For more information, call (800) 454-0021.