Premium
The moderating role of race/ethnicity on associations between insurance status and HPV vaccination among women in the USA
Author(s) -
Marshall Colin,
Chavan Bhakti,
Haile Zelalem T.
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12683
Subject(s) - medicine , odds ratio , vaccination , confidence interval , medicaid , demography , health insurance , ethnic group , gynecology , immunology , health care , sociology , anthropology , economics , economic growth
Objective To evaluate associations between insurance status and HPV vaccination. Methods The present cross‐sectional study analyzed data from women aged 18–26 years who participated in the National Health and Nutritional Examination Surveys 2009–2012 in the USA . Results The study included 621 women; 424 (68.3%) had some type of insurance and 198 (30.6%) had received the HPV vaccine. In the multivariable model, we found significant interactions between race/ethnicity and insurance status on receiving HPV vaccination. Compared with individuals with no insurance, non‐Hispanic black women with any type of insurance demonstrated increased likelihood of HPV vaccination (adjusted odds ratio [ aOR ] 3.63, 95% confidence interval [ CI ] 1.60–8.21; P =0.002). Among Mexican Americans, there was a negative association between having some insurance and HPV vaccination ( aOR 0.35, 95% CI 0.15–0.81; P =0.007). For non‐Hispanic black women, the association remained significant across all insurance types (private [ aOR 4.29, 95% CI 1.67–11.00; P =0.003], Medicaid [ aOR 2.86, 95% CI 1.15–7.13; P =0.025], and other [ aOR 4.74, 95% CI 1.06–21.15; P =0.042]). Non‐Hispanic white women with insurance other than private or Medicaid had a higher likelihood of HPV vaccination compared with uninsured individuals ( aOR 8.36, 95% CI 2.79–25.05; P <0.001). Conclusion The present findings help to identify at‐risk populations less likely to receive the HPV vaccine.