Evaluating equity-promoting interventions to prevent race-based inequities in influenza outcomes

Abstract

Seasonal influenza hospitalizations pose a considerable burden in the United States, with BIPOC (Black, Indigenous, and other People of Color) communities being disproportionately affected. To study these disparities, we fit an age- and race-stratified agent-based model of influenza transmission to demographic and hospitalization data. We tested 5 equity-promoting strategies targeting different aspects of inequity: equalizing (i) vaccination rates, (ii) comor- bidities, or (iii) work-risk distributions, (iv) reducing work contacts, or (v) a combination of equalizing both vaccination rates and comorbidities and reducing work contacts. Our analysis suggests that strategies reducing work contacts or equalizing vaccination rates would result in a more equitable distribution of symptomatic infections, with a substantial reduction in the number of symptomatic infections, with up to 17%fewer symptomatic infections in marginalized adults aged 18-49. Reducing comorbidities resulted in significant decreases in hospitalizations, with a reduction of over 40% in hospitalizations in marginalized groups. Notably, these inter- ventions resulted in better outcomes across all age and race groups, not only those prioritized by the interventions.