Mike the Mad Biologist

I was wrong. African-Americans and Latinos are already showing elevated numbers of swine flu hospitalizations in Massachusetts:

Since its arrival in Boston in late April, swine flu has proved to be a particular source of misery to the city’s African-American and Hispanic residents, causing hospitalizations at far higher levels than other groups, disease trackers report.

More than 3 of every 4 Bostonians who have spent time in the hospital because of the viral ailment are black or Hispanic, a finding that may reflect broader social ills, the top official at the Boston Public Health Commission said.

The same crowding in dense urban neighborhoods that fuels the spread of other germs may be spurring the transmission of swine flu, known scientifically as H1N1, disease specialists said. And the chronic conditions that are more prevalent in predominantly African-American and Hispanic neighborhoods – diabetes, for example – may make residents of those swaths of Boston especially vulnerable to the complications of flu….

“It’s definitely a very important observation that we need to track,” said Dr. Alfred DeMaria, top disease tracker at the state Department of Public Health. “But we don’t want to overinterpret it until we have more and better information.”

Researchers at the US Centers for Disease Control and Prevention are examining the issue from the national perspective, and their report on the subject is undergoing internal review before being released, an agency spokesman said yesterday.

The Boston disease specialists found that of the 71 city residents hospitalized with swine flu, 49 percent were African-American, and 28 percent were Hispanic. In both cases, the hospitalization rates were double each group’s overall presence in Boston’s population.

Similarly, the two groups accounted for a disproportionately large share of the 477 laboratory confirmed cases of swine flu in the city.

“It’s disheartening to see these patterns on our first pass at collecting data around H1N1,” said Barbara Ferrer, executive director of the Boston health agency. “I thought people were getting sick everywhere at the same level, but it wasn’t true. Some of our neighborhoods were much more impacted by this.”

Nobody is quite sure why, but there are some possible explanations:

Dr. Anita Barry, the top disease investigator at the city health agency, speculated that the composition of the city’s schools may provide a partial explanation.

“We know that school-aged children were primarily affected by H1N1, and in the Boston public school system, there is a majority of minority students,” Barry said.

The city investigators said the higher rates may also be a legacy of poverty and the demands of low-wage work. Parents in such jobs, Barry said, find themselves unable to stay home to care for ailing children because a day away from work means a day without pay. As a result, ill children are sometimes sent to school.

I don’t think we shouldn’t discount the effect of low-wage workers, such as food-handlers, directly transmitting the disease once the flu season kicks in either. But the larger issue is that too many people simply can not afford to quarantine themselves (i.e., miss work). I don’t know what we do about that.

At least, Massachusetts seems to be preparing to heavily vaccinate the population, although Intelligent Designer help Californians: with the level of cutbacks in ‘nonessential’ items like clinics for low-income people, I have no idea how they’re going to cope with this. Given CA’s size, that’s a serious concern.

Comments

  1. #1 stillwaggon
    August 18, 2009

    I do a little work occasionally for the Board of Health in a Massachusetts suburb fo about 14,000 residents. We have been preparing for a pandemic or other emergency for years, so we are not starting from scratch. We have a Medical Reserve Corps of about 60 health professionals, as well as two other volunteer emergency groups, the Citizens Emergency Response Team and the Community Crisis Team. The latter was formed after Columbine to handle psychologically stressful situations. We hold trainings and exercises, along with the police, fire, and EMTs, and have been called out to help other communities with emergencies. I’m pretty confident that we will do fairly well in this situation, although the actual situation cannot be known until it’s on top of us. Here’s wishing the best of luck to all.

  2. #2 addie
    August 18, 2009

    Up here in Canada, the Native Canadians are being hit the hardest.
    So, yes, something is up. I think it’s what you say above: about the nature of the work too–in the factory farm pig operations, meat plants, etc, as well as in the poverty.

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