INCREASING IMMUNIZATION RATES AMONG AFRICAN-AMERICAN ADULTS: PART I: MISSION STATEMENT AND PURPOSE
The National Medical Association (NMA) is the oldest and largest national organization representing African American physicians and health professionals in the United States. Established in 1895, the NMA is the collective voice of more than 22,000 African American physicians and the patients they serve. Since its inception, the NMA has been committed to improving the health status and outcomes of minority and disadvantaged people. While throughout its history the National Medical Association has focused primarily on health issues related to African Americans and medically underserved populations; however, its principles, goals, initiatives and philosophy encompass all sectors of the population.
Today, more than 100 after its founding, the National Medical Association is firmly established as a leader in medicine. The NMA serves as a catalyst for the elimination of disparities in health and the leading force for parity in medicine. tadacip
Immunizations have been primarily viewed as preventive medicine tool for use in children, and this has lead to under utilization among African American adults. Although there is growing awareness and numerous strategies have been developed to address under-immunization in adults, there has been no concentrated effort to promote immunization as a preventive health measure among adult African Americans and other minority groups.
Consequently, the NMA is concerned about consistently lower levels of immunization rates of African-Americans compared to those of Whites and other minorities. Of additional concern are higher rates of certain conditions such as diabetes and cardiovascular disease, which coupled with clinical treatment disparities, places African-Americans at higher risk for complications resulting from vaccine-preventable illnesses.
The NMA believes that too few African American adults are immunized. Despite increasing influenza and pneumococcal vaccination levels over the past ten years among adults aged 65 years or greater in all racial and ethnic groups, immunization levels among African American remain significantly below the Healthy People 2000 objective, which was achieved among Whites in 1997. Pneumococcal vaccination levels are especially low among older African Americans, and younger adults with medical conditions placing them at risk for complications from influenza and pneumococcal disease.
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Further, little progress has been made in hepatitis В vaccination of adults who are at high risk for infection; hepatitis В among African American adults is higher than among the majority population. These disparities heighten the need to address this critical health problem in the African American community.
Accordingly, in 1998 President Clinton included adult immunization as one of the six key areas to address in the “Initiative to Eliminate Racial and Ethnic Disparities in Health.” It was a step in the right direction, but much more must be done to reach the all time high immunization levels that have been achieved among children.
To this end, the NMA has assessed this health disparity in order to recommend proactive steps that can be undertaken by the Association and its membership. On June 24-26,1999, in Washington, DC, the NMA convened the Adult Immunization Consensus Panel comprised of the top experts on adult immunization in the country. During this panel, we drew on the knowledge of these experts and looked at the following areas:
♦ the disparity rates for vaccination;
♦ current literature on risk factors for under vaccination,
♦ disease conditions and complications;
♦ barriers to immunization;
♦ missed opportunities for vaccination; and
♦ intervention strategies, including the establishment of institutional and physician best practices.
In this paper, we first review information on the burden of vaccine-preventable diseases of adults, current recommendations for vaccination, effectiveness and cost effectiveness of vaccination, racial and ethnic disparities in vaccination coverage levels, barriers to and missed opportunities for vaccination, intervention strategies, and selected demonstration projects. We conclude with NMA recommendations for increasing vaccination of African American adults. online canadian pharmacy
