Social and Structural Determinants of Health Associated with COVID-19 Vaccine Hesitancy among Older Adults in the United States
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source
2.2. Sampling Design
2.3. Data Collection
2.4. Variables
2.4.1. Dependent Variable
2.4.2. Independent Variables
2.4.3. Demographic Variables
2.5. Analytical Methods
3. Results
3.1. Unweighted Descriptive Studies and Characteristics of the Respondents
Characteristics of the Respondents
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Frequency | Percentages |
---|---|---|
Dependent Variable | ||
Vaccine Intention | ||
Not Hesitant | 1142 | 49 |
Little Hesitant | 590 | 26 |
Somewhat Hesitant | 259 | 11 |
Very Hesitant | 320 | 14 |
Independent Variables | ||
Older Adults | ||
65–74 years | 1234 | 53 |
75–84 years | 777 | 34 |
85 years and older | 300 | 13 |
Immigration Status | ||
US-born | 1968 | 85 |
Immigrant | 343 | 15 |
Gender | ||
Female | 1405 | 61 |
Male | 906 | 39 |
Ethnicity/Race | ||
Black | 464 | 20 |
Other | 198 | 9 |
White | 1644 | 71 |
SDoHs Educational Level | ||
High School | 1080 | 47 |
Unknown Degree | 30 | 1 |
College Degree | 484 | 21 |
Graduate Degree | 256 | 11 |
No Degree | 461 | 20 |
Marital Status | ||
Married | 1105 | 48 |
Separated/Divorce | 433 | 19 |
Widowed | 624 | 27 |
Never Married | 139 | 6 |
Social Security Income | ||
Yes | 2080 | 91 |
No | 200 | 9 |
Broadband Internet Access | ||
Yes | 1334 | 59 |
No | 937 | 41 |
Medicare Health Insurance | ||
Yes | 2117 | 93 |
No | 162 | 7 |
StrDoHs Frequency of religious attendance | ||
At least once a week | 836 | 37 |
2/3 times a week | 206 | 9 |
At least one/more times a month | 375 | 17 |
Not at all | 837 | 37 |
Very Hesitant | Somewhat Hesitant | Little Hesitant | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
95% CI | 95% CI | 95% CI | ||||||||||
AOR | UL | LL | Sig | AOR | UL | LL | Sig | AOR | UL | LL | Sig | |
Marital Status | ||||||||||||
Never Married | (Ref. Category) | (Ref. Category) | (Ref. Category) | |||||||||
Married | 0.99 | 0.57 | 1.72 | 0.96 | 1.52 | 0.77 | 3.00 | 0.22 | 1.20 | 0.76 | 1.89 | 0.43 |
Separated/divorced | 1.34 | 0.74 | 2.40 | 0.34 | 2.32 | 1.15 | 4.68 | 0.02 | 1.06 | 0.65 | 1.75 | 0.81 |
Widowed | 1.30 | 0.73 | 2.31 | 0.38 | 1.47 | 0.73 | 3.00 | 0.28 | 1.02 | 0.63 | 1.65 | 0.95 |
Immigration Status | ||||||||||||
Immigrant | (Ref. Category) | (Ref. Category) | (Ref. Category) | |||||||||
US-born | 1.13 | 0.75 | 1.72 | 0.56 | 1.13 | 0.71 | 1.80 | 0.60 | 1.21 | 0.86 | 1.71 | 0.27 |
Educational Level | ||||||||||||
No degree | (Ref. Category) | (Ref. Category) | (Ref. Category) | |||||||||
High school | 0.91 | 0.63 | 1.31 | 0.61 | 0.75 | 0.50 | 1.13 | 0.18 | 0.70 | 0.52 | 0.95 | 0.02 |
Unknown degree | 1.44 | 0.53 | 3.92 | 0.48 | 0.62 | 0.16 | 2.33 | 0.48 | 0.48 | 0.16 | 1.40 | 0.18 |
College | 0.65 | 0.41 | 1.02 | 0.06 | 0.73 | 0.45 | 1.17 | 0.19 | 0.60 | 0.42 | 0.85 | 0.005 |
Graduate | 0.39 | 0.21 | 0.72 | 0.003 | 0.38 | 0.20 | 0.72 | 0.003 | 0.49 | 0.32 | 0.76 | 0.001 |
Social Security Benefits | ||||||||||||
No social security income | (Ref. Category) | (Ref. Category) | (Ref. Category) | |||||||||
Social security income | 1.09 | 0.65 | 1.82 | 0.75 | 0.94 | 0.54 | 1.62 | 0.82 | 0.89 | 0.60 | 1.34 | 0.58 |
Health Insurance | ||||||||||||
No medical health insurance | (Ref. Category) | (Ref. Category) | (Ref. Category) | |||||||||
Presence of health insurance | 0.91 | 0.53 | 1.56 | 0.72 | 1.43 | 0.75 | 2.72 | 0.28 | 1.25 | 0.78 | 2.00 | 0.36 |
Broadband Internet Use | ||||||||||||
No internet use | (Ref. Category) | (Ref. Category) | (Ref. Category) | |||||||||
Internet use | 0.76 | 0.56 | 1.03 | 0.08 | 1.11 | 0.79 | 1.55 | 0.56 | 1.02 | 0.80 | 1.31 | 0.87 |
Religiosity | ||||||||||||
Frequency of religious attendance | (Ref. Category) | (Ref. Category) | (Ref. Category) | |||||||||
At least once a week | 1.29 | 0.95 | 1.75 | 0.10 | 1.82 | 1.30 | 2.56 | <0.001 | 1.27 | 0.99 | 1.63 | 0.06 |
2/3 times a month | 0.77 | 0.47 | 1.28 | 0.32 | 0.84 | 0.47 | 1.50 | 0.55 | 1.25 | 0.86 | 1.82 | 0.23 |
At least one/more times a month | 0.79 | 0.53 | 1.20 | 0.27 | 1.18 | 0.77 | 1.82 | 0.46 | 0.99 | 0.73 | 1.35 | 0.95 |
Age | ||||||||||||
85 years and older | (Ref. Category) | (Ref. Category) | (Ref. Category) | |||||||||
65–74 years | 1.76 | 1.12 | 2.77 | 0.02 | 2.04 | 1.19 | 3.49 | 0.01 | 1.34 | 0.93 | 1.93 | 0.11 |
75–84 years | 0.89 | 0.57 | 1.40 | 0.62 | 1.26 | 0.73 | 2.15 | 0.41 | 1.12 | 0.79 | 1.59 | 0.53 |
Gender | ||||||||||||
Male | (Ref. Category) | (Ref. Category) | (Ref. Category) | |||||||||
Female | 1.90 | 1.42 | 2.55 | <0.001 | 1.95 | 1.42 | 2.67 | <0.001 | 1.69 | 1.35 | 2.12 | <0.001 |
Race | ||||||||||||
White | (Ref. Category) | (Ref. Category) | (Ref. Category) | |||||||||
Black | 2.54 | 1.83 | 3.53 | <0.001 | 2.36 | 1.66 | 3.36 | <0.001 | 1.89 | 1.42 | 2.50 | <0.001 |
Other | 1.26 | 0.76 | 2.07 | 0.37 | 1.09 | 0.62 | 1.91 | 0.78 | 0.80 | 0.52 | 1.24 | 0.32 |
The reference outcome category is Not Hesitant |
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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kalu, K.; Shah, G.; Tung, H.-J.; Bland, H.W. Social and Structural Determinants of Health Associated with COVID-19 Vaccine Hesitancy among Older Adults in the United States. Vaccines 2024, 12, 521. https://doi.org/10.3390/vaccines12050521
Kalu K, Shah G, Tung H-J, Bland HW. Social and Structural Determinants of Health Associated with COVID-19 Vaccine Hesitancy among Older Adults in the United States. Vaccines. 2024; 12(5):521. https://doi.org/10.3390/vaccines12050521
Chicago/Turabian StyleKalu, Kingsley, Gulzar Shah, Ho-Jui Tung, and Helen W. Bland. 2024. "Social and Structural Determinants of Health Associated with COVID-19 Vaccine Hesitancy among Older Adults in the United States" Vaccines 12, no. 5: 521. https://doi.org/10.3390/vaccines12050521