Education in the workplace

Social Determinant

Poverty and the Childhood Immunization Rate

The literature appears to support that the social determinant of poverty has a detrimental impact on the level of immunization of children between 0 and 3 years of age. The National Immunization Survey (NIS) provides vaccination coverage information for all children in the U.S. aged between 19 and 35 months. A study by Klevens and Luman (2001) used this data to measure the impact of poverty on immunization rates. Defining poverty according to the federal thresholds, this study found that those living above poverty had consistently higher levels of uptake of immunization than those living below the poverty threshold. The study did however find that the difference appears to be declining, with a gap of 13.6 percentage points in 1996, reduced to 10.0 percentage points in 1999. This may be associated with differing trends in both levels of poverty and general levels of immunization take-up. Between 1995 and 2003 the level of immunization in the U.S. increased from 52.3 to 79.8%, while the number of children living in poverty dropped by 17.3% (Becton et al., 2008). This still does not explain why there are lower levels of immunization among the poor in the first instance however.