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Public health unit funding per capita and seasonal influenza vaccination among youth and adults in Ontario, Canada in 2013/2014 and 2018/2019
  1. Jo Lin Chew1,
  2. Brendan T Smith2,3,
  3. Sarah A Buchan2,3,
  4. Ambikaipakan Senthilselvan1,
  5. Roman Pabayo1
  1. 1School of Public Health, University of Alberta, Edmonton, Alberta, Canada
  2. 2Public Health Ontario, Toronto, Ontario, Canada
  3. 3Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Jo Lin Chew; jchew{at}ualberta.ca

Abstract

Background Influenza vaccines are crucial in reducing the risk of influenza symptoms. We aimed to: (1) estimate the association between public health unit (PHU) funding per capita and influenza vaccination among individuals aged 12 and older in Ontario in 2013/2014 and 2018/2019 and (2) determine whether any observed associations were heterogeneous across household income groups, gender and age categories.

Methods Cross-sectional studies were conducted using the Canadian Community Health Survey, a population-representative survey that collects annual health data. PHU funding per capita was measured using the approved provincial funding for mandatory programmes and the Canadian Census Population Estimates. Self-reported influenza vaccination status in the past year was used. Multilevel logistic regression was used to estimate the association.

Results A case-complete weighted dataset revealed that 33.2% in 2013/2014 and 35.1% in 2018/2019 of respondents were vaccinated. In 2013/2014, every standard deviation (SD) increase in PHU funding per capita was associated with vaccination (OR: 1.08; 95% CI: 1.01, 1.15; SD: 14.1). Furthermore, for every SD increase in PHU funding per capita in 2013/2014, individuals from the lowest household income and between the ages of 50 and 64 years were 29% (95% CI: 1.10, 1.50) and 13% (95% CI: 1.03, 1.23) more likely to be vaccinated, respectively, while adjusting for confounders. No heterogeneous associations were observed in 2018/2019.

Conclusion Funding may have the potential to support PHU’s role in preventing diseases, promoting health and reducing health inequities among the population.

  • PUBLIC HEALTH
  • Health inequalities
  • EPIDEMIOLOGY
  • VACCINATION
  • INFLUENZA
  • Human

Data availability statement

Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. The analysis of the secondary data, Canadian Community Health Survey, was requested through Statistics Canada and accessed via the University of Alberta’s Research Data Centre (RDC). Data on public health unit funding per capita was collected by the Ontario Public Health Information Database (OPHID) team via surveys to Public Health Units. Data from this survey cannot be released due to a confidentiality agreement with public health units.

https://doi.org/10.1136/jech-2024-222467

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    Data availability statement

    Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. The analysis of the secondary data, Canadian Community Health Survey, was requested through Statistics Canada and accessed via the University of Alberta’s Research Data Centre (RDC). Data on public health unit funding per capita was collected by the Ontario Public Health Information Database (OPHID) team via surveys to Public Health Units. Data from this survey cannot be released due to a confidentiality agreement with public health units.

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    Footnotes

    • Contributors JLC contributed to the data acquisition, data analysis and writing of the manuscript. JLC is also responsible for the overall content [as guarantor] of this study. BTS was involved in data acquisition and provided critical feedback throughout the study. SAB contributed to insights to the study topic and variables of interest. AS provided expertise in the study methodology and analysis. RP provided supervision throughout the study and was involved with funding and data acquisition. All authors contributed to the conception and design of the work, interpretation of the data, critically reviewed the draft and provided approval for the submission of this manuscript.

    • Funding This work was supported by the Canadian Institutes of Health Research [CIHR #435172]. RP is a Tier II Canada Research Chair in Social and Health Inequities.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.