Last year's outbreak of H1N1 resulted in a higher toll on young, overweight minorities, say researchers at Intermountain Medical Center (IMC), who argue that not putting this population at the front of the vaccination line may have cost lives, and cost hospitals and taxpayers millions of dollars.
Children, pregnant women and people with lung problems were given first priority for H1N1 vaccinations, some of them standing in line for hours outside health departments.
But early on, doctors noticed the sickest patients were more likely to be young adults, obese and of Hispanic or Pacific Island descent, says Russ Miller, medical director of IMC's respiratory intensive care unit. They were also less likely to be insured, says Miller, lead author of a study confirming doctors' observations.
The study was published in this month's issue of Chest , the scientific medical journal of the American College of Chest Physicians.
Researchers examined the records of 47 H1N1 patients admitted to adult intensive care units at Intermountain Medical Center, LDS Hospital, and the University of Utah Health Sciences Center between May 19 and June 30, 2009, the first outbreak period in Utah. All of the 47 patients resided within Salt Lake County.
But there was a disproportionate number among minorities.
Pacific Islanders make up 1 percent of the county's population, but accounted for 26 percent of the H1N1 stays in ICU. Hispanics are 13 percent of the population, but 23 percent of the H1N1 cases studied.
The patients were also more likely to be overweight. All of the eight patients who died were obese or morbidly obese, the study found.
More research is needed to determine if obesity or ethnicity alone are risk factors, or whether it's a combination of things, said Miller.
"But at least we got a hint at some of the socioeconomic factors at play," said Miller, pointing to another disparity: a whopping 45 percent of the most severely ill had no health insurance. It's well documented that the uninsured delay getting care, he said.
The Salt Lake County data mirror similar findings in other parts of the country. It's not yet known whether they'll spur a change in national treatment and prevention guidelines.
State epidemiologist Robert Rolfs said next winter when H1N1 is likely to return along with seasonal flu, there likely won't be the same shortage of vaccines.
"At this point, we're not restricting it," said Rolfs. "We're recommending everyone be vaccinated."