Understanding influenza and influenza vaccination as health priorities among Black and Latino older adults using Q methodology

Disparities in influenza vaccination uptake among blacks and Latinos relative to whites persist.  Competing life and health priorities may explain suboptimal vaccination coverage.  Q methodology was used to explore life, health, and health action priorities among black and Latino adults aged ≥ 50 years in East and Central Harlem.  Five key informants were asked about older adults’ highest life priorities, primary health concerns, and health actions older adults are most likely to take to generate priority statements. Next, 41 older adults participated in three Q-sort activities in which they assigned a priority score to life, health and health action priorities from most important to least important.  The sample was 53.7% female, 46.3% Latino/a, 46.3% black; 78.1% had ≤ a high school education. Most (73.2%) had previously received the influenza vaccine; 46.3% were vaccinated and 12.2% reported having the flu in the past year.  Among 19 possible life priorities, health was ranked highest.  Among 32 health priorities, influenza was ranked 30^th, while influenza vaccine was ranked 26^th out of 29 priorities.  College education, very good/excellent self-reported health and aged 50-64 were associated with ranking health higher among life priorities.  College education and black ethnicity were associated with ranking influenza higher among health priorities.  No significant differences were observed for influenza vaccine ratings.  These results suggest that influenza and influenza vaccination are not high priorities relative to other health and health action priorities.   Tying influenza risk and influenza vaccination messaging to higher priority health concerns and actions may improve vaccination coverage.