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Date of Award

Spring 2026

Degree Name

Master of Public Health

Department

Other

Public Health Department

First Advisor

Suzanne Redington, DrPH, MPH, CPH

Abstract

Background: Influenza causes millions of illnesses and thousands of hospitalizations annually, with disparities impacting outcomes. Research often examines vaccination, education, and NPIs separately, with limited integration of social determinants of health (SDOH).

Purpose: This study explored how SDOH, including socioeconomic status, race, education, neighborhood environment, and healthcare access, are addressed in influenza prevention programs and their relationship to outcomes.

Methods: A PRISMA-guided systematic review of PubMed and EBSCO included U.S peer-reviewed studies published between 2005 and 2025. Data on study characteristics, population, interventions, SDOH, and outcomes were analyzed using descriptive statistics and narrative synthesis to examine the patterns of SDOH incorporation and reported outcomes.

Results: Twelve studies met the inclusion criteria. Vaccination programs were the most common; outcomes included influenza incidence, vaccination uptake, vaccination access and coverage, and program satisfaction. Most (n=9) reported positive outcomes on vaccination uptake, specifically with vulnerable populations. SDOH were associated with outcomes. Several studies demonstrated associations between Social Determinants of Health (SDOH) and outcomes. Lower SES and limited healthcare access were linked to lower baseline vaccination rates but improved with outreach, on-site services, and reduced barriers. Educational attainment influenced uptake, while culturally targeted strategies improved outcomes among minority populations.

Conclusion: These findings show the importance of addressing social determinants, particularly socioeconomic status, to improve influenza prevention effectiveness and reduce disparities in vaccination coverage. Public health programs should prioritize outreach, reduce structural barriers, and implement accessible, community-based vaccination programs.


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Social Determinants of Health and Influenza Prevention: A Systematic Review of Intervention Outcomes in the U.S.

Background: Influenza causes millions of illnesses and thousands of hospitalizations annually, with disparities impacting outcomes. Research often examines vaccination, education, and NPIs separately, with limited integration of social determinants of health (SDOH).

Purpose: This study explored how SDOH, including socioeconomic status, race, education, neighborhood environment, and healthcare access, are addressed in influenza prevention programs and their relationship to outcomes.

Methods: A PRISMA-guided systematic review of PubMed and EBSCO included U.S peer-reviewed studies published between 2005 and 2025. Data on study characteristics, population, interventions, SDOH, and outcomes were analyzed using descriptive statistics and narrative synthesis to examine the patterns of SDOH incorporation and reported outcomes.

Results: Twelve studies met the inclusion criteria. Vaccination programs were the most common; outcomes included influenza incidence, vaccination uptake, vaccination access and coverage, and program satisfaction. Most (n=9) reported positive outcomes on vaccination uptake, specifically with vulnerable populations. SDOH were associated with outcomes. Several studies demonstrated associations between Social Determinants of Health (SDOH) and outcomes. Lower SES and limited healthcare access were linked to lower baseline vaccination rates but improved with outreach, on-site services, and reduced barriers. Educational attainment influenced uptake, while culturally targeted strategies improved outcomes among minority populations.

Conclusion: These findings show the importance of addressing social determinants, particularly socioeconomic status, to improve influenza prevention effectiveness and reduce disparities in vaccination coverage. Public health programs should prioritize outreach, reduce structural barriers, and implement accessible, community-based vaccination programs.