Adoption of preventive behaviors in response to the 2009 H1N1 influenza pandemic: A multiethnic perspective

Gillian K. Steelfisher, Robert J. Blendon, Minah Kang, Johanna R.M. Ward, Emily B. Kahn, Kathryn E.W. Maddox, Keri M. Lubell, Myra Tucker, Eran N. Ben-Porath

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Background: As public health leaders prepare for possible future influenza pandemics, the rapid spread of 2009 H1N1 influenza highlights the need to focus on measures the public can adopt to help slow disease transmission. Such measures may relate to hygiene (e.g., hand washing), social distancing (e.g., avoiding places where many people gather), and pharmaceutical interventions (e.g., vaccination). Given the disproportionate impact of public health emergencies on minority communities in the United States, it is important to understand whether there are differences in acceptance across racial/ethnic groups that could lead to targeted and more effective policies and communications. Objectives: This study explores racial/ethnic differences in the adoption of preventive behaviors during the 2009 H1N1 influenza pandemic. Patients/Methods: Data are from a national telephone poll conducted March 17 to April 11, 2010, among a representative sample of 1123 white, 330 African American, 317 Hispanic, 268 Asian, and 262 American Indian/Alaska Native adults in the USA. Results: People in at least one racial/ethnic minority group were more likely than whites to adopt several behaviors related to hygiene, social distancing, and healthcare access, including increased hand washing and talking with a healthcare provider (P-values <0·05). Exceptions included avoiding others with influenza-like illnesses and receiving 2009 H1N1 and seasonal influenza vaccinations. After we controlled the data for socioeconomic status, demographic factors, healthcare access, and illness- and vaccine-related attitudes, nearly all racial/ethnic differences in behaviors persisted. Conclusions: Minority groups appear to be receptive to several preventive behaviors, but barriers to vaccination are more pervasive.

Original languageEnglish
Pages (from-to)131-142
Number of pages12
JournalInfluenza and other Respiratory Viruses
Issue number3
StatePublished - 1 May 2015

Bibliographical note

Publisher Copyright:
© 2015 The Authors.


  • H1N1 subtype
  • Health behavior
  • Influenza A virus
  • Pandemic
  • Public opinion
  • Race


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