Vaccination against human papillomavirus is an important safeguard for women against cervical cancer. But wide and troubling disparities persists in who receives the potentially lifesaving vaccine.
A recent analysis of women in New Haven County by a Yale School of Public Health student and others found inequities in vaccine uptake along racial, ethnic and economic lines and recommended new strategies to reach women who do not receive the vaccination.
Niti Mehta, an M.P.H candidate involved in the study, represented the School of Public Health at the Connecticut Public Health Association’s annual meeting and presented the findings to some of the state’s top public health officials and practitioners. The annual meeting convenes health professionals from community health clinics and agencies, schools of public health, municipalities and the state for a daylong conference. The theme of this year’s conference was “Equal Opportunities for Health: Overcoming Racial, Ethnic and Socioeconomic Disparities in Connecticut.”
“This work is important because the HPV vaccine has the potential to either reduce or widen known disparities in HPV-related diseases including cervical cancer. With the vaccine being relatively new, we do not currently know in which direction things will go,” said Linda Niccolai, an associate professor at the School of Public Health and director of the Human Papillomavirus Vaccine Impact Monitoring Project Across Connecticut (HPV-IMPACT) project. “Niti’s study is one of the first to show disparities in vaccine uptake among vulnerable women.”
Mehta, along with Alyssa Bilinski, a Yale College student who was also involved in the HPV study, interviewed 232 women with cervical cancer precursors from throughout greater New Haven. They found that uninsured women were more than eight times more likely not to have received the HPV vaccine and that women whose provider did not discuss the vaccine were also more likely not to receive the vaccine. They also found that black and Hispanic women were somewhat more likely to have not received the vaccine (50 percent and 45 percent more likely, respectively, though these differences were not statistically significant). Furthermore, Hispanic women were more likely to have not discussed vaccination with their providers.
“These data are disquieting because there is an excess burden of cervical cancer in impoverished and racial/ethnic minorities,” Mehta and Bilinski concluded in their presentation.
Both students did their research through the HPV-IMPACT project of the Emerging Infections Program at Yale, a CDC-funded collaboration with the Connecticut Department of Public Health. In another poster presentation, Bilinski presented findings from the project related to socioeconomic disparities in the burden of cervical cancer precursors throughout the state of Connecticut.
Elaine O’Keefe, executive director of the YSPH Office of Community Health and chair of the CPHA, noted that the event was focused on the social determinants of health and therefore attracted an exceptionally diverse audience. “Participants included numerous individuals outside of traditional public health such as housing, transportation and planning agencies, providing a great opportunity to disseminate the work and findings of student research,” she said.
The daylong conference was held at the Aqua Turf Club in Southington in late October. Public health and medical students from several universities in the state also gave presentations on their research to the gathering.
The conference is a valuable opportunity to share findings and receive feedback from some of the state’s top public health practitioners, said James Meek, associate director of the Yale Emerging Infections Program, who worked with the Yale students on the research.
“At EIP we encourage all our students to consider attending and especially presenting a poster of their work at the Connecticut Public Health Association meeting.” he said. “It’s a great way for us to disseminate our findings more broadly but it’s also a great way for MPH students to meet local public health professionals and, possibly, the people with whom they may soon be working.”