KEYWORDS:
community health centers, disparities, race/ethnicity, poverty

BACKGROUND:
Despite significant gains, immunization disparities persist for poor and minority children largely as a result of inadequate access to care and missed opportunities within the health care system. As high quality safety-net providers, community health centers may combat the structural and personal barriers that prevent regular access to coordinated care and thus timely immunization for vulnerable populations.

OBJECTIVE(S):
To compare childhood immunization rates at health centers to rates observed in the nation.

METHOD(S):
Up-to-date immunization rates for children under 5 years of age were calculated from the 1995 National Health Interview Survey (n=5901) and the methodologically congruent 1995 User and Visit Survey of health centers (n=277), and compared using t-test statistics.

RESULT(S):
Nationally, black children were significantly less likely than white children to have received DTP, polio, and Hib vaccinations (p<.05, p<.001, p<.01) and Hispanic children were less likely to have received Hib vaccination (p<.001). Among health center children, the only significant race/ethnicity disparity was a lower likelihood of polio vaccination for black children (p<.05). Hispanic health center children were more likely to be vaccinated for Hib and hepatitis-B than both poor and non-poor Hispanic children in the nation (p<.01, p<.05).

CONCLUSIONS(S):
Overall, these data suggest that health centers are well-positioned to address national immunization disparities in the context of comprehensive primary care. The wide array of outreach and enabling services provided at health centers is thought to facilitate continuity of care, critical in assuring immunization, which future research should uncover.

LEARNING OBJECTIVES:
Immunization rates for vulnerable children served at health centers are relatively equivalent and not significantly different from overall national rates. Health centers may offer an effective medium to address persistent immunization disparities.