Public health unit funding per capita and seasonal influenza vaccination among youth and adults in Ontario, Canada in 2013/2014 and 2018/2019

J Epidemiol Community Health. 2025 Feb 10;79(3):176-186. doi: 10.1136/jech-2024-222467.

Abstract

Background: Influenza vaccines are crucial in reducing the risk of influenza symptoms. We aimed to: (1) estimate the association between public health unit (PHU) funding per capita and influenza vaccination among individuals aged 12 and older in Ontario in 2013/2014 and 2018/2019 and (2) determine whether any observed associations were heterogeneous across household income groups, gender and age categories.

Methods: Cross-sectional studies were conducted using the Canadian Community Health Survey, a population-representative survey that collects annual health data. PHU funding per capita was measured using the approved provincial funding for mandatory programmes and the Canadian Census Population Estimates. Self-reported influenza vaccination status in the past year was used. Multilevel logistic regression was used to estimate the association.

Results: A case-complete weighted dataset revealed that 33.2% in 2013/2014 and 35.1% in 2018/2019 of respondents were vaccinated. In 2013/2014, every standard deviation (SD) increase in PHU funding per capita was associated with vaccination (OR: 1.08; 95% CI: 1.01, 1.15; SD: 14.1). Furthermore, for every SD increase in PHU funding per capita in 2013/2014, individuals from the lowest household income and between the ages of 50 and 64 years were 29% (95% CI: 1.10, 1.50) and 13% (95% CI: 1.03, 1.23) more likely to be vaccinated, respectively, while adjusting for confounders. No heterogeneous associations were observed in 2018/2019.

Conclusion: Funding may have the potential to support PHU's role in preventing diseases, promoting health and reducing health inequities among the population.

Keywords: EPIDEMIOLOGY; Health inequalities; Human; INFLUENZA; PUBLIC HEALTH; VACCINATION.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Cross-Sectional Studies
  • Female
  • Financing, Government*
  • Health Surveys
  • Humans
  • Influenza Vaccines* / administration & dosage
  • Influenza Vaccines* / economics
  • Influenza, Human* / prevention & control
  • Male
  • Middle Aged
  • Ontario
  • Public Health* / economics
  • Seasons
  • Vaccination* / economics
  • Vaccination* / statistics & numerical data
  • Young Adult

Substances

  • Influenza Vaccines