The Association Between HPV Vaccination and Neighborhood-Level Social Deprivation Among Latinos by Nativity.

Abstract

Latino community members have increased risk for human papillomavirus (HPV)-related cancers. HPV vaccination may be influenced by neighborhood-level social determinants of health and nativity. We examined differences in HPV vaccine coverage by social deprivation index (SDI) and nativity among Latino patients receiving care in community health centers (CHCs). We used electronic health record data for Latino patients aged 9-26 who received care in a multistate CHC network from 2012-2022 (n=212,611) to examine differences in HPV vaccine initiation and completion by SDI score tertile and nativity status, and by country of birth among those with country documented. Logistic regression was used to estimate covariate-adjusted odds ratios and prevalences. While those living in higher social deprivation areas had higher prevalence of vaccine coverage, this was not consistent across all groups. Initiation was highest among foreign-born Latinos living in areas with medium deprivation (52.7%, 95% CI: 47.6-57.8%), but was similar for all US-born and foreign-born Latinos, and by SDI tertile. Completion was highest among US-born Latinos living in the areas with the highest deprivation (40.6%, 95% CI: 37.8-43.3%). In this multistate CHC sample of Latino patients, we observed more vaccination among those with a documented country of birth compared to those without that data, with low variation by neighborhood SDI and by country of birth. The lack of difference by SDI could be due to the CHC setting and suggests that interventions to increase HPV vaccination targeting Latinos overall, rather than by neighborhood social determinants, may be most effective.