News Release

Multiple factors synergistically drive socioeconomic disparities in flu burden

Computational modeling identifies areas where inequities are most severe and overlooked

Peer-Reviewed Publication


Multiple factors synergistically drive socioeconomic disparities in flu burden

image: Flu view more 

Credit: Flockine, Pixabay

A comprehensive modeling study sheds new light on socioeconomic-based mechanisms that drive disparities in influenza burden across the U.S. Casey Zipfel of Georgetown University in Washington D.C. and colleagues present this analysis in the open-access journal PLOS Computational Biology.

People of lower socioeconomic status experience increased burden of influenza. Past studies have identified various factors that underlie this health inequity, including decreased flu vaccination, lack of access to paid sick leave, lack of healthcare access, increased susceptibility to infection, and different exposure patterns. However, no previous study has considered all of these factors at once.

For the new study, Zipfel and colleagues considered how multiple underlying factors independently and synergistically drive health disparities in influenza burden. They combined large-scale disease datasets and observations from past studies to develop data-driven computational models, enabling them to explore how various factors impact influenza transmission and burden for people of varying socioeconomic status across the U.S.

The analysis showed that people of lower socioeconomic status bear a disproportionate burden of influenza infection in the U.S., and this disparity arises from the synergistic combination of multiple social-economic and healthcare factors. The researchers also identified geographic regions where disparities are most severe and where existing systems to track influenza tend to overlook flu cases among people of low socioeconomic status.

"As the divide in health disparities grows wider across the world, it is imperative that we continue to understand how social determinants impact health, and how this is reflected geographically," Zipfel says. "Our work spotlights inequities in respiratory disease transmission, currently on display due to the COVID-19 pandemic."

The new findings could help inform efforts to eliminate public health disparities due to socioeconomic status and systemic racism. Meanwhile, the researchers note the need to collect better data on healthcare access and usage among people of low socioeconomic status in order to validate their model findings and inform future research and public health efforts.


Peer-reviewed; Simulation / modelling

In your coverage please use this URL to provide access to the freely available article in PLOS Computational Biology:

Citation: Zipfel CM, Colizza V, Bansal S (2021) Health inequities in influenza transmission and surveillance. PLoS Comput Biol 17(3): e1008642.

Funding: Research reported in this publication was supported by the National Institute Of General Medical Sciences of the National Institutes of Health under Award Number R01GM123007 (SB, The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. We also acknowledge support from the PhRMA Foundation, the Chateaubriand Fellowship Program, and the Georgetown Global Health Initiative (CMZ,,, The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.