Fig. 2.

(A–D) Standardized disparities in influenza vaccination between non-Hispanic White and Black short-stay (post-acute care) and long-stay (long-term care) NH residents, by state and hospital referral region, 2011–2018 influenza seasons. (B) and (D) include HRR boundaries in black and state boundaries in gray. Alaska, Hawaii, and Puerto Rico are not pictured as none met the minimum number of observations set by the eligibility criteria in any of the analyses. Influenza seasons were defined as starting on October 1 of one year and ending on March 31 of the following year based on historical influenza activity from the Centers for Disease Control and Prevention. Vaccination status leveraged data through June 30 to allow for sufficient time for vaccination status to be documented by nurses during resident assessments. Standardized estimates were calculated via nonparametric g-formula using a fully saturated linear regression model. Calculations of marginal quantities were completed by using predicted probabilities summed to a weighted average reflecting the age and sex distribution in the overall population. Percentage point differences are calculated as the proportion in White race residents vaccinated minus the proportion in Black race residents vaccinated, such that positive differences indicate the presence of a disparity.