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Open Access Open Badges Research article

Predictors of knowledge of H1N1 infection and transmission in the U.S. population

Elena Savoia1*, Marcia A Testa1 and Kasisomayajula Viswanath2

Author Affiliations

1 Department of Biostatistics and Division of Policy Translation and Leadership Development, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, U.S.A

2 Department of Society, Health and Human Development, Harvard School of Public Health, and Dana Farber Cancer Institute, 677 Huntington Avenue, Boston, MA 02115, U.S.A

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BMC Public Health 2012, 12:328  doi:10.1186/1471-2458-12-328

Published: 3 May 2012



The strength of a society’s response to a public health emergency depends partly on meeting the needs of all segments of the population, especially those who are most vulnerable and subject to greatest adversity. Since the early stages of the H1N1 pandemic, public communication of H1N1 information has been recognized as a challenging issue. Public communication is considered a critical public health task to mitigating adverse population health outcomes before, during, and after public health emergencies. To investigate knowledge and knowledge gaps in the general population regarding the H1N1 pandemic, and to identify the social determinants associated with those gaps, we conducted a survey in March 2010 using a representative random sample of U.S. households.


Data were gathered from 1,569 respondents (66.3% response rate) and analyzed using ordered logistic regression to study the impact of socioeconomic factors and demographic characteristics on the individual’s knowledge concerning H1N1 infection and transmission.


Results suggest that level of education and home ownership, reliable indicators of socioeconomic position (SEP), were associated with knowledge of H1N1. Level of education was found to be directly associated with level of knowledge about virus transmission [OR = 1.35, 95% C.I. 1.12-1.63]. Home ownership versus renting was also positively associated with knowledge on the signs and symptoms of H1N1 infection in particular [OR = 2.89, 95% C.I. 1.26-6.66].


Policymakers and public health practitioners should take specific SEP factors into consideration when implementing educational and preventive interventions promoting the health and preparedness of the population, and when designing communication campaigns during a public health emergency.

H1N1; Communication; Socioeconomic position; Neighborhood cohesion; U.S.A.; Race; Knowledge gaps; Survey