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By Rachael O'Connor
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The state that you live in could affect your vulnerability to contracting the flu, and the disparities are significant.
Researchers at Washington University in St Louis were inspired by the Centers for Disease Control and Prevention (CDC)'s metric for assessing the risk of natural disasters across the United States, which includes socio-economic and cultural factors.
Now, their analysis of those factors has suggested that certain states are at a higher risk for infection of influenza-like illnesses, as illustrated the map below.
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The researchers analyzed census data to find non-linear relationships between 39 different socioeconomic factors, health indicators and vulnerability to flu—including migration patterns, insurance coverage and proportions of elderly populations.
"This approach considers the relative importance of the many socioeconomic and health factors within a defined area," paper author and chemical engineer professor Rajan Chakrabarty said in a statement.
According to Chakrabarty, the index can show "hotstpots" of vulnerability in the U.S., allowing policymakers to develop targeted strategies to prevent the spread of the flu. H
He added: "Vulnerability does not come from a single factor but is shaped by urbanization, demographics, health care access, and economic disparities."
The map shows that just 11 states have a "very low" vulnerability: Alabama, Georgia, Idaho, Kansas, Mississippi, North Dakota, Oklahoma, Tennessee, Texas, Utah and Wyoming.
Alaska, Arkansas, Iowa, Kentucky, Louisiana, Missouri, Montana, Nebraska, Ohio and South Dakota were deemed to have "low" vulnerability, while Colorado, Illinois, Indiana, Minnesota, Nevada, New Hampshire, North Carolina, South Carolina, West Virginia and Wisconsin were deemed to be at "medium" risk.
The remaining states—Arizona, California, Connecticut, Delaware, Florida, Hawaii, Maine, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia and Washington—as well as the District of Columbia were all labeled as having a high "high" or "very high" vulnerability.
"Understanding the disproportionate burden of infectious diseases across regions with varying socio-economic characteristics is crucial for quantifying environmental health impacts and conducting effective risk assessments," Chakrabarty told Newsweek.
"Our research addresses the critical intersection of socio-economic factors and infectious diseases by introducing the concept of vulnerability mapping."
He explained that the study proposes "a novel machine-learning-driven framework to assess and map state-level vulnerability to Influenza-Like Illness (ILI) across the United States". It introduces" by introducing the vulnerability index by "integrating various socio-economic and health indicators, moving beyond traditional association-based analyses."
"With the help of the relative importance of each indicator in this index, we identified the highest vulnerable regions in the US and revealed significant regional disparities in vulnerability to ILI. The identification of vulnerable regions and the key influencing factors for each state [provides] valuable insights for policymakers and public health practitioners seeking to develop targeted interventions and enhance epidemic preparedness at a state level."
It also, he said "offers the broader public health research community insights into the concept of 'vulnerability', commonly used in climate science, for quantifying susceptibility and risk of infection."
Researchers believe that policymakers in some areas, such as dense metros with high numbers of foreign-born populations, need to better understand the combined effect of different socio-economic factors on disease spread.
Other areas may need to connect neglected rural populations to insurance and healthcare, or provide relief programs to link vulnerable groups with healthcare access.
Most areas will need extra resources to target all aspects of potential vulnerability, with states such as Michigan having a mix of both urban and rural regions with dual challenges.
Washington, D.C. is noted to be at risk because of its high population density and mobility and a large uninsured foreign-born population, while states like New Mexico and Arizona have heightened vulnerability due to a high number of elderly people, women and Hispanic people, which researchers say are populations more at risk for flu complications.
While the picture remains complicated, Chakrabarty said their research and associated map "can help strengthen our epidemic preparedness and response."
Do you have a tip on a health story that Newsweek should be covering? Do you have a question about influenza? Let us know via health@newsweek.com.
Update 03/11/26, 09:20 a.m. E.T: This article has been updated to include comment from Rajan Chakrabarty.
Reference
Tripathy, S. S., Puthussery, J. V., Kapoor, T. S., Cirrito, J. R., & Chakrabarty, R. K. (2026). Spatial variation in socio-economic vulnerability to Influenza-like Infection for the US population. PLOS Computational Biology, 22(1). https://doi.org/10.1371/journal.pcbi.1013839
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