Health and healthcare among the Chinese: Findings from US and Taiwan National Health Interview Surveys

Objective: To compare health status and healthcare utilization among the Chinese by immigrant status: non-immigrants (in Taiwan), Chinese immigrants (in the US), and Chinese-Americans. Methods: Data are for adults in 2001 Taiwan National Health Interview Survey and 1998-2006 US National Health Interview Survey. Multiple logistic regression is used to compare health status and healthcare utilization among the Chinese. Dependent variables include health status (self-reported health, obesity, smoking) and utilization (ER and hospital visits). Independent variables are indicators of immigrant status and years in the US. Covariates include age, gender, marital status, and education. Results: Chinese-Americans and Chinese immigrants differ by demographic characteristics, health status, and healthcare utilization. Not surprisingly, non-immigrant adults in Taiwan are more similar to Chinese immigrants than to Chinese-Americans in basic demographics (e.g. age, sex, marital status), but significantly different with respect to educational attainment. With respect to health status, Chinese immigrants are less likely to be obese or to have ever smoked than the other two groups. In contrast, self-reported health among Chinese-Americans is better than Chinese immigrants and non-immigrants. For healthcare utilization, non-immigrants in Taiwan are more likely to have past year ER and hospital visits. However, Chinese immigrants use fewer health services than Chinese-Americans. Conclusions: As the US immigrant population grows, immigrant health has the potential to impact the health of the American population, as well as the US healthcare system. Clues to immigrant health and healthcare needs may lie in a fuller understanding of health and healthcare in the country of origin.