259741 Health Insurance and Having a Regular Physician as Mediators between Acculturation and Health Examinations among Asian Americans

Tuesday, October 30, 2012

Sunmin Lee, ScD, MPH , Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD
Lu Chen, MPH , Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD
Mary Jung, MPH , Department of Epidemiology and Biostatistics, University of Maryland Schoo of Public Health, College Park, MD
Hee-Soon Juon, PhD , Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Background: Little is known about the patterns of receiving health examinations among Asian Americans.

Objective: To examine the association between acculturation and receiving health examinations within two years (cholesterol test, physical, eye, and dental exams) among Asian Americans.

Methods: We used data from 851 Chinese, Korean and Vietnamese Americans in Maryland. Acculturation was measured using an abridged version of the Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA), acculturation clusters, language preference, length of stay in the U.S., and age at arrival. Age, education, income, and ethnicity were used as control variables. Health insurance and having a regular physician were included as mediators.

Results: Multiple logistic regression analysis showed that acculturation was positively associated with the likelihood of having all health exams. Those who lived for more than 20 years in the U.S. were about 1.7 times [odds ratio (OR) and 95% confidence interval (CI): cholesterol test: 1.7 (1.1-2.5); dental exam: 1.6 (1.0-2.4); eye exam: 1.8 (1.2-2.6)] more likely than those who lived for 10 years or less to have had health exams. Mediating effects of health insurance and having a regular physician were found between acculturation variables and all health exams. The association between length of stay and cholesterol test was greatly reduced and became no longer significant after incorporating the mediating effect of regular physician (OR=1.1 (0.7-1.7) compared to OR=1.7 (1.1-2.5)).

Conclusion: Acculturation is associated with health exams among Asian Americans. This association is mediated by health insurance and having a regular physician.

Learning Areas:
Diversity and culture
Epidemiology
Public health or related research
Social and behavioral sciences

Learning Objectives:
Learning objectives: 1. Describe the patterns of health exams among Chinese, Korean, and Vietnamese Americans in Maryland. 2. Discuss the relationship between acculturation and health exam behaviors using multiple acculturation indicators. 3. Assess the mediating effects of health insurance and having a regular physician

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceptualized, designed the study. I also interpreted findings and wrote manuscript.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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