Ethnic variation in access to health care of Asian noncitizens in the United States
Methods: Data were derived from the 2009 California Health Interview Survey (CHIS), which is a statewide population-based random-digit-dial telephone survey. The sample for this study consisted of 561 Asian noncitizens (ages 18-64), including Chinese (n=177), Korean (n=233), and Vietnamese individuals (n=155). Guided by the modified Andersen's behavioral model of health care utilization, a series of logistic regression models were conducted after controlling for predisposing, enabling, need, and immigration-related factors. To account for the CHIS's complex sampling designs (e.g., stratification and unequal weighting), all statistical analyses were conducted using the survey procedures of SAS version 9.3.
Results: Chinese noncitizens reported the highest probability of having a usual source of health care (78.0%), followed by Vietnamese (59.8%) and Korean noncitizens (45.2%). The results of the bivariate analysis also suggest ethnic variation as having a usual source of health care (χ2 = 54.11, p <.01). However, after controlling for other covariates, this significant effect of ethnicity on having a usual source of care disappeared (p >.05). Among Chinese noncitizens, marital status, poverty, insurance status, and English proficiency were found to be associated with having a usual source of care, while age, education, and insurance status were found among Vietnamese noncitizens. Among Korean noncitizens, only poverty status was found to be associated with having a usual source of care.
Conclusions: The study identified vulnerable ethnic subgroups in health care access (e.g., Chinese noncitizens with lower English proficiency, uninsured Vietnamese noncitizens, and poor Korean noncitizens, etc.). To enhance health care access for these vulnerable subgroups of Asian noncitizens, health care professionals should account for the heterogeneity of health care in diverse cultural contexts.
Learning Areas:Diversity and culture
Provision of health care to the public
Social and behavioral sciences
Define the extent to which the access to health care differs by ethnicity among Asian noncitizens in the U.S. Identify the factors associated with health care access among different Asian ethnic subgroups
Keyword(s): Access to Health Care, Health Disparities
Qualified on the content I am responsible for because: I developed research questions, conducted data analyses, and prepared a manuscript with my research team.
Any relevant financial relationships? No
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