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Factors Associated with Health Insurance Status in an Asian American Population in New York City: Analysis of a Community-Based Survey

  • Cynthia Tan
  • Laura C. Wyatt
  • Julie A. Kranick
  • Simona C. Kwon
  • Oyinlola Oyebode
Article

Abstract

Background

Immigrants comprise approximately 13% of the US population and 33% lack health coverage. Asian Americans are the fastest growing immigrant group; many lack a usual source of care. This study examines factors associated with health insurance among Asian American immigrants living in New York City.

Methods

Community needs assessments were conducted among Asian American subgroups in New York City from 2013 to 2015; analysis was completed in 2017 and 2018. Descriptive statistics examined factors associated with health insurance status while stratifying by Asian ethnic subgroup; multivariable logistic regression models further assessed these associations (p < 0.05 significance level).

Results

Approximately 19% of the study population (n = 1399) was uninsured. Logistic regression models adjusted for all factors. Among East Asians, insurance status was associated with female sex (OR = 2.8, p = 0.005), excellent/very good health status (OR = 3.5, p = 0.014), and seeing a private doctor when sick or injured (OR = 3.2, p = 0.033). Among South Asians, insurance status was associated with high school/some college and college education (OR = 2.6 and 2.9, respectively, p = 0.039 and p = 0.021), having a routine health check in the past year (OR = 6.4, p < 0.001), no diabetes diagnosis (OR = 2.7, p = 0.030), and a tuberculosis diagnosis (OR = 4.7, p = 0.019). Among Southeast Asians, insurance status was associated with less than high school education (p < 0.05), living in the USA > 20 years (OR = 3.7, p = 0.009), having a routine health check in the past year (OR = 5.6, p = 0.025), and seeing a private doctor when sick or injured (OR = 2.6, p = 0.018).

Conclusions

Health insurance status was associated with differing factors among each subgroup. Findings may inform strategies to address challenges and barriers of healthcare access to immigrants, making healthcare more accessible to this underserved population.

Keywords

Health disparity research Racial/ethnic minority Health insurance Asian Americans Immigrants 

Notes

Funding

This publication is supported in part by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West Midlands Initiative, the National Institutes of Health–National Institute on Minority Health and Health Disparities award number U54MD000538, and the National Center for Advancing Translational Sciences award number UL1TR001445. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© W. Montague Cobb-NMA Health Institute 2018

Authors and Affiliations

  • Cynthia Tan
    • 1
  • Laura C. Wyatt
    • 2
  • Julie A. Kranick
    • 2
  • Simona C. Kwon
    • 2
  • Oyinlola Oyebode
    • 1
  1. 1.Warwick Medical SchoolUniversity of WarwickCoventryUK
  2. 2.Department of Population HealthNew York University School of MedicineNew YorkUSA

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