Abstract
Introduction
Many refugees that resettled into the United States (US) arrive with psychological and physical distress. Their health needs are often met with inadequate healthcare. A variety of barriers negatively affect their healthcare access. Knowledge of demographic and social predictors related to key healthcare access components among refugees is limited. This study examines potential predictors of interrupted healthcare coverage—one key component of healthcare access—among refugees living in the US.
Methods
Using the 2016 Annual Survey of Refugees (ASR)nation-wide data collected from 4037 refugees, multiple logistic regression methods were utilized to identify socio-demographic predictors of interrupted healthcare coverage. Interrupted healthcare coverage was defined as one or more months in the past 12 months without coverage by Refugee Medical Assistance (RMA), Medicaid, or private health insurance.
Results
The following five socio-demographic factors were associated with a higher likelihood of interrupted healthcare coverage: Male gender, 20–49 years of age, lack of marriage, resettlement into the south or Midwest, and poor or no current English proficiency. Refugees with no job were less likely to have interrupted coverage compared to employed refugees.
Discussion
The increased likelihood of interrupted coverage among refugees with poor or no English proficiency supports the belief that limited English proficiency is a barrier to healthcare insurance enrollment. The increased likelihood of interrupted coverage for refugees resettled in the South is consistent with prior literature. In view of clear regional differences, further consideration of the effect of policy differences on refugees living in the US is worthwhile. The findings may help early refugee contacts risk stratify and more effectively allocate limited resources and assist policy makers as they amend and update programs linked to refugee healthcare access (e.g., RMA).
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Data Availability
The original data source can be obtained at the following DOI: https://doi.org/10.3886/E104642V4.
Code Availability
The entire SAS code used to obtain all statistical results can be obtained by request to the corresponding author.
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Acknowledgements
I thank Sudha Jayaraman MD, MSc, FACS for her critical review of the original manuscript. I thank Shuo Yu Lin MS for his insight regarding the original statistical analysis revision.
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All authors contributed to the study conception and design. Kyle Baumann designed and coded the statistical analysis with critical oversight and revision by Tilahun Adera. Kyle Baumann wrote the original draft with critical revision by Tilahun Adera.
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Since the study does not meet regulatory criteria for human subjects research, Edward Via College of Osteopathic Medicine IRB determined full review and approval unnecessary.
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Baumann, K.J., Adera, T. Predictors of Interrupted Healthcare Coverage in a National Sample of US Refugees. J. Racial and Ethnic Health Disparities 9, 2090–2097 (2022). https://doi.org/10.1007/s40615-021-01147-9
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DOI: https://doi.org/10.1007/s40615-021-01147-9