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Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Effect of acculturation on variations in having a usual source of care among Asian Americans and non-Hispanic whites in California

TitleEffect of acculturation on variations in having a usual source of care among Asian Americans and non-Hispanic whites in California
Publication TypeJournal Article
Year of Publication2015
AuthorsChang, E, Chan, KS, Han, HR
JournalAm J Public Health
Volume105
Pagination398-407
Date PublishedFeb
ISBN Number1541-0048 (Electronic)0090-0036 (Linking)
Accession Number25033147
KeywordsAcculturation, Adolescent, Adult, Asian Americans/ statistics & numerical data, California/epidemiology, Educational Status, European Continental Ancestry Group/ statistics & numerical data, Female, Health Care Surveys, Health Services Accessibility/ statistics & numerical data, Healthcare Disparities/ethnology/statistics & numerical data, Humans, Insurance, Health/statistics & numerical data, Male, Middle Aged, Young Adult
Abstract

OBJECTIVES: We examined variations in having a usual source of care (USC) among non-Hispanic White and Asian American adults in California. METHODS: Data were from the 2005 and 2009 California Health Interview Survey. Using a modified Anderson model, we used multiple logistic regression to compare odds of having a USC between non-Hispanic White (n=38554) and Asian American adults (n=7566) and to examine associations with acculturation factors (English proficiency, length of residence, residence in a racially concordant neighborhood) and key enabling (employment, income, insurance) and predisposing (education) factors. RESULTS: Race-related disparities between Asian Americans and non-Hispanic Whites in having a USC were no longer significant after accounting for acculturation factors. Limited English proficiency and short time in the United States (<5 years) were significantly associated with not having a USC for both races. Increasing levels of education and insurance were not associated with better access among Asian Americans. CONCLUSIONS: Key differences exist in how Asian American and non-Hispanic White adults access care. Acculturation factors are key drivers of disparities and should be included in access-to-care models with Asians. Insurance and education are differentially significant for Asian Americans and non-Hispanic Whites.

PMCID

PMC4318297