Routine Gynecological Care (RGC) and Health Insurance Among Asian and Pacific Islander Women

PURPOSE: According to 2000 US census, people of Asian descent represented 4.2% of the US population, a 48.3% increase from 1990 (Grieco and Cassidy, 2001). Early accessibility and adequate utilization of prenatal care has been significantly associated with positive reproductive health among Asian women. However, research addressing Routine Gynecological Care (RGC) and health insurance status among young Asian and Pacific Islander (API) women based on nationally representative sample is limited. This study examines RGC among women who differ by health insurance status.

METHODS: Data were derived from National Longitudinal Study of Adolescent Health (Add Health) wave 3 (2001, ages 18-27). A nationally representative sample of young women (n=7,972) of Add Health data were analyzed. Health insurance status was categorized into three groups: no insurance, private insurance and public insurance. This study hypnotized that (1) the proportion of API young women who have received RGC is significantly lower compared to White, Black, and Hispanic women. (2) API young women are less likely to receive RGC compared to their white counterparts regardless of health insurance status. Chi-square tests and multivariate logistic regression analyses were conducted with consideration to the complex survey design.

RESULTS: Overall, 73.5% of young women reported receiving RGC. API women reported the lowest proportion of receiving RGC (59.9%) compared to White (73.1%), Black (82.6%), and Hispanic (67.8%) women. Compared to White women, API women are less likely to receive RGC (OR=0.60) while Black women are more likely. API women who have no insurance or private insurance are significantly less likely to receive RGC compared to their white counterparts However, there is no significant association between API and RGC among young women who have public insurance.

CONCLUSION: This study makes a significant contribution to the growing literature on RGC and health insurance status among young Asian and Pacific Islander (API) women. Considering the under-utilization of RGC care among API, RGC care targeting young API women is imperative regardless of health insurance status. Further effort is needed to consider barriers when designing interventions to improve the utilization of reproductive health service for API women.