Methods. Data were drawn from the Asian American Quality of Life (AAQoL) survey conducted in Austin, Texas in 2015. A total of 2,609 self-identified Asian Americans aged 18 and older were surveyed, using questionnaires available in English and six Asian languages (Mean age = 42.85, SD = 17.11, range = 18-98). CAM use was measured by asking participants if they had visited a folk medicine provider for health concerns during the past 12 months. Unmet healthcare needs were measured by asking participants if there was a time in the past 12 months that they needed medical care but could not receive it. Logistic regression models of unmet healthcare needs examined with (1) direct effects of CAM use, healthcare access variables (health insurance coverage, having regular check-ups, and needing assistance for healthcare use) and acculturation-related variables (years living in the U.S., English proficiency, and familiarity to American cultures) and (2) interactions of CAM use with healthcare access and acculturation-related variables. All analyses were conducted after controlling for socio-demographic variables and health-related variables (chronic medical condition and self-rated health).
Results. About 14% of the sample used CAM, and 11.4% reported having unmet healthcare needs. The higher odds of having unmet healthcare needs were observed among CAM users (OR = 2.09, 95% CI = 1.42, 3.07, p < .001). As hypothesized, the interaction terms of CAM use with health insurance (OR = .35, 95% CI =.14, .89, p<.05) and acculturation (OR = .39, 95% CI= .18, .82, p <.05) were found to be significant, indicating that the unmet healthcare needs were exacerbated among CAM users who were uninsured and less acculturated.
Conclusion and Implications. The present study extended the current knowledge base by identifying the role of health insurance and acculturation in the links between CAM use and unmet healthcare needs in diverse groups of Asian Americans. Findings suggest that unmet healthcare needs are likely when CAM is chosen as a substitute of conventional healthcare in the absence of resources (i.e., no health insurance coverage and unfamiliarity to American cultures) and calls attention to the groups with such vulnerabilities.