Preventive Care Utilization Among Asian Americans in the U.S

Background: Although preventive care is an essential component of comprehensive health care, a substantial proportion of the U.S. population lacks access to it. Disparities in preventive healthcare use are more pronounced in racial/ethnic minorities, including Asian Americans. The limited use of preventive care in Asian Americans is a public health concern not only because they are one of the fastest growing groups of the U.S. population but also because they face unique challenges associated with immigration, including language and culture. Guided by the Institute of Medicine’s model of access to healthcare, highlighting three primary types of barriers to health care: personal/cultural, financial, and structural barriers, the present study examined factors associated with preventive care utilization among Asian Americans.

Methods: Using data from the Asian American Quality of Life Survey (N = 2,535) funded by the City of Austin, TX, logistic regression models were estimated with demographic (age, gender, ethnicity, marital status, education), immigration-related (length of stay in the U.S., English proficiency, acculturation), health and access (self-rated health, health insurance coverage, transportation, usual source of care), and patient–provider relationship (satisfaction with prior healthcare services, communication problems in healthcare settings) variables.

Results: Approximately 15% of the sample reported that they had no health insurance that covered the cost of any medical visits. About one third of survey participants have not used any preventive health care services in the past 12 months. In the immigration-related variables, the odds of preventive care utilization were reduced among those who had resided in the U.S. for fewer than 10 years. In health and access variables, having health insurance and usual source of care increased the odds of preventive care utilization by 2.69 times (95% CI = 1.79 − 4.05, p < .001) and 2.98 times (95% CI = 2.20 − 4.03, p < .001), respectively. With regard to patient-provider relationship, those with a higher level of satisfaction with prior healthcare services were 1.29 times more likely to use preventive care than their counterparts.

Discussion: Health insurance emerged as a significant indicator of preventive healthcare use among Asian Americans in the current study. The Patient Protection and Affordable Care Act has extended health insurance coverage through federal and state marketplaces, and Medicaid expansion. However, Asian Americans still face many challenges and barriers in gaining access and coverage to the services and benefits offered by the ACA. Study findings call attention to the urgent need for systematic efforts to educate Asian American about their benefits and coverage from health care reform. Along with significant efforts to extend health insurance, usual source of care should be addressed as strategy to improve access to quality preventive care. The findings also underscore to improve the ability of health care providers and health care organizations to understand and respond effectively to the cultural and linguistic needs brought by Asian patients. In summary, findings advance our understanding of factors associated with the use of preventive healthcare in Asian Americans and provide practical implications for targeted interventions and strategic health planning.