Associations between Accessibility to Healthcare Service, Social Support, and Mental Health Among Korean Americans amid the COVID-19 Pandemic

Background: Previous studies have primarily focused on the negative impacts on individuals’ physical and mental health amid COVID-19. Therefore, it is crucial to understand cumulated social risks and locate preventative factors to expand effective public health practices and reduce health disparities predominantly among racial/ethnic minority groups in the U.S. For this purpose, we aimed to assess the relationship between Korean Americans’ mental health, accessibility to healthcare, and how they perceive their level of social support during the COVID-19 pandemic.

Methods: Utilizing a purposive sampling strategy, we distributed online surveys to Korean Americans from May 24, 2020, to June 14, 2020, generating 790 responses from participants residing in 42 states. Using SPSS 24, Binary Logistic and Ordinary Least Square regression analyses were employed.

Results: The association between Korean Americans’ experience of a language barrier while trying to receive up-to-date information about COVID-19 and their self-rated mental health status was negative and statistically significant after controlling for the effects of demographic factors. Those who reported that they experienced language barriers were less likely to report having a good self-rated mental health status (OR = -.644, p ≤ .05; 95% CI [.327, .844]). Furthermore, Korean Americans with higher social support were more likely to have higher self-rated mental health (OR =.171, p ≤ .001; 95% CI [1.091, 1.291]). However, the other variables related to individuals’ accessibility to health care services did not show significant associations. In terms of demographic variables, age (OR = .017, p ≤ .05; 95% CI [1.000, 1.036]) showed a significant relationship with self-rated mental health. Considering the accessibility to health care service variables, respondents’ experience of language barriers while trying to gain information about COVID-19 was significantly and positively associated with the level of psychological distress (B = 1.659, p ≤ .01; 95% CI [.433 - 2.885]). Likewise, the level of perceived social support was also significantly and negatively associated with the level of psychological distress (B = -.727, p ≤ .001; 95% CI [-.945, .509]).

Conclusion: Our findings recommend hiring Korean-English translators, bilingual practitioners or contracting with a medical translation service in community clinics or the hospital. Especially these services will be more effective for elderly Koreans who need more time to adjust to American healthcare systems than younger generations. In addition, community staff reach out to the individual household to ask for basic needs and reduce their loneliness. Long-term care facilities need to provide personal consulting with family members to make sure that their patients are well connected with their family members and their professional care is being met well. American policymakers and healthcare professionals need to understand and address the unique hardships within cultural and linguistic aspects Korean Americans experience amid COVID-19. Follow-up studies for examining psychological well-being and mental health of Asian Americans amid- and post-COVID-19 will be required to address how American social, political, and healthcare systems have made an effort to meet the needs of this racial and ethnic population.