Factors predicting forgone healthcare among Asian adolescents in New Zealand: unmasking variations in aggregate data

To examine the relationship between social support, safety, healthcare experience and forgone healthcare for Asian secondary school students in New Zealand by unmasking variations in aggregate Asian data.

The study population included 1,911 Asians (1,272 East Asians and 604 South Asians) from the Youth19 survey. The reference group included 3,053 Pākehā.

We found disparities in family socioeconomic status (SES), social support, safety in school and neighbourhood, healthcare experience and forgone healthcare between East Asians and South Asians compared to Pākehā. One in five Asians (20%) reported forgone healthcare. Compared to their Pākehā peers (18%), Asian students (AOR=1.18, CI=1.04-1.33) and East Asian students (AOR=1.24, CI=1.06-1.45) were more likely to experience forgone healthcare, but South Asian students were not (AOR=1.05, CI=0.86-1.28). Important unique predictors of forgone healthcare for both East and South Asian students were: being discriminated against by health professionals due to ethnicity, not having a family member to talk about their worries with, and unfair treatment by teachers. Other unique predictors varied: lower community and family SES, not getting enough quality time with family, and being bullied at school were significant predictors for East Asian students; low perceived neighbourhood safety was a predictor for South Asian students.

A complicated picture underlies the seemingly positive findings for the overall Asian group. We highlight the importance of disaggregating Asian youth data into East Asian and South Asian, to identify disparities in risk/protective factors and better inform targeted interventions.