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Utilization of Healthcare Among Asian Origin Groups and Citizenship Status
Milkie Vu1,2, Mary K Nielson1, Lilian N Bui1
1Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Background:
Citizenship status may be a barrier to engaging in preventive care, especially among Asian origin groups.
Objective:
This study examines differences in annual healthcare utilization among six different Asian-origin groups and whether these differences are influenced by citizenship status.
Design:
We conducted a cross-sectional analysis of data from the 2013-2022 California Health Interview Survey.
Participants:
Respondents aged 18 and older.
Main Measures:
The primary exposures were disaggregated Asian-origin groups (Chinese, Filipino, Japanese, Korean, South Asian, Vietnamese, and others) and citizenship status (U.S.-born, naturalized citizen, non-citizen). The outcome variable was annual healthcare utilization (yes or no). Weighted multivariable logistic regression was used to examine these associations.
Key Results:
Among the 214,684 eligible participants, Korean respondents showed the lowest prevalence of annual healthcare utilization (76%) among Asian origin groups. U.S.-born (71.8%) and non-citizen Korean (65.5%) respondents also had the lowest rates of annual healthcare utilization. In adjusted analyses, non-citizens had a 14% lower odds of annual healthcare utilization than U.S.-born respondents. Chinese and Korean respondents had lower odds of annual healthcare utilization compared with Hispanic/Latino respondents, with lower odds ranging from 27 to 34% (p < 0.05 for all groups). Finally, naturalized citizens who were Chinese, Korean, or categorized as "other Asian," and non-citizens Chinese respondents, had 29-48% lower odds of annual healthcare utilization (p < 0.05 for all groups).
Conclusions:
A lower odds of annual healthcare utilization was observed among Chinese and Korean respondents, particularly among naturalized citizens and non-citizens. This study highlights the importance of disaggregating data by Asian origin group and considering citizenship status as a key factor associated with annual healthcare utilization.
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