Medication access among immigrant populations in the United States

Immigrants face barriers, including limited health literacy and insurance coverage, that hinder healthcare access and contribute to poor health outcomes. There is limited research on the experiences of immigrants in obtaining medications.

1) Describe medication access in the past year, sociodemographic factors, and experiences across the four Medication Access Patient Journey (MAPJ) framework nodes among adult U.S. immigrants participating in an online opt-in survey, 2) Examine the bivariate relationship between sociodemographic factors, MAPJ nodes and medication access, 3) Assess the relationship between sociodemographic characteristics, MAPJ nodes and medication access, while controlling for covariates.

A cross-sectional, 30-item online survey was administered via a U.S. Qualtrics opt-in panel to immigrants ≥ 18 living in the U.S. who attempted to obtain a prescription medication in the past year. Medication access was measured using a yes/no item. MAPJ constructs included perceived need, help-seeking challenges, healthcare encounter experiences, and dispensing barriers. Health literacy was assessed with the Brief Health Literacy Screen. Data were analyzed using descriptive, bivariate, and logistic regression methods.

Participants (n=300) were 48.5 ± 17.1 years old and had lived in the U.S. for 29.0 ± 19.6 years. Most were female (62.9%), White (46.3%), and non-Hispanic (69.3%). About one-third held a bachelor's degree; 38.7% reported full-time employment. Insurance coverage was primarily through public/government programs (37.7%) or employer-sponsored plans (37.2%). Nearly half (48%) could not obtain their medications at least once in the past year. Lower health literacy (Odds Ratio [OR] = 0.87, 95% Confidence Interval [CI]=0.760-0.997), being employed (OR = 0.37, 95% CI=0.142-0.989), and greater challenges with prescription dispensing (OR=1.20, 95% CI=1.000-1.437) were significantly associated with medication access.

Despite being educated, employed, and insured, nearly half of survey respondents experienced medication access issues. Lower health literacy and dispensing challenges were key contributors, highlighting the need for pharmacist-led interventions.