Background: Immigrants comprise approximately 13% of the US population and 33% lack health coverage. Asian Americans are the fastest growing immigrant group; many lack a usual source of care. This study examines factors associated with health insurance among Asian American immigrants living in New York City.
Methods: Community needs assessments were conducted among Asian American subgroups in New York City from 2013 to 2015; analysis was completed in 2017 and 2018. Descriptive statistics examined factors associated with health insurance status while stratifying by Asian ethnic subgroup; multivariable logistic regression models further assessed these associations (p < 0.05 significance level).
Results: Approximately 19% of the study population (n = 1399) was uninsured. Logistic regression models adjusted for all factors. Among East Asians, insurance status was associated with female sex (OR = 2.8, p = 0.005), excellent/very good health status (OR = 3.5, p = 0.014), and seeing a private doctor when sick or injured (OR = 3.2, p = 0.033). Among South Asians, insurance status was associated with high school/some college and college education (OR = 2.6 and 2.9, respectively, p = 0.039 and p = 0.021), having a routine health check in the past year (OR = 6.4, p < 0.001), no diabetes diagnosis (OR = 2.7, p = 0.030), and a tuberculosis diagnosis (OR = 4.7, p = 0.019). Among Southeast Asians, insurance status was associated with less than high school education (p < 0.05), living in the USA > 20 years (OR = 3.7, p = 0.009), having a routine health check in the past year (OR = 5.6, p = 0.025), and seeing a private doctor when sick or injured (OR = 2.6, p = 0.018).
Conclusions: Health insurance status was associated with differing factors among each subgroup. Findings may inform strategies to address challenges and barriers of healthcare access to immigrants, making healthcare more accessible to this underserved population.
Keywords: Asian Americans; Health disparity research; Health insurance; Immigrants; Racial/ethnic minority.