Skip to main content
Top
Published in: Journal of Immigrant and Minority Health 6/2013

01-12-2013 | Original Paper

Nativity and Occupational Class Disparities in Uninsurance and Routine Preventive Care Use Among Asian Americans

Authors: Dolly A. John, A. B. de Castro, Bonnie Duran, Diane P. Martin

Published in: Journal of Immigrant and Minority Health | Issue 6/2013

Login to get access

Abstract

Using data from 1,530 Asian respondents of the 2002–2003 National Latino and Asian American Study, we examined how nativity and occupational class are associated with uninsurance, no routine physical check-up in the past year and no dental/eye exam use in the past year using weighted multivariate logistic regression models. Recent immigrants had increased odds of uninsurance and no dental/eye exam use than US-born Asians which became nonsignificant after controlling for occupational class and covariates. Unemployed and service workers had increased odds of uninsurance than white-collar workers even after controlling for income and limited English proficiency (LEP). Approximately 35–40 % of blue-collar and service workers reported neither type of preventive care use. Even after controlling for LEP, income, uninsurance, having a regular doctor or place of care, service workers had significantly increased odds of no physical check-up and no dental/eye exam use and blue-collar workers had marginally significant increased odds of no dental/eye exam use. Significant occupational disparities exist in access and preventive care use with workers in service occupations being particularly underserved.
Literature
1.
go back to reference Institute of Medicine. Committee on the consequences of uninsurance. Care without coverage: too little, too late. Washington, DC: National Academy Press; 2002. Institute of Medicine. Committee on the consequences of uninsurance. Care without coverage: too little, too late. Washington, DC: National Academy Press; 2002.
2.
go back to reference Institute of Medicine. Committee on Health Insurance Status and Its Consequences. America’s uninsured crisis: consequences for health and health care. Washington, DC: National Academies Press; 2009. Institute of Medicine. Committee on Health Insurance Status and Its Consequences. America’s uninsured crisis: consequences for health and health care. Washington, DC: National Academies Press; 2009.
3.
go back to reference Oboler SK, Prochazka AV, Gonzales R, Xu S, Anderson RJ. Public expectations and attitudes for annual physical examinations and testing. Ann Intern Med. 2002;136:652–9.PubMedCrossRef Oboler SK, Prochazka AV, Gonzales R, Xu S, Anderson RJ. Public expectations and attitudes for annual physical examinations and testing. Ann Intern Med. 2002;136:652–9.PubMedCrossRef
4.
go back to reference Prochazka AV, Lundahl K, Pearson W, Oboler SK, Anderson RJ. Support of evidence-based guidelines for the annual physical examination: a survey of primary care providers. Arch Intern Med. 2005;165:1347–52.PubMedCrossRef Prochazka AV, Lundahl K, Pearson W, Oboler SK, Anderson RJ. Support of evidence-based guidelines for the annual physical examination: a survey of primary care providers. Arch Intern Med. 2005;165:1347–52.PubMedCrossRef
5.
go back to reference Stone EG, Morton SC, Hulscher ME, Maglione MA, Roth EA, Grimshaw JM, Mittman BS, Rubenstein LV, Rubenstein LZ, Shekelle PG. Interventions that increase use of adult immunization and cancer screening services: a meta-analysis. Ann Intern Med. 2002;136:641–51.PubMedCrossRef Stone EG, Morton SC, Hulscher ME, Maglione MA, Roth EA, Grimshaw JM, Mittman BS, Rubenstein LV, Rubenstein LZ, Shekelle PG. Interventions that increase use of adult immunization and cancer screening services: a meta-analysis. Ann Intern Med. 2002;136:641–51.PubMedCrossRef
6.
go back to reference Laine C. The annual physical examination: needless ritual or necessary routine? Ann Intern Med. 2002;136:701–3.PubMedCrossRef Laine C. The annual physical examination: needless ritual or necessary routine? Ann Intern Med. 2002;136:701–3.PubMedCrossRef
7.
8.
go back to reference Reeves T, Bennett C. We the People: Asians in the United States. Census 2000 Special Reports, CENSR-17. 2004. Reeves T, Bennett C. We the People: Asians in the United States. Census 2000 Special Reports, CENSR-17. 2004.
9.
go back to reference Adler NE, Rehkopf DH. US disparities in health: descriptions, causes, and mechanisms. Annu Rev Public Health. 2008;29:235–52.PubMedCrossRef Adler NE, Rehkopf DH. US disparities in health: descriptions, causes, and mechanisms. Annu Rev Public Health. 2008;29:235–52.PubMedCrossRef
10.
go back to reference Derose KP, Bahney BW, Lurie N, Escarce JJ. Review: immigrants and health care access, quality, and cost. Med Care Res Rev. 2009;66:355–408.PubMedCrossRef Derose KP, Bahney BW, Lurie N, Escarce JJ. Review: immigrants and health care access, quality, and cost. Med Care Res Rev. 2009;66:355–408.PubMedCrossRef
11.
go back to reference Capps R, Fix M, Fortuny K. Trends in the low-wage immigrant labor force, 2000–2005. 2007. Capps R, Fix M, Fortuny K. Trends in the low-wage immigrant labor force, 2000–2005. 2007.
12.
go back to reference Kaiser Family Foundation. Immigrants’ health care coverage and access. 2003; 2009. Kaiser Family Foundation. Immigrants’ health care coverage and access. 2003; 2009.
13.
go back to reference Kaiser Family Foundation. Five basic facts on immigrants and their health care (#7761). 2008. Kaiser Family Foundation. Five basic facts on immigrants and their health care (#7761). 2008.
14.
go back to reference Carrasquillo O, Carrasquillo AI, Shea S. Health insurance coverage of immigrants living in the United States: differences by citizenship status and country of origin. Am J Public Health. 2000;90:917–23.PubMedCrossRef Carrasquillo O, Carrasquillo AI, Shea S. Health insurance coverage of immigrants living in the United States: differences by citizenship status and country of origin. Am J Public Health. 2000;90:917–23.PubMedCrossRef
15.
go back to reference Buchmueller TC. Lo Sasso AT, Lurie I, Dolfin S. Immigrants and employer-sponsored health insurance. Health Serv Res. 2007;42:286–310.PubMedCrossRef Buchmueller TC. Lo Sasso AT, Lurie I, Dolfin S. Immigrants and employer-sponsored health insurance. Health Serv Res. 2007;42:286–310.PubMedCrossRef
16.
go back to reference Derose KP, Escarce JJ, Lurie N. Immigrants and health care: sources of vulnerability. Health Aff (Millwood). 2007;26:1258–68.CrossRef Derose KP, Escarce JJ, Lurie N. Immigrants and health care: sources of vulnerability. Health Aff (Millwood). 2007;26:1258–68.CrossRef
17.
go back to reference McCauley LA. Immigrant workers in the United States: recent trends, vulnerable populations, and challenges for occupational health. AAOHN J. 2005;53:313–9.PubMed McCauley LA. Immigrant workers in the United States: recent trends, vulnerable populations, and challenges for occupational health. AAOHN J. 2005;53:313–9.PubMed
18.
go back to reference Okie S. Immigrants and health care–at the intersection of two broken systems. N Engl J Med. 2007;357:525–9.PubMedCrossRef Okie S. Immigrants and health care–at the intersection of two broken systems. N Engl J Med. 2007;357:525–9.PubMedCrossRef
19.
go back to reference Nwadiora E, McAdoo H. Acculturative stress among Amerasian refugees: gender and racial differences. Adolescence. 1996;31:477–87.PubMed Nwadiora E, McAdoo H. Acculturative stress among Amerasian refugees: gender and racial differences. Adolescence. 1996;31:477–87.PubMed
20.
go back to reference Kaushal N, Kaestner R. Welfare reform and health insurance of immigrants. Health Serv Res. 2005;40:697–721.PubMedCrossRef Kaushal N, Kaestner R. Welfare reform and health insurance of immigrants. Health Serv Res. 2005;40:697–721.PubMedCrossRef
21.
go back to reference Ku L, Matani S. Left out: immigrants’ access to health care and insurance. Health Aff (Millwood). 2001;20:247–56.CrossRef Ku L, Matani S. Left out: immigrants’ access to health care and insurance. Health Aff (Millwood). 2001;20:247–56.CrossRef
22.
go back to reference Lipscomb HJ, Loomis D, McDonald MA, Argue RA, Wing S. A conceptual model of work and health disparities in the United States. Int J Health Serv. 2006;36:25–50.PubMedCrossRef Lipscomb HJ, Loomis D, McDonald MA, Argue RA, Wing S. A conceptual model of work and health disparities in the United States. Int J Health Serv. 2006;36:25–50.PubMedCrossRef
23.
go back to reference Krieger N, Williams DR, Moss NE. Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health. 1997;18:341–78.PubMedCrossRef Krieger N, Williams DR, Moss NE. Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health. 1997;18:341–78.PubMedCrossRef
24.
go back to reference Lynch J, Kaplan G. Socioeconomic position: In: Berkman LF, Kawachi I, editors. Social epidemiology. New York: Oxford University Press; 2000. p13–35. Lynch J, Kaplan G. Socioeconomic position: In: Berkman LF, Kawachi I, editors. Social epidemiology. New York: Oxford University Press; 2000. p13–35.
25.
go back to reference Navarro V, Muntaner C. Political and economic determinants of population health and well-being : controversies and developments. Amityville: Baywood; 2004. Navarro V, Muntaner C. Political and economic determinants of population health and well-being : controversies and developments. Amityville: Baywood; 2004.
26.
go back to reference Fiscella K, Franks P, Gold MR, Clancy CM. Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care. JAMA. 2000;283:2579–84.PubMedCrossRef Fiscella K, Franks P, Gold MR, Clancy CM. Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care. JAMA. 2000;283:2579–84.PubMedCrossRef
27.
go back to reference Macintyre S, McKay L, Der G, Hiscock R. Socio-economic position and health: what you observe depends on how you measure it. J Public Health Med. 2003;25:288–94.PubMedCrossRef Macintyre S, McKay L, Der G, Hiscock R. Socio-economic position and health: what you observe depends on how you measure it. J Public Health Med. 2003;25:288–94.PubMedCrossRef
28.
go back to reference Marmot MG, Wilkinson RG. Social determinants of health. New York: Oxford University Press; 1999. Marmot MG, Wilkinson RG. Social determinants of health. New York: Oxford University Press; 1999.
29.
go back to reference Chandola T, Ferrie J, Sacker A, Marmot M. Social inequalities in self reported health in early old age: follow-up of prospective cohort study. BMJ. 2007;334:990.PubMedCrossRef Chandola T, Ferrie J, Sacker A, Marmot M. Social inequalities in self reported health in early old age: follow-up of prospective cohort study. BMJ. 2007;334:990.PubMedCrossRef
30.
go back to reference Krieger N, Barbeau EM, Soobader MJ. Class matters: US versus UK measures of occupational disparities in access to health services and health status in the 2000 U.S. National Health Interview Survey. Int J Health Serv. 2005;35:213–36.PubMedCrossRef Krieger N, Barbeau EM, Soobader MJ. Class matters: US versus UK measures of occupational disparities in access to health services and health status in the 2000 U.S. National Health Interview Survey. Int J Health Serv. 2005;35:213–36.PubMedCrossRef
31.
go back to reference Huang K, Carrasquillo O. The role of citizenship, employment, and socioeconomic characteristics in health insurance coverage among Asian subgroups in the United States. Med Care. 2008;46:1093–8.PubMedCrossRef Huang K, Carrasquillo O. The role of citizenship, employment, and socioeconomic characteristics in health insurance coverage among Asian subgroups in the United States. Med Care. 2008;46:1093–8.PubMedCrossRef
32.
go back to reference Alegria M, Cao Z, McGuire TG, Ojeda VD, Sribney B, Woo M, Takeuchi D. Health insurance coverage for vulnerable populations: contrasting Asian Americans and Latinos in the United States. Inquiry. 2006;43:231–54.PubMed Alegria M, Cao Z, McGuire TG, Ojeda VD, Sribney B, Woo M, Takeuchi D. Health insurance coverage for vulnerable populations: contrasting Asian Americans and Latinos in the United States. Inquiry. 2006;43:231–54.PubMed
33.
go back to reference Lee S, Nguyen HA, Jawad M, Kurata J. Linguistic minorities in a health survey. Public Opin Q. 2008;72:470–86.CrossRef Lee S, Nguyen HA, Jawad M, Kurata J. Linguistic minorities in a health survey. Public Opin Q. 2008;72:470–86.CrossRef
34.
go back to reference Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36:1–10.PubMedCrossRef Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36:1–10.PubMedCrossRef
35.
go back to reference Alegria M, Vila D, Woo M, Canino G, Takeuchi D, Vera M, Febo V, Guarnaccia P, Aguilar-Gaxiola S, Shrout P. Cultural relevance and equivalence in the NLAAS instrument: integrating etic and emic in the development of cross-cultural measures for a psychiatric epidemiology and services study of Latinos. Int J Methods Psychiatr Res. 2004;13:270–88.PubMedCrossRef Alegria M, Vila D, Woo M, Canino G, Takeuchi D, Vera M, Febo V, Guarnaccia P, Aguilar-Gaxiola S, Shrout P. Cultural relevance and equivalence in the NLAAS instrument: integrating etic and emic in the development of cross-cultural measures for a psychiatric epidemiology and services study of Latinos. Int J Methods Psychiatr Res. 2004;13:270–88.PubMedCrossRef
36.
go back to reference Pennell BE, Bowers A, Carr D, Chardoul S, Cheung GQ, Dinkelmann K, Gebler N, Hansen SE, Pennell S, Torres M. The development and implementation of the National Comorbidity Survey Replication, the National Survey of American Life, and the National Latino and Asian American Survey. Int J Methods Psychiatr Res. 2004;13:241–69.PubMedCrossRef Pennell BE, Bowers A, Carr D, Chardoul S, Cheung GQ, Dinkelmann K, Gebler N, Hansen SE, Pennell S, Torres M. The development and implementation of the National Comorbidity Survey Replication, the National Survey of American Life, and the National Latino and Asian American Survey. Int J Methods Psychiatr Res. 2004;13:241–69.PubMedCrossRef
37.
go back to reference Heeringa SG, Wagner J, Torres M, Duan N, Adams T, Berglund P. Sample designs and sampling methods for the collaborative psychiatric epidemiology studies (CPES). Int J Methods Psychiatr Res. 2004;13:221–40.PubMedCrossRef Heeringa SG, Wagner J, Torres M, Duan N, Adams T, Berglund P. Sample designs and sampling methods for the collaborative psychiatric epidemiology studies (CPES). Int J Methods Psychiatr Res. 2004;13:221–40.PubMedCrossRef
38.
go back to reference Rao JNK, Scott AJ. On Chi Squared tests for multiway contingency tables with cell proportions estimated from survey data. Ann Stat. 1984;12:46–60.CrossRef Rao JNK, Scott AJ. On Chi Squared tests for multiway contingency tables with cell proportions estimated from survey data. Ann Stat. 1984;12:46–60.CrossRef
39.
go back to reference Uehara ES, Takeuchi DT, Smukler M. Effects of combining disparate groups in the analysis of ethnic differences: variations among Asian American mental health service consumers in level of community functioning. Am J Community Psychol. 1994;22:83–99.PubMedCrossRef Uehara ES, Takeuchi DT, Smukler M. Effects of combining disparate groups in the analysis of ethnic differences: variations among Asian American mental health service consumers in level of community functioning. Am J Community Psychol. 1994;22:83–99.PubMedCrossRef
40.
go back to reference Williams DR, Collins C. US Socioeconomic and Racial Differences in Health: patterns and Explanations. Annu Rev Sociol. 1995;21:349–86.CrossRef Williams DR, Collins C. US Socioeconomic and Racial Differences in Health: patterns and Explanations. Annu Rev Sociol. 1995;21:349–86.CrossRef
41.
go back to reference Heeringa SG, Liu J. Complex sample design effects and inference for mental health survey data. Int J Methods Psychiatr Res. 1998;7:56–65.CrossRef Heeringa SG, Liu J. Complex sample design effects and inference for mental health survey data. Int J Methods Psychiatr Res. 1998;7:56–65.CrossRef
42.
43.
go back to reference Heeringa SG, West BT, Berglund PA. Applied survey data analysis. Boca Raton, FL: Chapman Hall/CRC Press; 2010. Heeringa SG, West BT, Berglund PA. Applied survey data analysis. Boca Raton, FL: Chapman Hall/CRC Press; 2010.
44.
go back to reference Archer KJ, Lemeshow S. Goodness-of-fit test for a logistic regression model fitted using survey sample data. Stata J. 2006;6:97–105. Archer KJ, Lemeshow S. Goodness-of-fit test for a logistic regression model fitted using survey sample data. Stata J. 2006;6:97–105.
45.
go back to reference Archer KJ, Lemeshow S, Hosmer DW. Goodness-of-fit tests for logistic regression models when data are collected using a complex sampling design. Comput Stat Data Anal. 2007;51:4450–64.CrossRef Archer KJ, Lemeshow S, Hosmer DW. Goodness-of-fit tests for logistic regression models when data are collected using a complex sampling design. Comput Stat Data Anal. 2007;51:4450–64.CrossRef
46.
go back to reference Kaiser Family Foundation and APIAHF. Health Coverage and Access to Care Among Asian Americans, Native Hawaiians and Pacific Islanders. 2008; 2009. Kaiser Family Foundation and APIAHF. Health Coverage and Access to Care Among Asian Americans, Native Hawaiians and Pacific Islanders. 2008; 2009.
47.
go back to reference U.S. Bureau of Labor Statistics. National Compensation Survey, Employee Benefits in the United States, March 2009; Bulletin 2731. U.S. Bureau of Labor Statistics. National Compensation Survey, Employee Benefits in the United States, March 2009; Bulletin 2731.
48.
go back to reference Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19:127–40.PubMedCrossRef Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19:127–40.PubMedCrossRef
49.
go back to reference Ku L. Health insurance coverage and medical expenditures of immigrants and native-born citizens in the United States. Am J Public Health. 2009;99:1322–8.PubMedCrossRef Ku L. Health insurance coverage and medical expenditures of immigrants and native-born citizens in the United States. Am J Public Health. 2009;99:1322–8.PubMedCrossRef
50.
go back to reference Khimm S. Why immigrants get short shrift on health reform. Washington Post 2010. Khimm S. Why immigrants get short shrift on health reform. Washington Post 2010.
51.
go back to reference Barbeau EM, Krieger N, Soobader MJ. Working class matters: socioeconomic disadvantage, race/ethnicity, gender, and smoking in NHIS 2000. Am J Public Health. 2004;94:269–78.PubMedCrossRef Barbeau EM, Krieger N, Soobader MJ. Working class matters: socioeconomic disadvantage, race/ethnicity, gender, and smoking in NHIS 2000. Am J Public Health. 2004;94:269–78.PubMedCrossRef
Metadata
Title
Nativity and Occupational Class Disparities in Uninsurance and Routine Preventive Care Use Among Asian Americans
Authors
Dolly A. John
A. B. de Castro
Bonnie Duran
Diane P. Martin
Publication date
01-12-2013
Publisher
Springer US
Published in
Journal of Immigrant and Minority Health / Issue 6/2013
Print ISSN: 1557-1912
Electronic ISSN: 1557-1920
DOI
https://doi.org/10.1007/s10903-013-9851-3

Other articles of this Issue 6/2013

Journal of Immigrant and Minority Health 6/2013 Go to the issue