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Description
The purpose of this thesis was to determine the health care access and utilization differences between foreign-born and U.S.-born Asian American and Pacific Islanders (AAPI) in San Diego County (SDC). Differences within ethnic groups were also examined. A secondary analysis of a cross-sectional study using the 2011 Asian Pacific Islander Community Health Network Community Needs Assessment (API-CHN CNA) was conducted to determine differences between nativity and health care access and utilization indicators. Foreign-born AAPIs were statistically more likely to have health insurance, a usual source of care (USC), and have had a doctor or medical visit in the past year compared to their U.S.-born counterparts. After adjusting for demographics, nativity was no longer a predictor of health care access or utilization. Demographic characteristics including age, income, and education were statistically significant predictors. When examining within ethnic groups, there were no differences between nativity and any of the health care access indicators. For health care utilization, only foreign-born Filipinos were more likely to have had a doctor or medical visit in the past year compared to U.S.-born Filipinos. When adjusting for demographics, ethnicity was a predictor of health care access and utilization. Compared to Samoans, Filipinos and Native Hawaiians had greater odds of having health insurance. All of the ethnicities, except for Cambodians, had greater odds of having dental insurance than Samoans. Chamorros and all of the Asian American subgroups had greater odds of having a USC than Samoans. All of the ethnic groups had lower odds of visiting a doctor or medical clinic in the past year, compared to Samoans. The results were inconsistent with previous literature, which has showed foreign-born AAPIs were worse off than U.S.-born AAPIs. However, past studies have indicated that other factors are stronger predictors than nativity after adjusting for demographic factors. Ethnicity remained a predictor and previous research also shows differences within AAPI ethnic groups. Future public health efforts should focus on the heterogeneity of AAPI ethnic groups and research examining knowledge, beliefs, and attitudes about health care access and utilization among AAPIs in SDC is warranted.
