Frequency and predictors of health services use by Native Hawaiians and Pacific Islanders: evidence from the U.S. National Health Interview Survey

Abstract

BackgroundNative Hawaiians and Pacific Islanders (NHPIs) are one of the fasting growing racial groups in the United States (US). NHPIs have a significantly higher disease burden than the US population as a whole, yet they remain underrepresented in research. The purpose of this study is to examine factors associated with health care utilization among NHPIs.MethodsDrawing from the 2014 NHPI-National Health Interview Survey, we used stereotype logistic regressions to examine utilization of emergency department (ED) and outpatient services among 2172 individuals aged 18 and older.ResultsNHPIs with chronic diseases were twice as likely to be multiple ED users and nearly four times as likely to be frequent-users of outpatient services. Social support played a protective role in preventing multiple use of ED. Having a usual source of care made it more than eight times as likely to be a frequent-user of outpatient services. Use of eHealth information increased the odds of using ED and outpatient services. Ability to afford health care increased the odds of using outpatient services. There was no association between health insurance coverage and use of ED and outpatient services among NHPIs.ConclusionsThis research provides the first available national estimates of health services use by NHPIs. Efforts to improve appropriate use of health services should consider leveraging the protective factors of social support to reduce the odds of frequent ED use, and having a usual source of care to increase use of outpatient services.

Variation in Usual Source of Care in Asian American, Native Hawaiian, and Other Pacific Islander Adult Medicaid Beneficiaries

“…It is also possible that the selection of health centers or clinics among AANHPI Medicaid beneficiaries may be related to the convenience of location,37 availability of appointments, or higher acceptance of Medicaid insurance 38. A recent study suggests that about 87% of Native Hawaiian and Pacific Islander patients report a USC 39. Our study builds upon this work, indicating that a substantially high proportion of Native Hawaiian and Pacific Islander Medicaid beneficiaries report a health center or clinic as their usual site of care.…”

Diabetes Disparities and Promising Interventions to Address Diabetes in Native Hawaiian and Pacific Islander Populations

“…While NHPI community members have a high prevalence of diabetes, research suggests they face many challenges in accessing health care and education for diabetes prevention and management The available literature documents low rates of adherence to self-management behaviors [27], limited access and participation in formal diabetes self-management education (DSME) [25,[27][28][29][30][31], and high rates of medication nonadherence [32][33][34]. Furthermore, NHPIs experience higher risks of end-stage renal disease and myocardial infarction as a result of uncontrolled diabetes [35,36].…”

Just data representation for Native Hawaiians and Pacific Islanders: A critical review of systemic Indigenous erasure in census and recommendations for psychologists

“…Disaggregated data shows that NHPIs—as a racial category—have significantly higher levels of socioeconomic disadvantages and disease burden than Asian Americans (Narcisse et al, 2018; Srinivasan & Guillermo, 2000); and when the AAPI category is used, the relatively advantageous profiles of Asian Americans and their relatively larger population size conjointly overshadow the specific health profiles and needs of NHPIs (Noah, 2018). In fact, existing disaggregated data conclusively documents the disparate issues in behavioral and mental health, access to health care, substance use, and inequalities in social determinants of health for NHPI communities across other racial/ethnic groups including Asian Americans (Braun et al, 2015; Morisako et al, 2017; Nadal & Kuramoto, 2016; Wong et al, 2004; Yamada et al, 2019).…”