Health care utilization among women on O'ahu: implications for Native Hawaiian women.

Women generally seek and use more health care services than do men. Women are also more likely to encounter financial and non-financial barriers to care than do their male counterparts. These differences are accentuated among low income and minority women. We examined health care utilization patterns among women on O'ahu using survey data, and compared those patterns among Native Hawaiian and other ethnic groups. We also provide prevalence rates for several critical women's health issues by ethnic group and explore demographic predictors for health care utilization. Although the vast majority of women have seen health care providers in the last year, ethnic and socioeconomic disparities were identified, especially with respect to our Native Hawaiian female population. A pattern for Native Hawaiian women reveals among the highest rates of depression, as well as sexual/physical/emotional abuse. Alarmingly, Native Hawaiian women are also less likely to have seen a provider in the last year, less likely to have insurance coverage, and more likely to visit emergency departments. Differences by provider type served to reinforce these disparities. In order to reduce barriers to health care utilization for Native Hawaiian women--and for all women in Hawai'i--we recommend universal insurance coverage that includes screening and counseling services. Additionally, training for health care providers is essential in order to improve culturally competent, psychological assessments of health issues for women, particularly Native Hawaiian women.