Samuel D Towne1,2,3,4,5, Karen H Kim Yeary6, Marie-Rachelle Narcisse7, Chris Long7, Zoran Bursac8, Rachel Totaram9, Elisa M Rodriguez6, Pearl McElfish7. 1. Department of Health Management and Informatics, University of Central Florida, Orlando, FL, 32816, USA. samuel.towne@ucf.edu. 2. Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, 32816, USA. samuel.towne@ucf.edu. 3. Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, 77843, USA. samuel.towne@ucf.edu. 4. Southwest Rural Health Research Center, Texas A&M University, College Station, TX, 77843, USA. samuel.towne@ucf.edu. 5. Center for Population Health and Aging, Texas A&M University, College Station, TX, 77843, USA. samuel.towne@ucf.edu. 6. Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, USA. 7. College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Ave, Fayetteville, AR, 72703, USA. 8. Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, 11200 SW 8th Street AHC5, Miami, FL, USA. 9. Department of Health Management and Informatics, University of Central Florida, Orlando, FL, 32816, USA.
Abstract
OBJECTIVE: We examined barriers to accessing medical care for migrant US-residing Marshallese Islanders. METHODS: Cross-sectional analyses were conducted to identify potential inequities. Surveys from largely migrant diabetic Marshallese Islanders (n = 255) were compared with nationally representative data. Two major outcomes were assessed including 1-whether or not one reported having forgone medical care in the past year because of cost-and 2-whether or not one reported not having a usual source of care. RESULTS: Overall, 74% and 77% of Marshallese Islanders reported forgone care and no usual source of care, respectively, versus 15% and 7% of the US diabetic population. In multivariable analyses, being younger; uninsured; unemployed; male; of lower education; Native American or Hispanic (versus White); and residing in the South were associated with forgone care nationwide, whereas only lacking insurance was associated with forgone care among Marshallese Islanders. Nationwide being younger; uninsured; unmarried; female; of lower education; Native American or Hispanic (versus White); and residing in the South were associated with not having a usual source of care, whereas only being younger and uninsured were associated with not having a usual source of care among Marshallese Islanders. CONCLUSION: The largest group of diabetic Marshallese Islanders in the continental US faces severe healthcare access inequities necessitating policies that increase access to health insurance options and associated resources.
OBJECTIVE: We examined barriers to accessing medical care for migrant US-residing Marshallese Islanders. METHODS: Cross-sectional analyses were conducted to identify potential inequities. Surveys from largely migrant diabetic Marshallese Islanders (n = 255) were compared with nationally representative data. Two major outcomes were assessed including 1-whether or not one reported having forgone medical care in the past year because of cost-and 2-whether or not one reported not having a usual source of care. RESULTS: Overall, 74% and 77% of Marshallese Islanders reported forgone care and no usual source of care, respectively, versus 15% and 7% of the US diabetic population. In multivariable analyses, being younger; uninsured; unemployed; male; of lower education; Native American or Hispanic (versus White); and residing in the South were associated with forgone care nationwide, whereas only lacking insurance was associated with forgone care among Marshallese Islanders. Nationwide being younger; uninsured; unmarried; female; of lower education; Native American or Hispanic (versus White); and residing in the South were associated with not having a usual source of care, whereas only being younger and uninsured were associated with not having a usual source of care among Marshallese Islanders. CONCLUSION: The largest group of diabetic Marshallese Islanders in the continental US faces severe healthcare access inequities necessitating policies that increase access to health insurance options and associated resources.
Entities:
Keywords:
Health disparities; Health inequities; Immigrant health; Social determinants of health
Authors: Louise H Moncla; Allison Black; Chas DeBolt; Misty Lang; Nicholas R Graff; Ailyn C Pérez-Osorio; Nicola F Müller; Dirk Haselow; Scott Lindquist; Trevor Bedford Journal: Elife Date: 2021-04-19 Impact factor: 8.140
Authors: Christopher S Walter; Marie-Rachelle Narcisse; Jennifer L Vincenzo; Pearl A McElfish; Holly C Felix Journal: Int J Environ Res Public Health Date: 2021-03-02 Impact factor: 3.390