Morisako Ashley K, Tauali'i Maile, Ambrose Adrian Jacques H, Withy Kelley
Native Hawaiian and Indigenous Health, Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI (AKM, MT).
Hawaii J Med Public Health. 2017 Mar;76(3 Suppl 1):36-41.
Native Hawaiians and Other Pacific Islanders (NHOPI) suffer from a number of poor health outcomes, such as high rates of overweight status, obesity, hypertension, and high rates of asthma and cancer mortality. In addition to a disproportionate burden of illness, barriers to health care access and utilization also exist. This study examines the effect of health insurance coverage on the health status of NHOPI in comparison to Asians. To analyze this relationship, the study uses the Behavioral Risk Factor Surveillance System (BRFSS) 2012 data and logistic regression. Findings show insured NHOPI were significantly more likely than insured Asian Americans to report poor or fair health after sequential cumulative adjustments of socioeconomic, lifestyle and behavioral factors, history of diagnosed diseases, and access to care (OR: 1.66, 95% CI:[1.34, 2.05]). Health insurance alone will not eliminate the present disparities experienced by NHOPI. Other barriers prohibit health care access for NHOPI that should be considered in the investigation and development of strategies to increase healthcare access and eliminate health disparities for NHOPI.
夏威夷原住民和其他太平洋岛民(NHOPI)面临一些健康问题,如超重、肥胖、高血压的高发病率,以及哮喘和癌症死亡率高。除了疾病负担过重外,获得和利用医疗保健也存在障碍。本研究考察了与亚洲人相比,医疗保险覆盖对NHOPI健康状况的影响。为分析这种关系,该研究使用了2012年行为风险因素监测系统(BRFSS)数据和逻辑回归。研究结果表明,在对社会经济、生活方式和行为因素、确诊疾病史以及获得医疗服务进行连续累积调整后,参保的NHOPI比参保的亚裔美国人更有可能报告健康状况不佳或一般(比值比:1.66,95%置信区间:[1.34, 2.05])。仅靠医疗保险并不能消除NHOPI目前所经历的差异。其他障碍阻碍了NHOPI获得医疗服务,在调查和制定增加医疗服务可及性及消除NHOPI健康差异的策略时应予以考虑。