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Evaluation of Access to Care Barriers and Their Effect on General Health Status Among Native Hawaiian and Pacific Islander Adults

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Abstract

There is a paucity of information on access to care barriers faced by Native Hawaiian and Pacific Islander (NHPI) community. This study utilized the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS) data to evaluate access to care barriers among NHPI population and their effect on general health status. Access to care barriers were categorized as financial barrier (affordability) and non-financial barriers (availability, accommodation, acceptability, and accessibility). Overall, 13.7% reported of the fair/poor general health and over 30% reported at least one access to care barrier. Logistic regression model was used to evaluate how financial and non-financial barriers affect general health status, adjusting for socio-demographic variables such as age, poverty threshold, and marital status and health-related variables such as smoking status and chronic health conditions. Those who reported financial barrier (21.2%) were more likely to be in fair/poor general health (odds ratio 2.25, 95% confidence interval 1.43–3.56). Non-financial barrier, reported by 20.0% of the study population, was found to be not associated with general health status after adjusting for socio-demographic and health-related variables. Improving access to care among NHPI community could be achieved by identifying and addressing the barriers, which in turn could lead to improvement in the general health status among NHPI community.

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Availability of data and material

The data are available in the Native Hawaiian and Pacific Islander National Health Interview Survey website, https://www.cdc.gov/nchs/nhis/nhpi.html.

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Funding

This work is partially supported by grant numbers U54MD007601 (Ola HAWAII) and U54GM138062 (PIKO) of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Authors and Affiliations

  1. Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA

    Devashri Prabhudesai, John J. Chen & Eunjung Lim

Authors
  1. Devashri Prabhudesai
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  2. John J. Chen
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Contributions

Devashri Prabhudesai conceptualized the study design and research questions, acquired data, performed data analysis and interpretation, and drafted the manuscript. Eunjung Lim and John J. Chen conceptualized the study design and research question, acquired data, interpreted data analysis, and reviewed and modified the manuscript draft. All authors read and approved the final manuscript.

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Correspondence to Eunjung Lim.

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Ethics approval

Data collection for the Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS) was approved by the National Center for Health Statistics Research Ethics Review Board. Analysis of de-identified data from the survey is exempt from federal regulations for the protection of human research participants.

This study was deemed exempt from review by University of Hawaiʻi Institutional Review Board (IRB #2021–01000).

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The authors declare no competing interests.

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Prabhudesai, D., Chen, J.J. & Lim, E. Evaluation of Access to Care Barriers and Their Effect on General Health Status Among Native Hawaiian and Pacific Islander Adults. J. Racial and Ethnic Health Disparities 10, 1178–1186 (2023). https://doi.org/10.1007/s40615-022-01304-8

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  • DOI: https://doi.org/10.1007/s40615-022-01304-8

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