The role of citizenship, employment, and socioeconomic characteristics in health insurance coverage among Asian subgroups in the United States.
BACKGROUND
Asians are the third largest and one of the fastest growing minority groups in the United States.


OBJECTIVE
We present health insurance data for the 6 largest national subgroups: Chinese, Filipino, Indian, Korean, Vietnamese, and Japanese. We also contrast the characteristics that result in differences in coverage, including the role of citizenship.


METHODS
Cross-sectional analysis of data from the 2006 Current Population Survey.


METHODS
We used responses to questions on nativity and parental nativity to categorize Asian respondents into subgroups.


METHODS
The 2006 CPS sampled 8918 Asians including 1923 Chinese, 2210 Filipino, 1302 Indian, 951 Korean, 903 Vietnamese, and 808 Japanese.


RESULTS
Koreans had the highest proportion lacking coverage at 29.8%, followed by Vietnamese at 21.5% and Chinese at 16.8%. Indians, Filipinos, and Japanese had rates of coverage similar to or better than non-Hispanics whites (NHWs). The proportion of US-born Chinese with employer coverage (65%) was similar to NHWs, but only 50% of Chinese noncitizens had employer coverage and 27% of these were uninsured. Among Koreans and Vietnamese, noncitizens were most vulnerable, with 41% and 31%, respectively, being uninsured. In contrast, 70% of noncitizen Indian had employer coverage and only 15% were uninsured. Gaps in coverage among Koreans and Vietnamese were largely due to employment in service industry and blue collar occupations as well as small firms, which are less likely to provide coverage.


CONCLUSIONS
The current system of employer coverage is not succeeding in covering Asian groups equitably. Distinct initiatives to expand health coverage would have variable effects on these diverse subgroups.
Huang
Kathie
K
Columbia University Medical Center, New York, New York 10032, USA.
Carrasquillo
Olveen
O
D000293:Adolescent; D000328:Adult; D001213:Asian / Q000145:classification / Q000706:statistics & numerical data*; D019352:Censuses; D002681:China / Q000208:ethnology; D003256:Community Participation; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D018864:Cultural Diversity; D003710:Demography; D054242:Emigrants and Immigrants / Q000145:classification / Q000706:statistics & numerical data; D006264:Health Benefit Plans, Employee / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000145:classification / Q000706:statistics & numerical data*; D007564:Japan / Q000208:ethnology; D007723:Korea / Q000208:ethnology; D017057:Medically Uninsured / Q000208:ethnology*; D008875:Middle Aged; D010679:Philippines / Q000208:ethnology; D012959:Socioeconomic Factors; D014481:United States; D014744:Vietnam / Q000208:ethnology