title: Effect of acculturation on variations in having a usual source of care among Asian Americans and non-Hispanic whites in California.
abstract: OBJECTIVE
  We examined variations in having a usual source of care (USC) among non-Hispanic White and Asian American adults in California.
  
  
  METHODS
  Data were from the 2005 and 2009 California Health Interview Survey. Using a modified Anderson model, we used multiple logistic regression to compare odds of having a USC between non-Hispanic White (n=38554) and Asian American adults (n=7566) and to examine associations with acculturation factors (English proficiency, length of residence, residence in a racially concordant neighborhood) and key enabling (employment, income, insurance) and predisposing (education) factors.
  
  
  RESULTS
  Race-related disparities between Asian Americans and non-Hispanic Whites in having a USC were no longer significant after accounting for acculturation factors. Limited English proficiency and short time in the United States (<5 years) were significantly associated with not having a USC for both races. Increasing levels of education and insurance were not associated with better access among Asian Americans.
  
  
  CONCLUSIONS
  Key differences exist in how Asian American and non-Hispanic White adults access care. Acculturation factors are key drivers of disparities and should be included in access-to-care models with Asians. Insurance and education are differentially significant for Asian Americans and non-Hispanic Whites.
authors.affiliation: At the time of this research, Eva Chang was with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Kitty S. Chan is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health. Hae-Ra Han is with the Department of Community-Public Health, Johns Hopkins School of Nursing.
authors.forename: Eva
authors.initials: E
authors.lastname: Chang
authors.forename: Kitty S
authors.initials: KS
authors.lastname: Chan
authors.forename: Hae-Ra
authors.initials: HR
authors.lastname: Han
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D001213:Asian / Q000706:statistics & numerical data*; D002140:California / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000208:ethnology / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult