title: Sub-Ethnic and Geographic Variations in Out-of-Pocket Private Health Insurance Premiums Among Mid-Life Asians.
abstract: OBJECTIVE
  This study examined out-of-pocket premium burden of mid-life Asian Americans by comparing six sub-groups of Asians after controlling for geographic clustering at the county and state levels.
  
  
  METHODS
  The 2007-2011 National Health Interview Survey was linked to community-level data and analyzed for 4,628 Asians (ages 50-64), including 697 Asian Indians, 1,125 Chinese, 1,393 Filipinos, 434 Japanese, 524 Koreans, and 455 Vietnamese. Non-Hispanic Whites were included as a comparison group ( n = 48,135). Three-level multilevel modeling (state > county > individual) was conducted.
  
  
  RESULTS
  Koreans and Vietnamese were found as vulnerable sub-groups considering their lower private health insurance rates and higher uninsured rates. Among those with private insurance, Asians, specifically Filipinos, paid significantly less than non-Hispanic Whites. Moderate but significant variations in the county- and state-level variance in out-of-pocket premiums were found, especially among mid-life Asians.
  
  
  CONCLUSIONS
  This study demonstrates the importance of examining within-group heterogeneity and geographic variations in understanding premium burden among mid-life Asians.
authors.affiliation: 1 The University of Tennessee, Knoxville, USA.
authors.forename: Sunha
authors.initials: S
authors.lastname: Choi
mesh_terms: D001213:Asian; D005006:Ethnicity; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research
keywords: Asian Americans; health insurance; mid-life adults