TY - JOUR
T1 - Asian American Enclaves and Healthcare Accessibility
T2 - An Ecologic Study Across Five States
AU - Guan, Alice
AU - Pruitt, Sandi L.
AU - Henry, Kevin A.
AU - Lin, Katherine
AU - Meltzer, Dan
AU - Canchola, Alison J.
AU - Rathod, Aniruddha B.
AU - Hughes, Amy E.
AU - Kroenke, Candyce H.
AU - Gomez, Scarlett L.
AU - Hiatt, Robert A.
AU - Stroup, Antoinette M.
AU - Pinheiro, Paulo S.
AU - Boscoe, Francis P.
AU - Zhu, Hong
AU - Shariff-Marco, Salma
N1 - Publisher Copyright:
© 2023 American Journal of Preventive Medicine
PY - 2023/12
Y1 - 2023/12
N2 - Introduction: Access to primary care has been a long-standing priority for improving population health. Asian Americans, who often settle in ethnic enclaves, have been found to underutilize health care. Understanding geographic primary care accessibility within Asian American enclaves can help to ensure the long-term health of this fast-growing population. Methods: U.S. Census data from five states (California, Florida, New Jersey, New York, and Texas) were used to develop and describe census-tract level measures of Asian American enclaves and social and built environment characteristics for years 2000 and 2010. The 2-step floating catchment area method was applied to National Provider Identifier data to develop a tract-level measure of geographic primary care accessibility. Analyses were conducted in 2022–2023, and associations between enclaves (versus nonenclaves) and geographic primary care accessibility were evaluated using multivariable Poisson regression with robust variance estimation, adjusting for potential area-level confounders. Results: Of 24,482 census tracts, 26.1% were classified as Asian American enclaves. Asian American enclaves were more likely to be metropolitan and have less poverty, lower crime, and lower proportions of uninsured individuals than nonenclaves. Asian American enclaves had higher primary care accessibility than nonenclaves (adjusted prevalence ratio=1.23, 95% CI=1.17, 1.29). Conclusions: Asian American enclaves in five of the most diverse and populous states in the U.S. had fewer markers of disadvantage and greater geographic primary care accessibility. This study contributes to the growing body of research elucidating the constellation of social and built environment features within Asian American enclaves and provides evidence of health-promoting characteristics of these neighborhoods.
AB - Introduction: Access to primary care has been a long-standing priority for improving population health. Asian Americans, who often settle in ethnic enclaves, have been found to underutilize health care. Understanding geographic primary care accessibility within Asian American enclaves can help to ensure the long-term health of this fast-growing population. Methods: U.S. Census data from five states (California, Florida, New Jersey, New York, and Texas) were used to develop and describe census-tract level measures of Asian American enclaves and social and built environment characteristics for years 2000 and 2010. The 2-step floating catchment area method was applied to National Provider Identifier data to develop a tract-level measure of geographic primary care accessibility. Analyses were conducted in 2022–2023, and associations between enclaves (versus nonenclaves) and geographic primary care accessibility were evaluated using multivariable Poisson regression with robust variance estimation, adjusting for potential area-level confounders. Results: Of 24,482 census tracts, 26.1% were classified as Asian American enclaves. Asian American enclaves were more likely to be metropolitan and have less poverty, lower crime, and lower proportions of uninsured individuals than nonenclaves. Asian American enclaves had higher primary care accessibility than nonenclaves (adjusted prevalence ratio=1.23, 95% CI=1.17, 1.29). Conclusions: Asian American enclaves in five of the most diverse and populous states in the U.S. had fewer markers of disadvantage and greater geographic primary care accessibility. This study contributes to the growing body of research elucidating the constellation of social and built environment features within Asian American enclaves and provides evidence of health-promoting characteristics of these neighborhoods.
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U2 - 10.1016/j.amepre.2023.07.001
DO - 10.1016/j.amepre.2023.07.001
M3 - Article
C2 - 37429388
AN - SCOPUS:85166197139
SN - 0749-3797
VL - 65
SP - 1015
EP - 1025
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
IS - 6
ER -