Personal Health

Study Reveals Health Care Woes of Asian Americans

High numbers of the working poor in this community don't qualify for public assistance, yet can't afford private insurance.
National health care studies often treat Asian Americans as a homogenous, and largely healthy group, but a new study analyzing three years of government-compiled data has revealed substantial pockets of poor health and low insurance levels within the population. Korean Americans, Native Hawaiians and Pacific Islanders clock in with lower levels of insurance than African Americans and whites.

The analysis, conducted by the Kaiser Family Foundation and the Asian & Pacific Islander American Health Forum, found that the proportion of non-elderly Asians who are uninsured varies widely, ranging from 12 percent of Japanese and Asian Indians, 14 percent of Filipinos, to 21 percent of Vietnamese and 24 percent of Native Hawaiians and Pacific Islanders.

Koreans have the highest rates of uninsured -- 31 percent. In comparison, 21 percent of African Americans, and 12 percent of non-elderly non-Hispanic whites are uninsured. Hispanics and American Indians and Alaska natives are two groups that have higher levels of uninsured than Koreans, with 34 and 32 percent uninsured respectively.

"If you look at these groups in the aggregate, Asian Americans tend to do well," says Dr. Cara James, a senior policy analyst with the Race, Ethnicity and Health Care Team at the Kaiser Family Foundation. "They are in good health and don't have as many problems with health coverage."

Over 16 percent of the nation's 13 million Asian Americans and half-million Native Hawaiians and Pacific Islanders are uninsured, giving the group a higher overall rate of insurance than African Americans, Hispanics and American Indians and Alaska natives. But look a little closer, James says, and "you have Koreans doing worse than African Americans, and equal to American Indians and Alaska natives."

The low level of insurance in the Korean American community is not the result of poverty, as one might expect, but rather because most Korean Americans -- around 60 percent -- either own or are employed by small companies that can't afford to provide their workers with health insurance.

Among those Koreans with insurance, only 49 percent have employer-sponsored health coverage. Asian Indians, on the other hand, had the highest rate of employer-sponsored coverage among all the Asian sub-groups, with 77 percent.

The analysis was based on data from the 2004, 2005 and 2006 National Health Interview Survey and Current Population Survey (CPS).

Much of the variation in health coverage among Asians may be due to how recently certain groups arrived in the United States, where they live geographically, income level, and the size of the firm where they work.

"Because Asians are the 'model minority,' it's a surprise to most when they look at the specific groups and see lower rates of insurance and access to health care," says Deeana Jang, policy director of the Asian & Pacific Islander American Health Forum. "Within Asian American subgroups, there are groups with higher poverty rates, and lower education levels."

Jang classes South East Asians, Native Hawaiians and Pacific Islanders within that group, adding that there is a strong link between income and levels of insurance. Those whose income puts them below the poverty line often qualify for Medicaid, but it's the "working poor" -- people who don't qualify for public assistance but can't afford to pay for private insurance -- whose plight the study reveals.

Jang hopes the study will drive the direction of the current presidential debate on health care. "The national debate is focused on health care reform, and if your goal is to achieve health care reform that truly reaches everybody, then you need to think of the Native Hawaiian, Pacific Islander, Korean and Vietnamese American communities -- all of them individually," she explains. "We are hoping that this will show the diversity of our communities."

"If you're going to have employer or employee mandates in your reform proposal, the affordability needs to be there. People in the Korean community would purchase insurance if it was affordable. And, for the Asian American populations that are just above the poverty level and don't qualify, maybe those public programs need to be expanded so they can cover more of the working class poor."
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