Effect of acculturation on variations in having a usual source of care among Asian Americans and non-Hispanic whites in California

Am J Public Health. 2015 Feb;105(2):398-407. doi: 10.2105/AJPH.2014.301950.


Objectives: 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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acculturation*
  • Adolescent
  • Adult
  • Asian Americans / statistics & numerical data*
  • California / epidemiology
  • Educational Status
  • European Continental Ancestry Group / statistics & numerical data*
  • Female
  • Health Care Surveys
  • Health Services Accessibility / statistics & numerical data*
  • Healthcare Disparities / ethnology
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Insurance, Health / statistics & numerical data
  • Male
  • Middle Aged
  • Young Adult