Health Care Access and Utilization among Korean American Adults in Alameda County, California: 1994 and 2002

Purpose: Since 1994, Asian Health Services, the Korean American Community Advisory Board, and the Center for Family and Community Health (University of California at Berkeley) have conducted periodic, population-based surveys on Korean American community health in Alameda County, California. The present study examines changes in health care access and utilization between 1994 and 2002 among Korean American adults in Alameda County, California. Method: We reanalyzed data from the 1994 and 2002 Korean Health Surveys. The primary variables of interest, health care access and utilization, were operationalized in terms of health insurance coverage, routine check-ups, a usual source of health care and reported barriers to health care. The frequency distribution of each indicator was calculated and its standard error was estimated using SUDAAN. The differences between 1994 and 2002 were examined with chi-square test. Results: Compared to 1994, Korean Americans in Alameda County were more likely to have health insurance coverage in 2002 (74.0% vs. 82.7%). Korean Americans in Alameda County were more likely to have received a recent (prior two years) routine health checkup in 2002 (50.4% vs. 57.2%). Health checkups increased over time for males, for adults with more than 12 years of education, and for employed adults. Also, compared to 1994, employed adults were more likely to have a usual source of health care in 2002 (66.5% vs. 78.4%). In both 1994 and 2002, high cost (58.0% vs. 47.8%) was the most commonly cited barrier to health care, and the next most frequently cited barriers were language (29.2% vs. 27.7%) and no time (29.2% vs. 30.3%). Conclusion: To improve health care utilization and health conditions, it is important to investigate factors related to health care and to monitor changing trends. Ongoing surveillance of health-related factors can contribute to the development of health education programs to reduce morbidity and mortality due to chronic disease, and thereby lead to improvements in health status among Korean Americans.