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Article Title

Is “Asian” a Meaningful Category for Studying and Reporting Health and Health Care Disparities? A Comparison of Filipino and Chinese Kaiser Permanente Northern California Members Aged 25–79 on Health Status, Selected Health Behaviors, and Use of the Patient Portal

Publication Date

4-30-2015

Keywords

health disparities, Asian health

Abstract

Background/Aims: While the broad category “Asian” is often used for health disparities studies and monitoring, results may not meaningfully describe a race/ethnicity, but rather mask important differences across Asian subgroups. To exemplify this, Kaiser Permanente Northern California (KPNC) Filipino and Chinese health plan members were compared on demographic and health characteristics and patient portal use.

Methods: Data from the 2008–2011 KPNC Member Health Surveys, 2011 KPNC disease registries and 2011 kp.org utilization were analyzed for Filipinos and Chinese aged 25–64 (non-senior) and 65–79 (senior) years. All differences listed are significant at P<0.05 by t-test.

Results: Compared to Chinese, non-senior Filipinos were less likely to be college graduates (57.2% vs. 73.6%), more likely to have incomes ≤ $25,000 (non-seniors: 7.4% vs. 4.3%; seniors: 32.8% vs. 17.1%) and less likely to have incomes over $80,000 (non-seniors: 42.8% vs. 58.6%; seniors: 16.8% vs. 32.2%). Filipinos were more likely to be diabetic (non-seniors: 14.4% vs. 5.5%; seniors: 38.8% vs. 21.4%) and hypertensive (non-seniors: 31.4% vs. 14.7%; seniors: 78.2% vs. 61.6%), and seniors were less likely to report excellent/very good health (31.3% vs. 42.3%). Filipino non-seniors were more likely to be smokers (10.3% vs. 5.0%) and more likely to sleep < 6 hours/day (14.4% vs. 6.2%). Filipinos aged 25–79 were less likely to consume 3+ servings fruit/vegetables daily (women: 26.1% vs. 50.6%; men: 18.6% vs. 37.8%), more likely to be obese (15.4% vs. 6.9%) and less likely to believe health behavior risks can greatly impact health (non-seniors: 68.3% vs. 82.6%; seniors: 59.9% vs. 71.9%). In 2011 Filipinos were less likely to have activated kp.org accounts and to have used a secure feature if they had a kp.org account (ages 25–44: women: 80.9% vs. 86.8% and 74.2% vs. 80.0%; men: 68.2% vs. 77.6% and 60.9% vs. 63.2%; ages 45–64: women 62.8% vs. 79.1% and 67.6% vs. 78.7%; men: 58.6% vs. 75.8% and 69.1% vs. 76.5%; ages 65–79: women 42.9% vs. 66.8% and 63.0% vs. 80.6%; men: 47.5% vs. 71.8% and 68.8% vs. 85.4%).

Discussion: Using the broad category “Asian” to study/monitor health and health care disparities is problematic, especially for comparing populations and applying results to “Asian” populations with different Asian ethnic mixes.

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