Abstract P186: Healthcare Access Disparities Among Asian, African, And Latino Immigrants With Hypertension Or Diabetes In The 2010-2018 National Health Interview Survey

Abstract

Background: Morbidity and mortality due to cardiovascular disease (CVD) disproportionately affects racial and ethnic minorities and can be mitigated by access to preventative services. However, research describing health access in immigrants with CVD risk in the US is lacking. Hypothesis: Immigrants with hypertension or diabetes will have less healthcare access (HCA) than US-born non-Hispanic (NH) White persons. Methods: We analyzed cross-sectional data from the 2010-2018 National Health Interview Survey on 75,631 Asian (N=3,120), African (N=393), and Latino (N=7,315) immigrants and US-born NH White (N=64,803) people with hypertension or diabetes. HCA was defined as insurance coverage, usual place for sick care, and delay in care due to cost. We used multivariable logistic regression to examine disparities in HCA between immigrants and NH Whites and compared HCA among immigrants stratified by length of US residence. Results: Participants had a mean (±SE) age of 60.4 (±0.1) years (52% female). After adjusting for sociodemographic factors, health status, and region, Asian immigrants were 13% more likely to be insured than NH Whites, but this pattern was not statistically significant (95% CI: 0.93-1.39, Table ). Compared to NH Whites, African [adjusted odds ratio (AOR): 0.56; 95% CI: 0.39-0.80] and Latino (AOR: 0.65; 95% CI: 0.57-0.74) immigrants were less likely to be insured, and Asian (AOR: 0.50; 95% CI: 0.41-0.60) and Latino (AOR: 0.70; 95% CI: 0.63-0.79) immigrants were less likely to delay care due to cost. All immigrant groups were less likely to have a usual place for sick care. Compared to those with <10 years of US residence, HCA did not improve in African immigrants with ≥10 years of residence (data not shown). Conclusion: Immigrants with CVD risk are less likely to establish a usual place for sick care, yet Asian immigrants may be less likely to experience gaps in HCA compared to NH White people. CVD health policies must account for heterogeneity among and within immigrant groups to improve HCA and prevent CVD complications.