Utilization of Healthcare Among Asian Origin Groups and Citizenship Status

Background: Citizenship status may be a barrier to engaging in preventive care, especially among Asian origin groups. Objective: This study examines differences in annual healthcare utilization among six different Asian-origin groups and whether these differences are influenced by citizenship status. Design: We conducted a cross-sectional analysis of data from the 2013–2022 California Health Interview Survey. Participants: Respondents aged 18 and older. Main Measures: The primary exposures were disaggregated Asian-origin groups (Chinese, Filipino, Japanese, Korean, South Asian, Vietnamese, and others) and citizenship status (U.S.-born, naturalized citizen, non-citizen). The outcome variable was annual healthcare utilization (yes or no). Weighted multivariable logistic regression was used to examine these associations. Key Results: Among the 214,684 eligible participants, Korean respondents showed the lowest prevalence of annual healthcare utilization (76%) among Asian origin groups. U.S.-born (71.8%) and non-citizen Korean (65.5%) respondents also had the lowest rates of annual healthcare utilization. In adjusted analyses, non-citizens had a 14% lower odds of annual healthcare utilization than U.S.-born respondents. Chinese and Korean respondents had lower odds of annual healthcare utilization compared with Hispanic/Latino respondents, with lower odds ranging from 27 to 34% (p < 0.05 for all groups). Finally, naturalized citizens who were Chinese, Korean, or categorized as “other Asian,” and non-citizens Chinese respondents, had 29–48% lower odds of annual healthcare utilization (p < 0.05 for all groups). Conclusions: A lower odds of annual healthcare utilization was observed among Chinese and Korean respondents, particularly among naturalized citizens and non-citizens. This study highlights the importance of disaggregating data by Asian origin group and considering citizenship status as a key factor associated with annual healthcare utilization.