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Abstract

Asian American (AA) and Native Hawaiian and Pacific Islander (NHPI) people are often aggregated into a monolithic group, but when they are disaggregated into ethnic groups (e.g., Chinese), inequities can be identified. Using a representative sample of adult Medicaid enrollees (N=55,215), the authors assessed inequities in self-reported access to mental or behavioral health services between non-Hispanic AA and NHPI Medicaid enrollees and non-Hispanic White Medicaid enrollees, both by racial group and across 10 disaggregated ethnic groups. AA and NHPI enrollees, by race and all 10 ethnicities, reported significantly worse mental health care access than did White enrollees. The magnitude of disparities also differed between ethnic groups, ranging from −14.6 percentage points for Native Hawaiian enrollees to −43.6 percentage points for Vietnamese enrollees.

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Information

Published In

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Psychiatric Services

History

Received: 20 December 2023
Revision received: 22 May 2024
Accepted: 22 August 2024
Published online: 19 December 2024

Keywords

  1. Asian Americans
  2. Native Hawaiians and Pacific Islanders
  3. Quality of care
  4. Patient satisfaction
  5. Insurance

Authors

Details

Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston (Nguyen); Department of Health Services, Policy, and Practice (Nguyen) and Department of Epidemiology (Choy), Brown University School of Public Health, Providence, Rhode Island; Medicare Payment Advisory Commission, Washington, D.C. (Oh); Department of Population Health, Section for Health Equity, New York University Grossman School of Medicine, New York City (Ðoàn); Asian American Research Center on Health, San Francisco (Chu); Department of Health Policy and Management, Fielding School of Public Health (Banawa), Center for Health Policy Research (Banawa), and Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine (Oronce), University of California, Los Angeles, Los Angeles; Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles (Oronce); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut (Choy); Department of Public Health, Wayne State University, Detroit (Zhou).
Eunhae G. Oh, Ph.D., M.P.P.
Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston (Nguyen); Department of Health Services, Policy, and Practice (Nguyen) and Department of Epidemiology (Choy), Brown University School of Public Health, Providence, Rhode Island; Medicare Payment Advisory Commission, Washington, D.C. (Oh); Department of Population Health, Section for Health Equity, New York University Grossman School of Medicine, New York City (Ðoàn); Asian American Research Center on Health, San Francisco (Chu); Department of Health Policy and Management, Fielding School of Public Health (Banawa), Center for Health Policy Research (Banawa), and Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine (Oronce), University of California, Los Angeles, Los Angeles; Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles (Oronce); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut (Choy); Department of Public Health, Wayne State University, Detroit (Zhou).
Lan N. Ðoàn, Ph.D., M.P.H.
Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston (Nguyen); Department of Health Services, Policy, and Practice (Nguyen) and Department of Epidemiology (Choy), Brown University School of Public Health, Providence, Rhode Island; Medicare Payment Advisory Commission, Washington, D.C. (Oh); Department of Population Health, Section for Health Equity, New York University Grossman School of Medicine, New York City (Ðoàn); Asian American Research Center on Health, San Francisco (Chu); Department of Health Policy and Management, Fielding School of Public Health (Banawa), Center for Health Policy Research (Banawa), and Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine (Oronce), University of California, Los Angeles, Los Angeles; Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles (Oronce); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut (Choy); Department of Public Health, Wayne State University, Detroit (Zhou).
Christina T. Chu, B.A.
Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston (Nguyen); Department of Health Services, Policy, and Practice (Nguyen) and Department of Epidemiology (Choy), Brown University School of Public Health, Providence, Rhode Island; Medicare Payment Advisory Commission, Washington, D.C. (Oh); Department of Population Health, Section for Health Equity, New York University Grossman School of Medicine, New York City (Ðoàn); Asian American Research Center on Health, San Francisco (Chu); Department of Health Policy and Management, Fielding School of Public Health (Banawa), Center for Health Policy Research (Banawa), and Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine (Oronce), University of California, Los Angeles, Los Angeles; Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles (Oronce); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut (Choy); Department of Public Health, Wayne State University, Detroit (Zhou).
Rachel A. Banawa, M.S.P.H.
Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston (Nguyen); Department of Health Services, Policy, and Practice (Nguyen) and Department of Epidemiology (Choy), Brown University School of Public Health, Providence, Rhode Island; Medicare Payment Advisory Commission, Washington, D.C. (Oh); Department of Population Health, Section for Health Equity, New York University Grossman School of Medicine, New York City (Ðoàn); Asian American Research Center on Health, San Francisco (Chu); Department of Health Policy and Management, Fielding School of Public Health (Banawa), Center for Health Policy Research (Banawa), and Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine (Oronce), University of California, Los Angeles, Los Angeles; Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles (Oronce); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut (Choy); Department of Public Health, Wayne State University, Detroit (Zhou).
Carlos Irwin A. Oronce, M.D., Ph.D.
Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston (Nguyen); Department of Health Services, Policy, and Practice (Nguyen) and Department of Epidemiology (Choy), Brown University School of Public Health, Providence, Rhode Island; Medicare Payment Advisory Commission, Washington, D.C. (Oh); Department of Population Health, Section for Health Equity, New York University Grossman School of Medicine, New York City (Ðoàn); Asian American Research Center on Health, San Francisco (Chu); Department of Health Policy and Management, Fielding School of Public Health (Banawa), Center for Health Policy Research (Banawa), and Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine (Oronce), University of California, Los Angeles, Los Angeles; Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles (Oronce); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut (Choy); Department of Public Health, Wayne State University, Detroit (Zhou).
Courtney C. Choy, Ph.D., M.P.H.
Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston (Nguyen); Department of Health Services, Policy, and Practice (Nguyen) and Department of Epidemiology (Choy), Brown University School of Public Health, Providence, Rhode Island; Medicare Payment Advisory Commission, Washington, D.C. (Oh); Department of Population Health, Section for Health Equity, New York University Grossman School of Medicine, New York City (Ðoàn); Asian American Research Center on Health, San Francisco (Chu); Department of Health Policy and Management, Fielding School of Public Health (Banawa), Center for Health Policy Research (Banawa), and Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine (Oronce), University of California, Los Angeles, Los Angeles; Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles (Oronce); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut (Choy); Department of Public Health, Wayne State University, Detroit (Zhou).
Sasha Zhou, Ph.D.
Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston (Nguyen); Department of Health Services, Policy, and Practice (Nguyen) and Department of Epidemiology (Choy), Brown University School of Public Health, Providence, Rhode Island; Medicare Payment Advisory Commission, Washington, D.C. (Oh); Department of Population Health, Section for Health Equity, New York University Grossman School of Medicine, New York City (Ðoàn); Asian American Research Center on Health, San Francisco (Chu); Department of Health Policy and Management, Fielding School of Public Health (Banawa), Center for Health Policy Research (Banawa), and Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine (Oronce), University of California, Los Angeles, Los Angeles; Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles (Oronce); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut (Choy); Department of Public Health, Wayne State University, Detroit (Zhou).

Notes

Send correspondence to Dr. Nguyen ([email protected]). Roberto Lewis-Fernández, M.D., and Deidre M. Anglin, Ph.D., are editors of this column.

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

These views represent the opinions of the authors and not necessarily those of their institutions.

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