--- title: "Healthcare access and use in Korean Americans: English use. | Sutter Health" description: "In a study of Korean Americans, health care utilization was primarily driven by having health insurance and a usual source of care." url: "https://www.sutterhealth.org/research/publications/healthcare-access-use-korean-ams-english-use-1055312415" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Healthcare access and use in Korean Americans: English use. # Healthcare access and utilization among Korean Americans: the mediating role of English use and proficiency. Li J, Maxwell AE, Glenn BA, Herrmann AK, Chang LC, Crespi CM, & Bastani R. _Int J Soc Sci Res. 2016;4(1):83-97._ 2016-01-21 ## Abstract The literature suggests that Korean Americans underutilize health services. Cultural factors and language barriers appear to influence this pattern of low utilization, but studies on the relationships among length of stay in the U.S., English use and proficiency, and utilization of health services among Korean Americans have yielded inconsistent results. This study examines whether English language use and proficiency plays a mediating role in the relationships between length of stay in the U.S. and health insurance coverage, access to and use of care. Structural equation modeling was used for mediation analysis with multiple dependent variables among Korean Americans (N=555) using baseline data from a large trial designed to increase Hepatitis B testing. The results show 36% of the total effect of proportion of lifetime in the U.S. on having health insurance was significantly mediated by English use and proficiency (indirect effect=0.166, SE=0.07, p<.05; direct effect=0.296, SE=0.13, p<.05). Proportion of lifetime in the U.S. was not associated with usual source of care and health service utilization. Instead, health care utilization was primarily driven by having health insurance and a usual source of care, further underscoring the importance of these factors. A focus on increasing English use and proficiency and insurance coverage among older, female, less educated Korean Americans has the potential to mitigate health disparities associated with reduced access to health services in this population. [PubMed abstract](http://www.macrothink.org/journal/index.php/ijssr/article/view/8678) ![Jiang Li, Ph.D., MPH](https://dyn.mktgcdn.com/p/H4OFJqNxBzDqkSWaIqDBiZgqIsHNsHLWdLuMd9IlNx0/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Jiang Li, Ph.D., MPH Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/jiang-li-phd-mph-1049681008) ## Research topics - [Aging and Longevity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Aging+and+Longevity%5C%22%22) - [Health Disparities](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Disparities%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Women's Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Women%27s+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Weight counseling for elderly patients in primary care: how often and how much time.](https://www.sutterhealth.org/research/publications/wt-counseling-elders-primary-care-1055312562) Tai-Seale T, Tai-Seale M, Zhang W. 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Health Aff (Millwood). 2015 Apr 1;34(4):609-15. doi: 10.1377/hlthaff.2014.1013. 2015 Apr 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/healthcare-access-use-korean-ams-english-use-1055312415#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Healthcare access and use in Korean Americans: English use."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/healthcare-access-use-korean-ams-english-use-1055312415#medicalscholarlyarticle","name":"Healthcare access and utilization among Korean Americans: the mediating role of English use and proficiency.","headline":"Healthcare access and use in Korean Americans: English use.","abstract":"The literature suggests that Korean Americans underutilize health services. Cultural factors and language barriers appear to influence this pattern of low utilization, but studies on the relationships among length of stay in the U.S., English use and proficiency, and utilization of health services among Korean Americans have yielded inconsistent results. This study examines whether English language use and proficiency plays a mediating role in the relationships between length of stay in the U.S. and health insurance coverage, access to and use of care. Structural equation modeling was used for mediation analysis with multiple dependent variables among Korean Americans (N=555) using baseline data from a large trial designed to increase Hepatitis B testing. The results show 36% of the total effect of proportion of lifetime in the U.S. on having health insurance was significantly mediated by English use and proficiency (indirect effect=0.166, SE=0.07, p\u003c.05; direct effect=0.296, SE=0.13, p\u003c.05). Proportion of lifetime in the U.S. was not associated with usual source of care and health service utilization. Instead, health care utilization was primarily driven by having health insurance and a usual source of care, further underscoring the importance of these factors. A focus on increasing English use and proficiency and insurance coverage among older, female, less educated Korean Americans has the potential to mitigate health disparities associated with reduced access to health services in this population.","description":"In a study of Korean Americans, health care utilization was primarily driven by having health insurance and a usual source of care.","keywords":["Aging and Longevity","Health Disparities","Health Services","Women's Health"],"datePublished":"2016-01-21","url":"https://www.sutterhealth.org/research/publications/healthcare-access-use-korean-ams-english-use-1055312415","inLanguage":"en-US","isPartOf":{"@type":"Periodical","name":"Int J Soc Sci Res"},"author":[{"@type":"Person","@id":"https://www.sutterhealth.org/research/investigators/jiang-li-phd-mph-1049681008","name":"Li J","url":"https://www.sutterhealth.org/research/investigators/jiang-li-phd-mph-1049681008"},{"@type":"Person","name":"Maxwell AE"},{"@type":"Person","name":"Glenn BA"},{"@type":"Person","name":"Herrmann AK"},{"@type":"Person","name":"Chang LC"},{"@type":"Person","name":"Crespi CM"},{"@type":"Person","name":"Bastani R"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Aging and Longevity","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Aging+and+Longevity%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Disparities","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Disparities%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Services","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Services%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Women's Health","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Women%27s+Health%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/healthcare-access-use-korean-ams-english-use-1055312415","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/healthcare-access-use-korean-ams-english-use-1055312415#breadcrumblist"}}} ```