Health care utilization among Middle Eastern, Hispanic/Latino, and Asian immigrants in the United States: an application of Andersen's behavioral model

Objectives: To examine whether Andersen's model explains health care utilization among Middle Eastern immigrants and to examine gender and ethnic differences in health care utilization of Middle Eastern, Hispanic/Latino, and Asian immigrants in the United States.

Method: Using data from the 2000-2017 National Health Interview Surveys (NHIS), this study compares patterns of health care utilization among Middle Eastern (ME) immigrants to those among Hispanic/Latino and Asian immigrants in the U.S. Specifically, we use Andersen's Behavioral Model of Health Care Utilization to model the likelihood of seeing a doctor in the past 12 months for these three immigrant groups. Additionally, the current study emphasizes the predisposing factor of gender and its differences across and within these groups.

Results: Andersen's behavioral framework is partially suited to predict the likelihood of seeing a doctor in the past 12 months among ME immigrants. Immigrant women, regardless of their ethnicity, are significantly more likely than men to report seeing a doctor in the past 12 months. Moreover, the effects of the predisposing, need, and enabling characteristics for Hispanics and Asians are significantly different from those for ME immigrants. Additionally, although Asians are significantly less likely to utilize the health care system than ME immigrants, there are no significant differences comparing Hispanics/Latinos to ME immigrants. Furthermore, Andersen's behavioral framework explains ethnicity and gender differences particularly when comparing Asian men to ME men and Asian women to ME women.

Conclusions: This study highlights the importance of considering ethnicity and gender differences when examining health outcomes of immigrants.