IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v16y2019i7p1302-d221914.html
   My bibliography  Save this article

Unmet Mental Health Care Needs among Asian Americans 10–11 Years After Exposure to the World Trade Center Attack

Author

Listed:
  • Winnie W. Kung

    (Fordham University, Graduate School of Social Service, 113 West 60th Street, New York, NY 11375, USA)

  • Xiaoran Wang

    (Fordham University, Graduate School of Social Service, 113 West 60th Street, New York, NY 11375, USA)

  • Xinhua Liu

    (Columbia University, Mailman School of Public Health, 722 W 168th Street, New York, NY 10032, USA)

  • Emily Goldmann

    (New York University, College of Global Public Health, 715/719 Broadway, 10th floor, New York, NY 10003, USA)

  • Debbie Huang

    (Columbia University, Mailman School of Public Health, 722 W 168th Street, New York, NY 10032, USA)

Abstract

This study investigated the prevalence of unmet mental health care needs (UMHCN) and their associated factors among 2344 Asian Americans directly exposed to the World Trade Center (WTC) attack 10–11 years afterwards. Given the pervasive underutilization of mental health services among Asians, their subjective evaluation of unmet needs could provide more nuanced information on disparities of service. We used the WTC Health Registry data and found that 12% of Asian Americans indicated UMHCN: 69% attributing it to attitudinal barriers, 36% to cost barriers, and 29% to access barriers. Among all the factors significantly related to UMHCN in the logistic model, disruption of health insurance in the past year had the largest odds ratio (OR = 2.37, 95% confidence interval: 1.61–3.48), though similar to functional impairment due to mental disorders. Post-9/11 mental health diagnosis, probable mental disorder and ≥14 poor mental health days in the past month were also associated with greater odds of UMHCN, while greater social support was associated with lower odds. Results suggest that continued outreach efforts to provide mental health education to Asian communities to increase knowledge about mental illness and treatment options, reduce stigmatization of mental illness, and offer free mental health services are crucial to address UMHCN.

Suggested Citation

  • Winnie W. Kung & Xiaoran Wang & Xinhua Liu & Emily Goldmann & Debbie Huang, 2019. "Unmet Mental Health Care Needs among Asian Americans 10–11 Years After Exposure to the World Trade Center Attack," IJERPH, MDPI, vol. 16(7), pages 1-15, April.
  • Handle: RePEc:gam:jijerp:v:16:y:2019:i:7:p:1302-:d:221914
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/16/7/1302/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/16/7/1302/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Nelson, Connie Holmes & Park, Jungwee, 2006. "The nature and correlates of unmet health care needs in Ontario, Canada," Social Science & Medicine, Elsevier, vol. 62(9), pages 2291-2300, May.
    2. Balsa, Ana I. & McGuire, Thomas G., 2003. "Prejudice, clinical uncertainty and stereotyping as sources of health disparities," Journal of Health Economics, Elsevier, vol. 22(1), pages 89-116, January.
    3. Abe-Kim, J. & Takeuchi, D.T. & Hong, S. & Zane, N. & Sue, S. & Spencer, M.S. & Appel, H. & Nicdao, E. & Alegría, M., 2007. "Use of mental health-related services among immigrant and US-born Asian Americans: Results from the National Latino and Asian American Study," American Journal of Public Health, American Public Health Association, vol. 97(1), pages 91-98.
    4. Balsa, Ana I. & McGuire, Thomas G., 2001. "Statistical discrimination in health care," Journal of Health Economics, Elsevier, vol. 20(6), pages 881-907, November.
    5. Yang, Lawrence Hsin & Kleinman, Arthur & Link, Bruce G. & Phelan, Jo C. & Lee, Sing & Good, Byron, 2007. "Culture and stigma: Adding moral experience to stigma theory," Social Science & Medicine, Elsevier, vol. 64(7), pages 1524-1535, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Robert M. Brackbill & Judith M. Graber & William A. (Allen) Robison, 2019. "Editorial for “Long-Term Health Effects of the 9/11 Disaster” in International Journal of Environmental Research and Public Health , 2019," IJERPH, MDPI, vol. 16(18), pages 1-6, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Allin, Sara & Grignon, Michel & Le Grand, Julian, 2010. "Subjective unmet need and utilization of health care services in Canada: What are the equity implications?," Social Science & Medicine, Elsevier, vol. 70(3), pages 465-472, February.
    2. Katz, Arlene M. & Alegría, Margarita, 2009. "The clinical encounter as local moral world: Shifts of assumptions and transformation in relational context," Social Science & Medicine, Elsevier, vol. 68(7), pages 1238-1246, April.
    3. Setti Rais Ali & Paul Dourgnon & Lise Rochaix, 2018. "Social Capital or Education: What Matters Most to Cut Time to Diagnosis?," Working Papers halshs-01703170, HAL.
    4. Chatterji, P & Joo, H & Lahiri, K, 2011. "Beware of Being Unaware: Racial Disparities in Chronic Illness in the US," Health, Econometrics and Data Group (HEDG) Working Papers 11/11, HEDG, c/o Department of Economics, University of York.
    5. Emilia Simeonova, 2009. "Race, Quality of Care and Patient Outcomes: What Can We Learn from the Department of Veterans Affairs?," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 37(3), pages 279-298, September.
    6. Dourgnon, Paul & Pourat, Nadereh & Rocco, Lorenzo, 2023. "European immigrant health policies, immigrants’ health, and immigrants’ access to healthcare," Health Policy, Elsevier, vol. 127(C), pages 37-43.
    7. Grytten, Jostein & Skau, Irene & Sørensen, Rune, 2011. "Do expert patients get better treatment than others? Agency discrimination and statistical discrimination in obstetrics," Journal of Health Economics, Elsevier, vol. 30(1), pages 163-180, January.
    8. Brian Rubineau & Yoon Kang, 2012. "Bias in White: A Longitudinal Natural Experiment Measuring Changes in Discrimination," Management Science, INFORMS, vol. 58(4), pages 660-677, April.
    9. Jakobsson, Niklas & Kotsadam, Andreas & Syse, Astri & Øien, Henning, 2016. "Gender bias in public long-term care? A survey experiment among care managers," Journal of Economic Behavior & Organization, Elsevier, vol. 131(PB), pages 126-138.
    10. Silvia Angerer & Christian Waibel & Harald Stummer, 2019. "Discrimination in Health Care: A Field Experiment on the Impact of Patients’ Socioeconomic Status on Access to Care," American Journal of Health Economics, MIT Press, vol. 5(4), pages 407-427, Fall.
    11. Pinka Chatterji & Heesoo Joo & Kajal Lahiri, 2010. "Beware of Unawareness: Racial/Ethnic Disparities in Awareness of Chronic Diseases," NBER Working Papers 16578, National Bureau of Economic Research, Inc.
    12. Rajiv Sharma & Miron Stano & Renu Gehring, 2008. "Short‐term fluctuations in hospital demand: implications for admission, discharge, and discriminatory behavior," RAND Journal of Economics, RAND Corporation, vol. 39(2), pages 586-606, June.
    13. Linda Dynan, 2009. "The Contribution of Economists to Understanding Racial Health Disparities in the US," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 37(3), pages 213-223, September.
    14. Lutfey, Karen E. & Link, Carol L. & Grant, Richard W. & Marceau, Lisa D. & McKinlay, John B., 2009. "Is certainty more important than diagnosis for understanding race and gender disparities?: An experiment using coronary heart disease and depression case vignettes," Health Policy, Elsevier, vol. 89(3), pages 279-287, March.
    15. Eric French & Elaine Kelly & Richard Cookson & Carol Propper & Miqdad Asaria & Rosalind Raine, 2016. "Socio‐Economic Inequalities in Health Care in England," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 371-403, September.
    16. Varcoe, Colleen & Browne, Annette J. & Wong, Sabrina & Smye, Victoria L., 2009. "Harms and benefits: Collecting ethnicity data in a clinical context," Social Science & Medicine, Elsevier, vol. 68(9), pages 1659-1666, May.
    17. Johnston, David W. & Lordan, Grace, 2012. "Discrimination makes me sick! An examination of the discrimination–health relationship," Journal of Health Economics, Elsevier, vol. 31(1), pages 99-111.
    18. Song, Jieun & Mailick, Marsha R. & Greenberg, Jan S., 2018. "Health of parents of individuals with developmental disorders or mental health problems: Impacts of stigma," Social Science & Medicine, Elsevier, vol. 217(C), pages 152-158.
    19. Nicolai Fink Simonsen & Anne Sophie Oxholm & Søren Rud Kristensen & Luigi Siciliani, 2020. "What explains differences in waiting times for health care across socioeconomic status?," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1764-1785, December.
    20. Jong Won Min, 2019. "The Influence of Stigma and Views on Mental Health Treatment Effectiveness on Service Use by Age and Ethnicity: Evidence From the CDC BRFSS 2007, 2009, and 2012," SAGE Open, , vol. 9(3), pages 21582440198, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:16:y:2019:i:7:p:1302-:d:221914. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.