Health insurance, healthcare utilization and language use among populations who experience risk for tuberculosis, California 2014–2017

California tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with tuberculosis. Adequate health insurance and robust healthcare utilization are crucial to meeting these goals, but information on these factors for populatio...

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Published inPloS one Vol. 17; no. 5; p. e0268739
Main Authors Readhead, Adam, Flood, Jennifer, Barry, Pennan
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 24.05.2022
Public Library of Science (PLoS)
Subjects
Biology and Life Sciences
Birth
Confidence intervals
Country of birth
Diabetes
Diabetes mellitus
Disease prevention
Education
Educational attainment
English language
Evaluation
Health care
Health care policy
Health insurance
Health maintenance organizations
Health risks
Health services utilization
HMOs
Hospitals
Human subjects
Infections
Insurance
Language
Medical care
Medicine and Health Sciences
Non-English languages
People and places
Polls & surveys
Population
Populations
Poverty
Prevention
Public health
Risk
Risk factors
Social Sciences
Socioeconomic factors
Surveys
Tuberculosis
Utilization
United States
Vietnam
United States > US
Philippines
China
Mexico
California
India
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Abstract California tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with tuberculosis. Adequate health insurance and robust healthcare utilization are crucial to meeting these goals, but information on these factors for populations that experience risk for TB is limited. We used data from the 2014-2017 California Health Interview Survey (n = 82,758), a population-based dual-frame telephone survey to calculate survey proportions and 95% confidence intervals (CI) stratified by country of birth, focusing on persons from countries of birth with the highest number of TB cases in California. Survey proportions for recent doctor's visit, overall health, smoking, and diabetes were age-adjusted. Among 18-64 year-olds, 27% (CI: 25-30) of persons born in Mexico reported being uninsured in contrast with 3% (CI: 1-5) of persons born in India. Report of recent doctor's visit was highest among persons born in the Philippines, 84% (CI: 80-89) and lowest among Chinese-born persons, 70% (CI: 63-76). Persons born in Mexico were more likely to report community clinics as their usual source of care than persons born in China, Vietnam, or the Philippines. Poverty was highest among Mexican-born persons, 56% (CI: 54-58) and lowest among Indian-born persons, 9% (CI: 5-13). Of adults with a medical visit in a non-English language, 96% (CI: 96-97) were non-U.S.-born, but only 42% (CI: 40-44) of non-U.S.-born persons had a visit in a non-English language. Many, though not all, of the populations that experience risk for TB had health insurance and used healthcare. We found key differences in usual source of care and language use by country of birth which should be considered when planning outreach to specific providers, clinic systems, insurers and communities for TB prevention and case-finding.
AbstractList California tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with tuberculosis. Adequate health insurance and robust healthcare utilization are crucial to meeting these goals, but information on these factors for populations that experience risk for TB is limited. We used data from the 2014-2017 California Health Interview Survey (n = 82,758), a population-based dual-frame telephone survey to calculate survey proportions and 95% confidence intervals (CI) stratified by country of birth, focusing on persons from countries of birth with the highest number of TB cases in California. Survey proportions for recent doctor's visit, overall health, smoking, and diabetes were age-adjusted. Among 18-64 year-olds, 27% (CI: 25-30) of persons born in Mexico reported being uninsured in contrast with 3% (CI: 1-5) of persons born in India. Report of recent doctor's visit was highest among persons born in the Philippines, 84% (CI: 80-89) and lowest among Chinese-born persons, 70% (CI: 63-76). Persons born in Mexico were more likely to report community clinics as their usual source of care than persons born in China, Vietnam, or the Philippines. Poverty was highest among Mexican-born persons, 56% (CI: 54-58) and lowest among Indian-born persons, 9% (CI: 5-13). Of adults with a medical visit in a non-English language, 96% (CI: 96-97) were non-U.S.-born, but only 42% (CI: 40-44) of non-U.S.-born persons had a visit in a non-English language. Many, though not all, of the populations that experience risk for TB had health insurance and used healthcare. We found key differences in usual source of care and language use by country of birth which should be considered when planning outreach to specific providers, clinic systems, insurers and communities for TB prevention and case-finding.
Background California tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with tuberculosis. Adequate health insurance and robust healthcare utilization are crucial to meeting these goals, but information on these factors for populations that experience risk for TB is limited. Methods We used data from the 2014–2017 California Health Interview Survey (n = 82,758), a population-based dual-frame telephone survey to calculate survey proportions and 95% confidence intervals (CI) stratified by country of birth, focusing on persons from countries of birth with the highest number of TB cases in California. Survey proportions for recent doctor’s visit, overall health, smoking, and diabetes were age-adjusted. Results Among 18–64 year-olds, 27% (CI: 25–30) of persons born in Mexico reported being uninsured in contrast with 3% (CI: 1–5) of persons born in India. Report of recent doctor’s visit was highest among persons born in the Philippines, 84% (CI: 80–89) and lowest among Chinese-born persons, 70% (CI: 63–76). Persons born in Mexico were more likely to report community clinics as their usual source of care than persons born in China, Vietnam, or the Philippines. Poverty was highest among Mexican-born persons, 56% (CI: 54–58) and lowest among Indian-born persons, 9% (CI: 5–13). Of adults with a medical visit in a non-English language, 96% (CI: 96–97) were non-U.S.-born, but only 42% (CI: 40–44) of non-U.S.-born persons had a visit in a non-English language. Discussion Many, though not all, of the populations that experience risk for TB had health insurance and used healthcare. We found key differences in usual source of care and language use by country of birth which should be considered when planning outreach to specific providers, clinic systems, insurers and communities for TB prevention and case-finding.
Background California tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with tuberculosis. Adequate health insurance and robust healthcare utilization are crucial to meeting these goals, but information on these factors for populations that experience risk for TB is limited. Methods We used data from the 2014–2017 California Health Interview Survey (n = 82,758), a population-based dual-frame telephone survey to calculate survey proportions and 95% confidence intervals (CI) stratified by country of birth, focusing on persons from countries of birth with the highest number of TB cases in California. Survey proportions for recent doctor’s visit, overall health, smoking, and diabetes were age-adjusted. Results Among 18–64 year-olds, 27% (CI: 25–30) of persons born in Mexico reported being uninsured in contrast with 3% (CI: 1–5) of persons born in India. Report of recent doctor’s visit was highest among persons born in the Philippines, 84% (CI: 80–89) and lowest among Chinese-born persons, 70% (CI: 63–76). Persons born in Mexico were more likely to report community clinics as their usual source of care than persons born in China, Vietnam, or the Philippines. Poverty was highest among Mexican-born persons, 56% (CI: 54–58) and lowest among Indian-born persons, 9% (CI: 5–13). Of adults with a medical visit in a non-English language, 96% (CI: 96–97) were non-U.S.-born, but only 42% (CI: 40–44) of non-U.S.-born persons had a visit in a non-English language. Discussion Many, though not all, of the populations that experience risk for TB had health insurance and used healthcare. We found key differences in usual source of care and language use by country of birth which should be considered when planning outreach to specific providers, clinic systems, insurers and communities for TB prevention and case-finding.
California tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with tuberculosis. Adequate health insurance and robust healthcare utilization are crucial to meeting these goals, but information on these factors for populations that experience risk for TB is limited. We used data from the 2014-2017 California Health Interview Survey (n = 82,758), a population-based dual-frame telephone survey to calculate survey proportions and 95% confidence intervals (CI) stratified by country of birth, focusing on persons from countries of birth with the highest number of TB cases in California. Survey proportions for recent doctor's visit, overall health, smoking, and diabetes were age-adjusted. Among 18-64 year-olds, 27% (CI: 25-30) of persons born in Mexico reported being uninsured in contrast with 3% (CI: 1-5) of persons born in India. Report of recent doctor's visit was highest among persons born in the Philippines, 84% (CI: 80-89) and lowest among Chinese-born persons, 70% (CI: 63-76). Persons born in Mexico were more likely to report community clinics as their usual source of care than persons born in China, Vietnam, or the Philippines. Poverty was highest among Mexican-born persons, 56% (CI: 54-58) and lowest among Indian-born persons, 9% (CI: 5-13). Of adults with a medical visit in a non-English language, 96% (CI: 96-97) were non-U.S.-born, but only 42% (CI: 40-44) of non-U.S.-born persons had a visit in a non-English language. Many, though not all, of the populations that experience risk for TB had health insurance and used healthcare. We found key differences in usual source of care and language use by country of birth which should be considered when planning outreach to specific providers, clinic systems, insurers and communities for TB prevention and case-finding.
California tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with tuberculosis. Adequate health insurance and robust healthcare utilization are crucial to meeting these goals, but information on these factors for populations that experience risk for TB is limited.BACKGROUNDCalifornia tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with tuberculosis. Adequate health insurance and robust healthcare utilization are crucial to meeting these goals, but information on these factors for populations that experience risk for TB is limited.We used data from the 2014-2017 California Health Interview Survey (n = 82,758), a population-based dual-frame telephone survey to calculate survey proportions and 95% confidence intervals (CI) stratified by country of birth, focusing on persons from countries of birth with the highest number of TB cases in California. Survey proportions for recent doctor's visit, overall health, smoking, and diabetes were age-adjusted.METHODSWe used data from the 2014-2017 California Health Interview Survey (n = 82,758), a population-based dual-frame telephone survey to calculate survey proportions and 95% confidence intervals (CI) stratified by country of birth, focusing on persons from countries of birth with the highest number of TB cases in California. Survey proportions for recent doctor's visit, overall health, smoking, and diabetes were age-adjusted.Among 18-64 year-olds, 27% (CI: 25-30) of persons born in Mexico reported being uninsured in contrast with 3% (CI: 1-5) of persons born in India. Report of recent doctor's visit was highest among persons born in the Philippines, 84% (CI: 80-89) and lowest among Chinese-born persons, 70% (CI: 63-76). Persons born in Mexico were more likely to report community clinics as their usual source of care than persons born in China, Vietnam, or the Philippines. Poverty was highest among Mexican-born persons, 56% (CI: 54-58) and lowest among Indian-born persons, 9% (CI: 5-13). Of adults with a medical visit in a non-English language, 96% (CI: 96-97) were non-U.S.-born, but only 42% (CI: 40-44) of non-U.S.-born persons had a visit in a non-English language.RESULTSAmong 18-64 year-olds, 27% (CI: 25-30) of persons born in Mexico reported being uninsured in contrast with 3% (CI: 1-5) of persons born in India. Report of recent doctor's visit was highest among persons born in the Philippines, 84% (CI: 80-89) and lowest among Chinese-born persons, 70% (CI: 63-76). Persons born in Mexico were more likely to report community clinics as their usual source of care than persons born in China, Vietnam, or the Philippines. Poverty was highest among Mexican-born persons, 56% (CI: 54-58) and lowest among Indian-born persons, 9% (CI: 5-13). Of adults with a medical visit in a non-English language, 96% (CI: 96-97) were non-U.S.-born, but only 42% (CI: 40-44) of non-U.S.-born persons had a visit in a non-English language.Many, though not all, of the populations that experience risk for TB had health insurance and used healthcare. We found key differences in usual source of care and language use by country of birth which should be considered when planning outreach to specific providers, clinic systems, insurers and communities for TB prevention and case-finding.DISCUSSIONMany, though not all, of the populations that experience risk for TB had health insurance and used healthcare. We found key differences in usual source of care and language use by country of birth which should be considered when planning outreach to specific providers, clinic systems, insurers and communities for TB prevention and case-finding.
BackgroundCalifornia tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with tuberculosis. Adequate health insurance and robust healthcare utilization are crucial to meeting these goals, but information on these factors for populations that experience risk for TB is limited.MethodsWe used data from the 2014-2017 California Health Interview Survey (n = 82,758), a population-based dual-frame telephone survey to calculate survey proportions and 95% confidence intervals (CI) stratified by country of birth, focusing on persons from countries of birth with the highest number of TB cases in California. Survey proportions for recent doctor's visit, overall health, smoking, and diabetes were age-adjusted.ResultsAmong 18-64 year-olds, 27% (CI: 25-30) of persons born in Mexico reported being uninsured in contrast with 3% (CI: 1-5) of persons born in India. Report of recent doctor's visit was highest among persons born in the Philippines, 84% (CI: 80-89) and lowest among Chinese-born persons, 70% (CI: 63-76). Persons born in Mexico were more likely to report community clinics as their usual source of care than persons born in China, Vietnam, or the Philippines. Poverty was highest among Mexican-born persons, 56% (CI: 54-58) and lowest among Indian-born persons, 9% (CI: 5-13). Of adults with a medical visit in a non-English language, 96% (CI: 96-97) were non-U.S.-born, but only 42% (CI: 40-44) of non-U.S.-born persons had a visit in a non-English language.DiscussionMany, though not all, of the populations that experience risk for TB had health insurance and used healthcare. We found key differences in usual source of care and language use by country of birth which should be considered when planning outreach to specific providers, clinic systems, insurers and communities for TB prevention and case-finding.
Audience Academic
Author Flood, Jennifer
Barry, Pennan
Readhead, Adam
AuthorAffiliation 2 Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, United States of America
University of the Punjab, PAKISTAN
1 Tuberculosis Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, California, United States of America
AuthorAffiliation_xml – name: 2 Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, United States of America
– name: University of the Punjab, PAKISTAN
– name: 1 Tuberculosis Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, California, United States of America
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/35609051$$D View this record in MEDLINE/PubMed
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CitedBy_id crossref_primary_10_1001_jama_2023_4967
crossref_primary_10_1016_j_focus_2023_100148
crossref_primary_10_1007_s10903_022_01438_1
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Competing Interests: The authors have declared that no competing interests exist.
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Snippet California tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with tuberculosis....
Background California tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with...
BackgroundCalifornia tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with...
Background California tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with...
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SubjectTerms Biology and Life Sciences
Birth
Confidence intervals
Country of birth
Diabetes
Diabetes mellitus
Disease prevention
Education
Educational attainment
English language
Evaluation
Health care
Health care policy
Health insurance
Health maintenance organizations
Health risks
Health services utilization
HMOs
Hospitals
Human subjects
Infections
Insurance
Language
Medical care
Medicine and Health Sciences
Non-English languages
People and places
Polls & surveys
Population
Populations
Poverty
Prevention
Public health
Risk
Risk factors
Social Sciences
Socioeconomic factors
Surveys
Tuberculosis
Utilization
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Title Health insurance, healthcare utilization and language use among populations who experience risk for tuberculosis, California 2014–2017
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