Health Literacy and Access to Care in Cancer Screening Among Korean Americans

Abstract

Background: Health literacy and access to care are critical facilitators for preventive health behaviors. After the passage of the Affordable Care Act in March 2010, little has been studied about how improved health insurance coverage has impacted the use of preventive health services among Korean Americans. Objective: The study assessed the impact of access to care, use of services, and health literacy on cancer screening among Korean Americans. Methods: A descriptive cross-sectional study of 377 Korean Americans age 18 years and older was conducted with a survey and convenient sampling in Texas. Key Results: Although 79% of the sample had health insurance, 32% had never visited a health care provider, and 14% were delayed in care in the past 12 months. Only 11.6% were confident to complete medical forms, and 69.5% had limited levels of confidence. Cancer screening compliance rates were: mammography (50.4% at age 40–54 years; 46.6% at age 55 years and older), a Pap smear (29.4% at age 21–29 years; 78.4% at age 30–65 years; 72.2% at age 66 years and older), and colorectal cancer screening at age 45 years and older (stool tests 15.1%; sigmoidoscopy 27%; colonoscopy 51.3%). Multiple logistic regression analyses revealed that household income, gender, health insurance, and health literacy were significantly associated with self-reported cancer screening. Conclusions: Korean Americans who participated in this study are characterized by marginalized health literacy, underused health care services, and significantly lower cancer screening compliance than the goals of Healthy People 2020. The following interventions are suggested to improve health literacy and health insurance literacy on cancer screening: culturally sensitive and linguistically appropriate education for the guidelines concordant with cancer screening, effective communication skills with health care providers, support for navigating the health care system, and development of internet- or social media-based health education programs to meet the preferred communication methods of this population. [ HLRP: Health Literacy Research and Practice . 2021;5(4):e310–e318. ] Plain Language Summary: Despite having improved health insurance coverage, Korean Americans of this study have marginalized health literacy, limited health insurance literacy, low cancer screening compliance, and underused health care services. The results of this study suggest several strategies to improve health literacy and health insurance literacy for Korean Americans, which may also apply to other groups with similar barriers.

Development and Modification of a Culturally Tailored Education Program to Prevent Breast Cancer in Korean Immigrant Women in New York City

“…The increase in BC prevalence among these women is likely related, at least in part, to their low BC screening rates that are influenced by their health beliefs regarding BC screening [ 4 – 6 ]. Even though the American Cancer Society (ACS) recommends a yearly mammogram for women aged 40 years or more, recent studies reported that about 10–53% of KA women had a mammogram in the last 2 years, and about 10–29% never had a mammogram in their lifetimes [ 5 – 7 ]. Early BC screening starting at age 40 is especially important for these women.…”

The Moderating Role of Collectivism on Physical Activity and Family Support

“…[10][11][12] Korean Americans are one of the fastest growing ethnic groups in the US, and 59% of them are first-generation with limited English proficiency, which limits access to quality health care and increases health inequities. [13][14][15][16][17] Consequently, Korean Americans are at considerable risk for cardiovascular disease, including hypertension (31%-53%), type 2 diabetes (8%-20%), and obesity (45%-56%). 11,[18][19][20][21][22] To reduce health disparities related to low levels of PA among minoritized racial and ethnic populations, it is essential to implement PA interventions that consider the unique cultural values and norms of the specific target population.…”

“…Korean Americans are one of the fastest growing ethnic groups in the US, and 59% of them are first-generation with limited English proficiency, which limits access to quality health care and increases health inequities 13–17. Consequently, Korean Americans are at considerable risk for cardiovascular disease, including hypertension (31%-53%), type 2 diabetes (8%-20%), and obesity (45%-56%) 11,18–22…”