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Latin American immigrants have limited access to health insurance in Japan: a cross sectional study.

ABSTRACT: BACKGROUND: Japan provides universal health insurance to all legal residents. Prior research has suggested that immigrants to Japan disproportionately lack health insurance coverage, but no prior study has used rigorous methodology to examine this issue among Latin American immigrants in Japan. The aim of our study, therefore, was to assess the pattern of health insurance coverage and predictors of uninsurance among documented Latin American immigrants in Japan. METHODS: We used a cross sectional, mixed method approach using a probability proportional to estimated size sampling procedure. Of 1052 eligible Latin American residents mapped through extensive fieldwork in selected clusters, 400 immigrant residents living in Nagahama City, Japan were randomly selected for our study. Data were collected through face-to-face interviews using a structured questionnaire developed from qualitative interviews. RESULTS: Our response rate was 70.5% (n = 282). Respondents were mainly from Brazil (69.9%), under 40 years of age (64.5%) and had lived in Japan for 9.45 years (SE 0.44; median, 8.00). We found a high prevalence of uninsurance (19.8%) among our sample compared with the estimated national average of 1.3% in the general population. Among the insured full time workers (n = 209), 55.5% were not covered by the Employee's Health Insurance. Many immigrants cited financial trade-offs as the main reasons for uninsurance. Lacking of knowledge that health insurance is mandatory in Japan, not having a chronic disease, and having one or no children were strong predictors of uninsurance. CONCLUSIONS: Lack of health insurance for immigrants in Japan is a serious concern for this population as well as for the Japanese health care system. Appropriate measures should be taken to facilitate access to health insurance for this vulnerable population.

SUBMITTER: Suguimoto SP

PROVIDER: S-EPMC3373364 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Latin American immigrants have limited access to health insurance in Japan: a cross sectional study.

Suguimoto S Pilar SP Ono-Kihara Masako M Feldman Mitchell D MD Kihara Masahiro M

BMC public health 20120325

<h4>Background</h4>Japan provides universal health insurance to all legal residents. Prior research has suggested that immigrants to Japan disproportionately lack health insurance coverage, but no prior study has used rigorous methodology to examine this issue among Latin American immigrants in Japan. The aim of our study, therefore, was to assess the pattern of health insurance coverage and predictors of uninsurance among documented Latin American immigrants in Japan.<h4>Methods</h4>We used a c ...[more]

PMID: 22443284

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Project description:BackgroundRadiology is a useful tool for diagnosis and intervention in medical practice, and all the components within the teaching-learning process of this subject during undergraduate studies influence successful knowledge application.ObjectiveThis study aimed to describe the level of knowledge in radiology of students in the last two years of medical school and curricular characteristics of their courses in seven Latin American countries.MethodsA multicenter cross-sectional study was carried out on medical students of 7 Latin American countries (Bolivia, Brazil, Colombia, Ecuador, Mexico, Paraguay, and Peru) in their final two years of medical school, using an online questionnaire validated by experts and adapted for each country that assessed knowledge and curricular characteristics in radiology subject. Scores were assigned according to the number of correct answers for the knowledge test. The T-test, and regression analysis with one-way ANOVA were used to search for relationships between the level of knowledge and other variables.ResultsA total of 1514 medical students participated in this study. All countries had similar participation (n > 200); most participants were women 57.8%. The country with the highest knowledge score was Brazil. Male, sixth year (internship) and from public universities students had higher knowledge score (n < 0.05). Participants, who considered radiology more important, and who reported higher compliance with teaching staff with the proposed syllabus, and programmed classes, obtained better scores (n < 0.05).ConclusionsLatin American medical students included in this study have a regular overall level of knowledge of Radiology, apparently influenced by curricular differences such as class and academic program compliance. Efforts to better understand and improve academic training are indispensable.LimitationsThe study was subject to selection bias determined by non-probability convenience sampling. The questionnaire assessed only theoretical knowledge and the evaluation system was designed by the investigators.

Project description:Background Many states in the United States (US) have introduced barriers to impede voting among individuals from socio-economically disadvantaged groups. This may reduce representation thereby decreasing access to lifesaving goods, such as health insurance. Methods We used cross-sectional data from 242,727 adults in the 50 states and District of Columbia participating in the US 2017 Behavioral Risk Factor Surveillance System (BRFSS). To quantify access to voting, the Cost of Voting Index (COVI), a global measure of barriers to voting within a state during a US election was used. Multilevel modeling was used to determine whether barriers to voting were associated with health insurance status after adjusting for individual- and state-level covariates. Analyses were stratified by racial/ethnic identity, household income, and age group. Findings A one standard deviation (SD) increase in COVI score was associated with an overall increased odds of being uninsured (OR=1.25; 95% CI=1.22, 1.28). This association was also present for Non-Hispanic Black (OR=1.18; 95% CI=1.13,1.22), Hispanic (1.18; 95% CI=1.15,1.21), and Asian (OR=1.45;95%CI=1.27,1.66), and other Non-Hispanic (OR=1.12, 95% CI=1.06, 1.18) US adults, but not for White Non-Hispanic and Native US adults. Likewise, a one SD increase in COVI among adults from low-income households was associated with an increased odds of being uninsured (OR=1.32; 95% CI=1.26,1.38) but there was no association among individuals with incomes greater than $75,000. This association was similar for younger US adults (OR=1.22; 95%CI=1.20,1.24) but not among those aged 45 to 64. Interpretation Groups commonly targeted by voting restriction laws—those with low incomes, who are racial minorities, and who are young—are also less likely to be insured in states with more voting restrictions. However, those who are wealthier, white or older are no more likely to be uninsured irrespective of the level of voting restrictions. Funding Pabayo is a Tier II Canada Research Chair.

Project description:This study compares the health-related quality of life of Spanish-born and Latin American-born individuals settled in Spain. Socio-demographic and psychosocial factors associated with health-related quality of life are analyzed.A cross-sectional Primary Health Care multi center-based study of Latin American-born (n = 691) and Spanish-born (n = 903) outpatients from 15 Primary Health Care Centers (Madrid, Spain). The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) was used to assess health-related quality of life. Socio-demographic, psychosocial, and specific migration data were also collected.Compared to Spanish-born participants, Latin American-born participants reported higher health-related quality of life in the physical functioning and vitality dimensions. Across the entire sample, Latin American-born participants, younger participants, men and those with high social support reported significantly higher levels of physical health. Men with higher social support and a higher income reported significantly higher mental health. When stratified by gender, data show that for men physical health was only positively associated with younger age. For women, in addition to age, social support and marital status were significantly related. Both men and women with higher social support and income had significantly better mental health. Finally, for immigrants, the physical and mental health components of health-related quality of life were not found to be significantly associated with any of the pre-migration factors or conditions of migration. Only the variable "exposure to political violence" was significantly associated with the mental health component (p = 0.014).The key factors to understanding HRQoL among Latin American-born immigrants settled in Spain are age, sex and social support. Therefore, strategies to maintain optimal health outcomes in these immigrant communities should include public policies on social inclusion in the host society and focus on improving social support networks in order to foster and maintain the health and HRQoL of this group.

Dataset Information

Latin American immigrants have limited access to health insurance in Japan: a cross sectional study.

Publications

Latin American immigrants have limited access to health insurance in Japan: a cross sectional study.

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