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

Winnie W. Kung, Xiaoran Wang, Xinhua Liu, Emily Goldmann, Debbie Huang

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalInternational journal of environmental research and public health
Volume16
Issue number7
DOIs
StatePublished - Apr 11 2019

Fingerprint

Asian Americans
Mental Health
Delivery of Health Care
Mental Health Services
Mental Disorders
Stereotyping
Health Insurance
Health Education
Social Support
Registries
Cross-Sectional Studies
Logistic Models
Odds Ratio
Confidence Intervals
Costs and Cost Analysis
Health

Keywords

  • Asian Americans
  • disaster
  • health insurance
  • mental health conditions
  • mental health service use
  • social support
  • stressful life events
  • unmet mental health care needs
  • World Trade Center attack

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

Unmet Mental Health Care Needs among Asian Americans 10⁻11 Years After Exposure to the World Trade Center Attack. / Kung, Winnie W.; Wang, Xiaoran; Liu, Xinhua; Goldmann, Emily; Huang, Debbie.

In: International journal of environmental research and public health, Vol. 16, No. 7, 11.04.2019.

Research output: Contribution to journalArticle

@article{1e2a8631174c41299e6679ae951a1321,
title = "Unmet Mental Health Care Needs among Asian Americans 10⁻11 Years After Exposure to the World Trade Center Attack",
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.",
keywords = "Asian Americans, disaster, health insurance, mental health conditions, mental health service use, social support, stressful life events, unmet mental health care needs, World Trade Center attack",
author = "Kung, {Winnie W.} and Xiaoran Wang and Xinhua Liu and Emily Goldmann and Debbie Huang",
year = "2019",
month = "4",
day = "11",
doi = "10.3390/ijerph16071302",
language = "English (US)",
volume = "16",
journal = "International Journal of Environmental Research and Public Health",
issn = "1661-7827",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
number = "7",

}

TY - JOUR

T1 - Unmet Mental Health Care Needs among Asian Americans 10⁻11 Years After Exposure to the World Trade Center Attack

AU - Kung, Winnie W.

AU - Wang, Xiaoran

AU - Liu, Xinhua

AU - Goldmann, Emily

AU - Huang, Debbie

PY - 2019/4/11

Y1 - 2019/4/11

N2 - 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.

AB - 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.

KW - Asian Americans

KW - disaster

KW - health insurance

KW - mental health conditions

KW - mental health service use

KW - social support

KW - stressful life events

KW - unmet mental health care needs

KW - World Trade Center attack

UR - http://www.scopus.com/inward/record.url?scp=85064818127&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064818127&partnerID=8YFLogxK

U2 - 10.3390/ijerph16071302

DO - 10.3390/ijerph16071302

M3 - Article

C2 - 30979006

AN - SCOPUS:85064818127

VL - 16

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

SN - 1661-7827

IS - 7

ER -