Approximately one million Southeast Asian refugees have resettled in the United States since 1975. Health policy and programs directed toward these refugees have evolved serendipitously; a response to crisis rather than to thoughtful planning. The purpose of this study was to apply the Andersen and Aday access to health care framework to guide the collection of information about how varied ethnic groups of Southeast Asian refugees (Cambodian, Vietnamese, Lao, and Hmong), living in a low-impact area, experience and interact with the health care system. The goal of this process was to suggest effective program strategies and health policies to better serve this population. Using a method of secondary analysis, a post hoc application of elected elements of the Andersen and Aday framework were studied in relation to data collected in a needs assessment study conducted in Western Massachusetts. In addition, patterns of health service utilization were analyzed using Refugee Medical Assistance/Medicaid expenditure data with comparison to findings from the present study and others reported in the literature. Major findings suggested the usefulness of the framework for planners and policy makers as they consider intervention strategies for culturally diverse populations like the varied Southeast Asian groups in this study. The model did point to the influence of predisposing variables as being of extreme importance in influencing care seeking and use suggesting a heavier weighting of this element in the equation. Perceived need, unmet needs, and identified problems, while identified and acknowledged by the refugee groups, did not increase use of health services and appeared to have less influence than one's health beliefs and attitudes as determined by ethnicity. Other findings suggest that access and utilization of health services by Southeast Asian refugees in a low-impact area such as Western Massachusetts is similar to patterns noted in high-density areas. However, the process of accessing a smaller array of services may be more complex. Recommendations for program planning, policy development and future research are offered.
| Identifer | oai:union.ndltd.org:UMASS/oai:scholarworks.umass.edu:dissertations-2628 |
| Date | 01 January 1990 |
| Creators | Muldoon, Jeannine Dumont |
| Publisher | ScholarWorks@UMass Amherst |
| Source Sets | University of Massachusetts, Amherst |
| Language | English |
| Detected Language | English |
| Type | text |
| Source | Doctoral Dissertations Available from Proquest |
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