Examining Health Insurance and Non-Medical Challenges Among Vietnamese Americans in Texas During the COVID-19 Pandemic

Abstract

When COVID-19 data on Asian Americans are available, they are frequently aggregated, concealing community-specific concerns. Consequently, there is limited COVID-19 literature on Vietnamese Americans. In this study, we investigated the association between health insurance coverage and non-medical challenges during the COVID-19 pandemic, in Vietnamese Americans in Texas. The NIH Community Engagement Alliance (CEAL) Common Survey 2 was administered electronically in English and Vietnamese and contained 23 questions about non-medical drivers of health, COVID-19 vaccination, and research participation. Vietnamese American adults in Texas were recruited between September 2021 and March 2022 via partnerships with community organizations. Responses were compared and analyzed using logistic regression. Of 217 respondents, 23 (11%) were uninsured. Of the uninsured participants, 43% lost health insurance coverage during the COVID-19 pandemic. Uninsured individuals had significantly higher odds of experiencing non-medical challenges, including obtaining housing (OR = 6.10, p < 0.001), food (OR = 6.41, p < 0.001), and medications (OR = 3.45, p < 0.05) than insured individuals. Uninsured individuals had a significantly longer time-lapse since seeing a healthcare provider (ordinal OR = 0.20, p < 0.05) than insured individuals. Thus, lack of insurance is strongly associated with non-medical challenges during the COVID-19 pandemic among Vietnamese Americans in Texas. Disaggregating data can address non-medical drivers of health, advancing equity for marginalized communities.