Health Maintenance and Access to Care Among Japanese Living in the U.S. (Pittsburgh, Pennsylvania) / General Medicine

<b>Introduction:</b> Minority ethnic populations have experienced poor health and barriers to accessing care, including Asian American and Pacific Islanders (AAPIs) in the US. Despite some evidence, there is inadequate understanding of the shortcomings of access to care for AAPIs due to substantial variations in health status among AAPI sub-ethnicities. In order to illuminate the access to care issue, we aimed to determine the prevalence of health insurance coverage and health maintenance visits to primary care among one of the major AAPI ethnicities, Japanese in the US city of Pittsburgh, Pennsylvania.<br><b>Methods:</b> Japanese in Pittsburgh registered at an urban primary care clinic where bilingual providers are available were surveyed in terms of health insurance and health maintenance exam. The key results were compared to age- and gender-matched Japanese averages from Japan's national data (Japanese National Health and Nutrition Survey, J-NHANS).<br><b>Results:</b> Of 97 identified for inclusion, all responded (Response rate, 100.0%). The majority of respondents (87.5%) had US-based health insurance. Only 38.5% of men and 17.5% of women visited their primary care physicians for annual health maintenance visits within a year (P < .001 compared to J-NHANS). Only 38.6% of the Japanese women in Pittsburgh who had primary care physicians had annual gynecological exams within a year. The prevalence of annual dental exams within a year was 55.0% and 68.4% in men and women, respectively.<br><b>Conclusions:</b> Despite the high rate of health insurance coverage, Japanese in Pittsburgh had far less health maintenance visits than expected. Improving access to preventive care may help to reduce unnecessary disease.

Community-Oriented Primary Care (COPC) for Japanese in Pittsburgh, U. S. A / 日本プライマリ・ケア連合学会誌

 Living overseas affects heath significantly. This needs to be addressed adequately for Japanese who live in the U. S. based on the existing evidence of negative impacts on health such as increased coronary heart disease mortality and stress. In addition to care at individual level as primary care providers, community-oriented primary care (COPC) provides primary care physicians with great potential to use as a tool of community medicine to improve their health at the community level. In this article, we report our case of COPC activity ; defining the community, choosing the health issue, implementing an intervention and its initial evaluation as well as the process of involving the community targeting Japanese in Pittsburgh, USA. The present article also includes a hypothesis-driven research question, measurement, analysis and the results followed by discussion with the lessons learned through our COPC activities. This article will not only inform readers of the COPC case but also provide practical and applicable insight to community medicine in readers' settings.