Exploring chronic disease disparities in Korean Americans and interventions to reduce disparities

D.P.H. University of Hawaii at Manoa 2014.Includes bibliographical references.Korean Americans (KAs) are less likely to seek timely and adequate health care than their counterparts in South Korea and the general US population. Investigating multilevel factors to prevent and control chronic disease in KAs is essential. The purpose of this three-paper dissertation is to explore disparities in health care and effective interventions to reduce health disparities in KAs. Chapter one provides an overview of health risk factors and chronic disease among KAs, and socio-demographic and health characteristics of KAs in Hawaii. Chapter two presents the findings from the first of three studies, which investigated Hawaii inpatient discharge database. Findings suggest that KAs are at higher risk of being hospitalized for preventable chronic conditions in general and for congestive heart failure specifically relative to Whites in Hawaii. Chapter three includes findings from the second study, which systematically reviewed the literature on interventions to prevent or control chronic disease in KAs. Findings suggest that provision of culturally appropriate and committed social support is a critical way of improving health among KAs. Chapter four reveals findings from the third study, which interviewed faith-based organization leaders in Hawaii. Results suggest that faith leaders are willing to collaborate with outside public health researchers, professionals, and providers if the program reflects congregants' needs and faith leaders' decisions. Chapter five presents conclusions of this three-study investigation of chronic disease disparities among KAs and how to reduce them. Three important conclusions emerged: (1) KAs in Hawaii experience poorer access to and utilization of outpatient primary and/or preventive care services relative to Whites in Hawaii; (2) coupling social support by lay health workers, nurses, and family members with health information is an effective way to help prevent and control chronic disease among KAs; and (3) leaders of faith-based organizations serving Hawaii's KA population are receptive to working with public health practitioners and researchers to reduce barriers to health care, channel health information, and increase engagement in health programs for their congregants