Latin American immigrants have limited access to health insurance in Japan: a cross sectional study

BMC Public Health

Masahiro Kihara²  Mitchell D Feldman¹  Masako Ono-Kihara²  S Pilar Suguimoto² 

[1] Department of Medicine, University of California San Francisco, 1545 Divisadero, Suite 315, San Francisco, CA 94143-0320, USA;Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan

关键词: Latin America;    Japan;    Foreign workers;    Immigrants;    Health insurance;   

Others  :  1163737
DOI  :  10.1186/1471-2458-12-238

 received in 2011-11-25, accepted in 2012-03-25,  发布年份 2012

【 摘 要 】

Background

Japan provides universal health insurance to all legal residents. Prior research has suggested that immigrants to Japan disproportionately lack health insurance coverage, but no prior study has used rigorous methodology to examine this issue among Latin American immigrants in Japan. The aim of our study, therefore, was to assess the pattern of health insurance coverage and predictors of uninsurance among documented Latin American immigrants in Japan.

Methods

We used a cross sectional, mixed method approach using a probability proportional to estimated size sampling procedure. Of 1052 eligible Latin American residents mapped through extensive fieldwork in selected clusters, 400 immigrant residents living in Nagahama City, Japan were randomly selected for our study. Data were collected through face-to-face interviews using a structured questionnaire developed from qualitative interviews.

Results

Our response rate was 70.5% (n = 282). Respondents were mainly from Brazil (69.9%), under 40 years of age (64.5%) and had lived in Japan for 9.45 years (SE 0.44; median, 8.00). We found a high prevalence of uninsurance (19.8%) among our sample compared with the estimated national average of 1.3% in the general population. Among the insured full time workers (n = 209), 55.5% were not covered by the Employee's Health Insurance. Many immigrants cited financial trade-offs as the main reasons for uninsurance. Lacking of knowledge that health insurance is mandatory in Japan, not having a chronic disease, and having one or no children were strong predictors of uninsurance.

Conclusions

Lack of health insurance for immigrants in Japan is a serious concern for this population as well as for the Japanese health care system. Appropriate measures should be taken to facilitate access to health insurance for this vulnerable population.

【 授权许可】

   
2012 Suguimoto et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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