Differential COVID-19 preventive behaviors among Asian subgroups in the United States.

BACKGROUND: Given the observed within-Asian disparity in COVID-19 incidence, we aimed to explore the differential preventive behaviors among Asian subgroups in the United States. METHODS: Based on data from the Asian subsample (N = 982) of the 2020 Health, Ethnicity, and Pandemic survey, we estimated the weighted proportion of noncompliance with Centers for Disease Control and Prevention (CDC) guidelines on preventive behaviors and COVID-19 testing by Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, Other Asian). We examined these subgroup differences after adjusting for demographic factors and state-level clustering. RESULTS: Filipinos demonstrated the lowest rate of noncompliance for mask-wearing, social distancing, and handwashing. As compared with the Filipinos, our logistic models showed that the Chinese and the 'other Asians' subgroup had significantly higher risk of noncompliance with mask-wearing, while the Japanese, the Vietnamese, and other Asians were significantly more likely to report noncompliance with social distancing. CONCLUSIONS: The significant variation of preventive behavior across Asian subgroups signals the necessity of data disaggregation when it comes to understanding the health behavior of Asian Americans, which is critical for future pandemic preparedness. The excess behavioral risk among certain Asian subgroups (especially those 'other Asians') warrants further investigation and interventions about the driving forces behind these disparities.

California's Comprehensive Perinatal Services Program and birth outcomes.

Introduction: California's Medicaid (Medi-Cal) sponsors Comprehensive Perinatal Services Program (CPSP), a program with enhanced perinatal care for women (more education, nutritional supplements, and psychosocial counseling/support). Past evaluations of CPSP's effectiveness in birth outcomes were limited to pilot programs and yielded mixed results. Methods: We used 2012-2016 California's statewide data about singleton live births with any receipt of prenatal care (N = 2,385,811) to examine whether Medi-Cal with CPSP enrollment was associated with lower odds of preterm birth (PTB), spontaneous PTB, and low birthweight (LBW) than non-CPSP births. With three binary variables of PTB, spontaneous PTB, and LBW as the response variables, three multilevel logistic models were used to compare the outcomes of participants enrolled in Medi-Cal with CPSP against those with private insurance, adjusting for maternal factors and county-level covariates. Results: Logistic models showed that participants enrolled to Medi-Cal with CPSP [n (%) = 89,009 (3.7)] had lower odds of PTB, spontaneous PTB and LBW, respectively, as compared with those with private insurance [n (%) = 1,133,140 (47.2)]. Within the Medi-Cal sub-population, the CPSP enrollment was associated with lower odds of PTB, SPTB and LBW than Medicaid beneficiaries without CPSP [n (%) = 967,094 (40.3)]. Discussion: With statewide data, these findings revealed a robust link between CPSP enrollment and better birth outcomes. Expanding access to comprehensive prenatal services could be an important strategy to improve birth outcomes.