Asian Americans are diverse ethnic groups originating from about 52 different countries ranging from the Far East, Southeast Asia and India. This means that though they share some common traits, there are many differences in language and culture. Unfortunately, many times when it comes to healthcare and treatment, this ethnic minority can be combined into one group. Dr. Sonal Patel, a double-board certified allergist and clinical immunologist, and second-generation Indian immigrant, shared her unique understanding of the problems facing Asian Americans with us.
One of the major problems that Asian Americans face are systematic biases in data collection and programs that group the various groups of Asian Americans together. “While Asian Americans are the fastest growing minority, they are still a smaller percentage of the population. So, when it comes to studies, things can be difficult. For example, if we look at rates of asthma, one study showed about 10% asthma rates for Korean Americans versus 23% asthma rates for Filipino Americans and 7% asthma rates for Indian Americans. These rates are even more diverse if you're recently immigrated or if you're a second generation Asian American,” Dr. Patel explained.
After initially training in pediatrics at a county hospital, Dr. Patel did extensive work with underprivileged communities in inner city settings. “During residency, we saw a lot of children with asthma, and it drew me in. Rates of asthma are higher in inner city children compared to non-inner-city populations,” she explained. “There are different reasons that are speculated for that: pollution that can be caused by being closer to freeways, and access to quality and specialized healthcare is extremely lacking.”
Unfortunately, many studies underestimated the diversity that exists among Asian Americans from the start because of something known as The Model Minority Myth. “Earlier studies were biased and recorded that many Asian Americans were well off and healthy. Though this was true for some, it was an inaccurate representation because they did not consider the large number of refugees and undocumented immigrants coming into the U.S. with a lower level of education,” said Dr. Patel.
In fact, low socioeconomic status is a major barrier that prevents many Asian Americans from receiving adequate health insurance. “Patients without healthcare, especially those who are undocumented, don’t even have access to government-funded insurance, like Medicare, so they don’t have access to preventative treatments. Also, they typically won’t seek treatment until later when the disease has progressed and it is much harder to treat.”
“Language barriers are also a big problem, particularly in Asian populations,” She continued. With more than 800 spoken languages and dialects among the Asian population, it is no wonder that it poses such a barrier for health care professionals. “There may not be a translator available and even when there is, the quality of translation can vary.”
Asian patients can also be unwilling to share information for several reasons, including mistrust, cultural belief differences or fears over trust or privacy. For example, many Asian Americans use alternative medicine. “Oftentimes western medicine has not looked highly upon alternative and complementary therapies until recently, so patients are hesitant to bring that up to a physician. But if you are not sharing that with your physician, they can't make an informed decision about treatment,” Dr. Patel said.
“In addition, in older Asian American patients there is a lot of stoicism, so they don't really say something is bothering them until it's really bad. Asian Americans may also be less likely to bring up problems with a treatment plan as well, for cultural reasons. They value politeness so they may feel uncomfortable contradicting a physician for instance.”
It is important that we bridge these gaps because currently Asian Americans are disproportionately affected by many health conditions. In lung health alone, smoking and tobacco use has ravaged some Asian American communities. Young Asian Americans have the highest increase in smoking rates of any other racial group. In addition, certain Asian American populations with lung cancer were 15% less likely to be diagnosed early and 10% more likely to not receive any treatment compared to white Americans. In fact, lung cancer is 18% higher among Southeast Asians than white Americans. Asian Americans also have the highest occurrence of tuberculosis (TB) than all other ethnic groups.
“I think as providers, we have to know all these cultural barriers so that we can better educate our patients. Education and open communication are key.”
Blog last updated: May 12, 2021