Asian Americans are the fastest growing ethnic group in the United States, with a population of more than 20 million as of 2020, and a projected growth to about 46 million by 2060. But because this group is so diverse, they are at a great disadvantage when it comes to healthcare. In fact, according to the Census Bureau, people considered under the Asian umbrella identified with more than 20 different countries, all of which have their own languages and histories. It is therefore improbable to think that data collected for the group as a whole would accurately portray each subgroup.
The six largest Asian American subpopulations include Chinese, Asian Indian, Filipino, Vietnamese, Korean and Japanese. Those subgroups represent approximately 97% of the total Asian American population, which means that when surveyed, some of the population is not considered at all. In addition, these six larger subgroups each have unique needs that are not expressed when they aren’t sampled individually. Data disaggregation is key to ensuring that the issues facing these communities are addressed.
“Data drives resources, funding and policy. If you don’t have the granular data to really look at how distinct groups are facing challenges in healthcare, you are not only going to be doing a disservice to those communities but by ignoring them you’re never going to be achieve equity.” Rod Lew, MPH, of APPEAL told the American Lung Association. “It perpetuates what we call the Model Minority Myth which says that not only are all Asian Americans the same, but they are prosperous, they are healthy and there are no needs for them.”
The term “Asian American” was developed in 1968 by Yuji Ichioka and Emma Gee during the founding of the Asian American Political Alliance, as a way of bringing together diverse Asian American groups in solidarity. This definition was expanded in the 1980s when the U.S. Census added Pacific Islanders to the group.
Health Care Obstacles
According to the U.S. Department of Health and Human Services Office of Minority Health report, Asian Americans have a high prevalence of COPD, hepatitis B, HIV/AIDS, smoking, tuberculosis and liver disease. In fact, Asian Americans are 33 times more likely to contract tuberculosis than white Americans. The report also found that, though Asian Americans generally have lower cancer rates, they are twice as likely to die from cancer compared to their white counterparts. Many of these disparities are attributed to a few factors; infrequent medical visits, language and cultural barriers, and lack of health insurance.
Trying to Communicate
Even though 73% or people who identified as Asian alone are U.S. citizens, many Asian Americans value tradition and history, so around 73% also reported speaking their language of choice, not English, at home. For this reason, Asian Americans 5 years of age and older who are not proficient English speakers varies: 48% of Vietnamese, 42% of Chinese, 19.8% of Filipinos and 17.7% of Asian Indians. This is a major barrier as having a common language with your healthcare provider is essential to arrange a doctor’s appointment, explain symptoms, and understanding diagnosis and treatments. With more than 800 spoken languages and dialects among the Asian population, “There may not be a translator available and even when there is, the quality of translation can vary” said Dr. Sonal Patel, a double-board certified allergist and clinical immunologist, and second-generation Indian immigrant.
According to the national data we do have, Asian Americans are 5% more likely to be uninsured than white Americans, but these gaps widen among subgroups. For instance, for instance, 31% of Korean Americans, 21% of Vietnamese Americans, 20% of other South Asian Americans, 16% of Chinese Americans and 14% of Filipino Americans are uninsured. This is a huge problem as those without insurance are more likely to skip regular doctor visits and even 40% put off visits to the physician when they are ill.
Since its inception in 2012, the Affordable Care Act (ACA) has led to significant improvements in Asian American access to health care. However, even when they have insurance, expensive out-of-pocket cost can prevent many Asian Americans from seeking care. More specifically, people of Cambodian and Vietnamese descent are three times more likely to skip doctor visits due to cost compared to all other U.S. residents. In this case, many Asian Americans reported using complementary and alternative medicine (CAM) instead of relying on Western practices.
Making a Change
Data on Asian American health, particularly for the Asian subgroups, is scarce, and many health disparities for this population remain unknown. That is why it is so important that researchers begin to collect and report data on each individual subgroup. In May 2021, the Biden Administration took an important step by signing an executive order that established and reinvigorate the White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders, but there is still more to do.
Blog last updated: August 23, 2023