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Asian American and Pacific Islander Health Disparities

written by Jennifer Nelson Written by Jennifer Nelson
Jennifer Nelson

Jennifer Nelson

Jennifer is a contributing health writer who has been researching and writing health content with PlushCare for 3 years. She is passionate about bringing accessible healthcare and mental health services to people everywhere.

Read more posts by this author.
reviewed by Dr. Katalin Karolyi Reviewed by Dr. Katalin Karolyi
Dr. Katalin Karolyi

Dr. Katalin Karolyi

Katalin Karolyi, M.D. earned her medical degree at the University of Debrecen. After completing her residency program in pathology at the Kenezy Hospital, she obtained a postdoctoral position at Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida.

June 30, 2021 Read Time - 6 minutes

Health Disparities Among Asian Americans and Pacific Islanders

Did you know that Asian Americans and Pacific Islanders (AAPI) are the fastest-growing racial group in the United States? There are about 24 million AAPI Americans in the country, with AAPI communities consisting of approximately 50 ethnic groups speaking more than 100 languages.

With such a diverse and growing population, it shouldn’t come as a surprise that Asian American and Pacific Islander health disparities are a very real problem.

For example, when lumped into one population, Asian Americans and Pacific Islanders are about as likely to be uninsured as White people. However, Bangladeshis are about three times as likely to be uninsured as Japanese people and about twice as likely as Whites.

What are some of the risk factors contributing to AAPI health disparities? How can we, as a country, try to reduce those disparities? And how can you as an individual support AAPI communities? Let’s discuss.

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Risk Factors Contributing to AAPI Health Disparities

There are numerous reasons for AAPI health disparities. Here are some of the most significant issues.

Lack of Health Insurance

While about 7% of natural-born American citizens were uninsured as of 2016, 14% of Nepalese Americans, 12% of Micronesians, and 9% of Laotians were uninsured. Meanwhile, only 4% of Japanese Americans and 5% of Native Hawaiians, Filipinos, and Asian Indians lacked insurance.

Lack of health insurance limits access to care, contributing to poorer health outcomes for certain parts of the AAPI community.

Lower Quality of Care

Some AAPI communities get a lower quality of care than others. As an example, Native Hawaiians and other Pacific Islanders receive less prenatal care in the first trimester and have higher infant mortality than Whites.

Immigration-Based Barriers

Fear of jeopardizing their immigration status or citizenship application process may prevent some AAPIs from seeking health care, especially mental health care. Additionally, 35% of noncitizens are uninsured, further complicating the ability to receive health care. 

Language Barriers

Overall, nearly one in three (32.6%) AAPI Americans are not fluent in English, and 60% of AAPIs aged 65 and older have limited English proficiency. However, fluency rates vary by subgroup, with 44.8% of Chinese, 20.9 % of Filipinos, and 18.7% of Asian Indians not fluent in English, further contributing to health disparities within the AAPI population.

Cultural Barriers

Traditional and non-Western types of medicine are still the preferred choice for some within some AAPI communities. A few examples include:

  • Traditional Chinese medicine
  • Japanese herbal medicine
  • Ayurveda (the traditional medicine of India)
  • Tibetan medicine
  • Folk nutritional therapy
  • Acupuncture
  • Massage therapy
  • Guided meditation
  • Energy healing exercises (such as tai chi and qi gong)
  • Spiritual healing

Cultural barriers also tend to be a substantial factor in the low incidence of AAPIs seeking out mental health care.

Food and Housing Insecurity

While the Asian poverty rate is almost identical to the White poverty rate (9.7% and 9% respectively) as of 2019, that is still more than a million and a half AAPIs who may struggle with food and housing. 

Health not only tends to take a back seat when you are trying to figure out when and where to get your next meal, but it is also directly negatively impacted. One study showed that “Healthier foods cost nearly twice as much as unhealthier foods per serving on average.”


Related: Nutrition for Weight Management


Infrequent Doctor Visits

As a result of all the previously listed risk factors, AAPIs are less likely to have a personal doctor than Whites and are less likely to seek medical care (19.4% and 12.9% respectively).

Research Challenges

Asian American and Pacific Islanders are an incredibly diverse population. However, they tend to get grouped into a single category. In fact, the many groups within the AAPI category have different health challenges, but those are not being studied very much. More research into the disparities within the AAPI umbrella could help reduce those disparities.

AAPI Mental Health

Fewer than one in four (23.3%) AAPI adults with a mental illness receive treatment. That is compared to four in 10 (41%) people with mental illnesses in the United States. Some of the reasons for this include:

  • Shame and stigma
  • Language barriers
  • Lack of health insurance coverage
  • The “model minority” stereotype
  • Spirituality and faith
  • Immigration status
  • Preference for traditional/non-Western medicine

Read: Mental Health Counseling Online


How to Reduce Health Disparities for the AAPI Population

There is no single answer about how to reduce health disparities and improve AAPI access to health care, but some things that may help include:

  • Expanding health insurance coverage
  • Increasing awareness of racial and ethnic disparities in care
  • Improving access to language-access services and interpreters
  • Increasing the knowledge base on causes and interventions
  • Improving the number and capacity of providers in underserved communities

Healthcare Online 

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Click here to schedule a virtual therapy appointment with an online therapist.

  • Browse our network of top therapist to find one that matches your needs.

  • Get private and secure emotional support weekly from your dedicated therapist.

  • Experience comprehensive care with unlimited access to your care team and primary care physician.

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How to Support Asian American and Pacific Islander Communities

If you would like to help support AAPI communities, here are some organizations you could consider contributing to:


Read More About Asian American and Pacific Islander Health Disparities


Sources:

PlushCare is dedicated to providing you with accurate and trustworthy health information.

Get Healthy Stay Healthy. Health Disparities Among Asian Americans and Pacific Islanders. Accessed on May 13, 2021 at https://www.gethealthystayhealthy.com/articles/health-disparities-among-asian-americans-and-pacific-islanders-1

Asian & Pacific Islander American Health Forum. Health Care Access. Accessed on May 13, 2021 at https://www.apiahf.org/focus/health-care-access/

Centers for Disease Control and Prevention. Asian American & Pacific Islander Heritage. Accessed on May 13, 2021 at https://www.cdc.gov/healthequity/features/asian-pacific/index.html

National Alliance on Mental Illness. Asian American and Pacific Islander. Accessed on May 13, 2021 at https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Asian-American-and-Pacific-Islander

Kaiser Family Foundation.  Eliminating Racial/Ethnic Disparities in Health Care: What are the Options? Accessed on May 13, 2021 at https://www.kff.org/racial-equity-and-health-policy/issue-brief/eliminating-racialethnic-disparities-in-health-care-what/

Assistant Secretary for Planning and Evaluation. Health Insurance Coverage Changes Since Implementation of the Affordable Care Act: Asian Americans and Pacific Islanders. Accessed on May 26, 2021 at https://aspe.hhs.gov/system/files/pdf/265581/aspe-uninsured-trends-aapi-ib.pdf

Kaiser Family Foundation. Poverty Rate by Race/Ethnicity. Accessed on May 27, 2021 at https://www.kff.org/other/state-indicator/poverty-rate-by-raceethnicity/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

International Journal of Environmental Research and Public Health. Neighborhood Prices of Healthier and Unhealthier Foods and Associations with Diet Quality: Evidence from the Multi-Ethnic Study of Atherosclerosis. Accessed on May 27, 2021 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708033/

Mental Health First Aid. 5 Surprising Mental Health Statistics. Accessed on May 27, 2021 at https://www.mentalhealthfirstaid.org/2019/02/5-surprising-mental-health-statistics/

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog. The PlushCare blog, or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. For more information click here.

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