Not the Model Minority: How to Address Disparities in Asian American Health Care

By Jang, Deeanna; Surapruik, Ann | Asian American Policy Review, Annual 2009 | Go to article overview

Not the Model Minority: How to Address Disparities in Asian American Health Care


Jang, Deeanna, Surapruik, Ann, Asian American Policy Review


Introduction

In 1985, the Secretary of the U.S. Department of Health and Human Services (HHS) published a report on Black and minority health that for the first time documented the extent of excess deaths experienced by Blacks and other minorities. Although the report assessed the extent of health disparities among Asian Americans, African Americans, Hispanics, and Native Americans, it used limited and inaccurate data on Asian American, Native Hawaiian, and Pacific Islander1 health, which led to the finding that Asian Americans as a group are healthier than other racial groups in the United States. By presenting Asian American and Native Hawaiian and Pacific Islander (NHPI) data as an aggregate, with methodological challenges such as small sample sizes and surveys conducted only in English, the report failed to give a true picture of the heath needs of Asian American and NHPI communities. Concerned that the report would reinforce the "model minority" myth and that health issues impacting Asian Americans and NHPIs would continue to be neglected by the federal government, Asian American and NHPI health professionals and advocates began to push at the national level for better data, policies, and programs that would improve the health and well-being of Asian Americans, Native Hawaiians, and Pacific Islanders. One result of these efforts was the formation of national Asian American health organizations including the Asian American Health Forum, now the Asian & Pacific Islander American Health Forum, and the Association of Asian Pacific Community Health Organizations.

A major focus of Asian American and NHPI health advocacy has been and continues to be the improvement of data collection and research on Asian American, Native Hawaiian, and Pacific Islander health. Asian American and NHPI advocates have also worked in coalition with other racial and ethnic minority health advocates to highlight racial and ethnic disparities in health status and health care access. This article provides an overview of disparities in health care and health status experienced by Asian Americans, Native Hawaiians, and Pacific Islanders and highlights policies at the federal level that would help address these disparities and promote health equity.

Disparities in Health Coverage

As a group, Asian Americans, Native Hawaiians, and Pacific Islanders are more likely to be uninsured than non-Hispanic Whites. Specific Asian American and Native Hawaiian and Pacific Islander groups face extremely high uninsured rates; from 2004-2006, 24 percent of NHPIs and 31 percent of Korean Americans were uninsured (Kaiser and APIAHF 2008).

The high rate of uninsured in several Asian American communities is related to their employment in small businesses that do not offer health insurance benefits. For example, more than half of Korean Americans work in businesses with less than twenty-five employees. Yet, only half of employees in such firms are provided coverage through their employer. As a result, Korean Americans have one of the lowest rates of employer-sponsored health coverage among Asian Americans and NHPIs (49 percent) and the highest rate of uninsured (31 percent) (Kaiser and APIAHF 2008).

Improving coverage among Asian Americans and Native Hawaiian and Pacific Islanders will require strategies that reach those who fall through the gaps of our current health insurance system. Low-income and immigrant Asian Americans and Pacific Islanders are significantly more likely to be uninsured and less likely to receive coverage through their job. For example, immigrant Asian Americans and Pacific Islanders are three times more likely than Asian Americans and Pacific Islanders who are citizens to lack health insurance. Nearly a quarter of Southeast Asians, Native Hawaiians, and Pacific Islanders are poor, and only 15 percent of poor Asian Americans and NHPIs have employer-based coverage, according to unpublished data from the Kaiser Family Foundation and the Asian & Pacific Islander American Health Forum. …

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