Health Equity for Asian American, Native Hawaiian, and Pacific Islander Children and Youth: What's Racism Got to Do with It?

By Mayeno, Laurin; Kaholokula, Joseph Keawe'aimoku et al. | Poverty & Race, July/August 2011 | Go to article overview

Health Equity for Asian American, Native Hawaiian, and Pacific Islander Children and Youth: What's Racism Got to Do with It?


Mayeno, Laurin, Kaholokula, Joseph Keawe'aimoku, Liu, David M. K. I., Asato, Lloyd Y., Tseng, Winston, Poverty & Race


* Since entering high school, Kekoa, a 16-year-old obese Native Hawaiian male with type 2 diabetes, has become depressed and taken up cigarette smoking and drinking on a daily basis.

* In 2007, Seung-Hui Cho, a 23-year-old Korean American college student with mental illness, killed 32 people and wounded many more, before committing suicide.

These are two individual examples of health inequities that threaten the well-being of Asian American (AA) and Native Hawaiian and Pacific Islander (NHPI) children and youth. In this commentary, we highlight these health inequities and pose the question: "What's racism got to do with it?" We begin by presenting data on health inequities and briefly discuss existing investigation and theory. We then explore, through the stories of Kekoa and Seung-Hui, how the health of children and youth of AA and NHPI communities is shaped by pervasive racism in our society. While focusing on the fundamental problems that contribute to health inequities among AA and NHPI children and youth, we also discuss the supportive role that family, community and cultore can play in fostering their health and well-being.

Disaggregating AA and NHPI

NHPI and AA communities have distinct histories, cultures, experiences and health challenges. The arbitrary grouping together of NHPI and AA for data collection and funding purposes creates barriers to understanding and addressing their health issues. Within both the NHPI and AA categories, there are numerous communities whose acculturation experiences, socioeconomic status and health issues are very different. Therefore, when possible, we will make distinctions between different ethnic groups that fall under these broader classifications and respect each group's cultural and classification preferences.

Recognizing Health Inequities

Before we can address AA and NHPI health inequities, they must be acknowledged. Over the past few decades, AA and NHPI advocates and researchers have increased visibility for health inequities that impact their communities. NHPI communities have worked to have their health issues become visible and recognized as distinct from those impacting AAs. AA communities have worked to dispel the myth of the model minority and, with the use of disaggregated data, have demonstrated that not all AAs are healthy, particularly recent immigrant and low-income AAs. (Native Hawaiians and other Pacific Islanders are people whose origins are from three main groups of Islands in the Pacific: Polynesia, Micronesia and Melanesia. Native Hawaiians are the largest group of Pacific Islanders in the U.S. Other major Pacific Islander groups in the U.S. include Samoans, Guamanians (Chamorro) and other Micronesian Groups (Federated State of Micronesia, Republic of the Marshall Islands and Republic of Palau). Asian Americans are persons with ancestry from Asian countries and islands in the Pacific Rim who live in the United States. The largest Asian-American populations are Chinese, Filipino, Asian Indian, Vietnamese, Korean and Japanese, each of which number over 1 million. Cambodian, Laotian, Pakistani and Hmong number over 200,000 each.) Although much of the data is focused on adults, there is recently a growing body of evidence that health inequities do indeed exist for AA and NHPI children and youth. Here are some examples:

Native Hawaiian and Pacific Islander Children and Youth

* From 2003-2005, NHPI mothers in California and Hawaii had higher rates of low birth weight and preterm birth than Whites (4.1 % LBW and 7.5% pre-term birth), with rates for Marshallese mothers among the highest: low birth weight 8.4% and pre-term birth 18.8%.

* 54 % of Samoan children (5th graders) in California followed by "Other" Pacific Islander (42%), Guamanian (35%), Native Hawaiian (35 %) and Tahitian (34%) children are not within the Healthy Fitness Zone according to their body mass index, compared to the state average (32%) and Whites (23%). …

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