Understanding the Asian American Disparities During COVID 19

Coronavirus disease in the United States has shown great disparities in morbidity along

racial lines, and we can observe from studies that Asian Americans have taken a great hit. In

aggregate, Asian American deaths makeup 4.4% of the population in the United States, but they represent 5.7% of the total pathogenic population. Disaggregated data show more complexity. In New York City, for example, the Asian American population is 13.9%, but they compose 7.9% of the city’s COVID deaths. The answer as to why Asian Americans are having such a difficult time during this pandemic is complicated. Some reasons are that they make up a disproportionate proportion of essential workers on the frontlines, as well as social factors such as intergenerational residency, poverty, and lack of health insurance. Xenophobia and racism due to COVID also serve as barriers keeping Asian Americans from proper healthcare. This blog is going to explore these aforementioned factors, as well as suggest some policy implications that could help mitigate such troubling statistics.

According to the Asian Pacific American Labor Alliance, over two million Asian Americans work in transportation, healthcare, and service industries. (Filipinos, in fact, make up 20% of registered nurses in New York City.) They, therefore, are introduced to the virus strain at a rate higher than the general population. When they get home, many are not able to practice social distance because they live in homes with high densities, as younger and older generations of Asian Americans live under the same roof. This is especially true for those who live in housing projects in New York City, where it is overcrowded all-around. Indeed, Chinese Americans, Japanese Americans, and Filipino Americans are more likely to live in three-generational households than their white counterparts. The reasons for such intergenerational living include filial piety and financial resources. Regardless of the reasons, such high rates of co-dependent living indicate an important risk that must be considered in a culturally competent healthcare system.

Next, poverty rates among Asian Americans are keeping them out of the mainstream healthcare system. Asian Americans make up a unique demographic in that some ethnic subgroups are more likely to be living under the federally-defined poverty level than others. For instance, more Hmong, Khmer, Laotian, and Vietnamese live in poverty than their Chinese, Korean, and Japanese counterparts. 93.7% of Hmongs and 57.1% of Vietnamese live in poverty nationally. For any racial group regardless of whether it is during or before the COVID pandemic, poverty is a leading indicator of lack of healthcare resources and thus morbidity levels. Asian Americans as a whole are also less likely to have health insurance than their white counterparts, and of those who do use their health insurance, few were satisfied with the healthcare they receive. Another issue interrelated with poverty is the language barrier may Asians face. Only 1 in 3 Asian Americans have limited English proficiency, but lack of English proficiency affects employment, exacerbates health care problems related to racial discrimination, and restricts access to services.

Another troubling issue that is not novel to the COVID pandemic is the high level of xenophobia and scapegoating Asian Americans are facing. Asian Americans have faced a long history of racism in light of public health crises, whether that be during the 1900 San Francisco quarantine due to fear of the bubonic plague or the more recent 2003 severe acute respiratory syndrome (SARS) pandemic. During this current pandemic, Asian Americans are once again reminded that they are seen as “forever foreigners.” The xenophobia Asian Americans have faced has even been blatantly incorporated into the federal government, as seen when the Trump administration called the coronavirus disease the “China virus.” Across the United States, Asian Americans have faced a slew of hate crimes. An example of this is the brutal stabbing in New York several months ago. Xenophobia and racism during the pandemic only serve to exclude Asians from healthcare for fear of retaliation.

There are three possible solutions to address the death disparity. For one, the federal and

state governments must release complete and accurate racial/ethnic demographic data on COVID infection and mortality rates. Ideally, they should stratify such data by socioeconomic status and primary languages. Only after we identify this vulnerable population and gain a more thorough understanding can we begin to formulate necessary measures to combat disparities. The government should also funnel more resources into community-based care, encouraging community leaders to establish self-determination and hence long-term health equity. Public service announcements should be announced in different languages so that no racial group is neglected in getting information that would help with their health. If we neglect more vulnerable subgroups of the Asian American communities, then we would just be contributing to the model minority myth and only those with high income and education levels receive proper care. The statistics raised in the blog are certainly troubling, but there is hope as we take action to remedy this social problem.

Works Cited:

https://www.sgo.org/clinical-practice/management/covid-19-resources-for-health-care-pract

itioners/promoting-health-equity-in-the-covid-19-era

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7531609/

https://www.apmresearchlab.org/covid/deaths-by-race#other