Running head: ASIAN AMERICAN IMMIGRANTS HEALTH CARE VULNERABILIT

Asian American Immigrants Health Care Vulnerability

Nga Le
Ferris State University

Asian American Immigrants Health Care Vulnerability

Immigrants have been identified as a vulnerable population, where according to Derose,
Escarce, and Lurie (2007), immigrants use less health care, have lower rates of health insurance,
and receive lower quality of care. In narrowing down the broad subject of immigrants; Asian
American immigrants are of focus. According to the Office of Management and Budget (2014),
Asians are defined as people who have origins in any of the original peoples in the Far East,
Southeast Asia, or the Indian subcontinent, such as Cambodia, China, India, Korea, Japan,
Malaysia, Pakistan, Thailand, the Philippine Islands, and Vietnam (Centers for Disease Control
and Prevention [CDC]). The factors that affect Asian immigrants vulnerability includes Asian

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stereotyping, their socioeconomic background, immigration status, limited English proficiency,
and federal, state, and local policies on access to publicly funded health care relating to
marginalization and stigma. The Asian population has grown since May 7, 1843, when the
Japanese immigrants first set foot on American soil (CDC, 2014). In 2011, the United States
(U.S.) Asian population was estimated at 18.2 million in the U.S. population, and furthermore,
the Census Bureau projects that by 2050, it is estimated that there will be more than 40.6 million
Asian Americans living in the U. S., comprising 9.2 percent of the entire U.S. population (CDC,
2014). This makes Asian Americans one of the fastest growing racial/ethnic groups. Therefore,
it is important for nurses to learn and employ cultural sensitive approaches while providing
assistance with access to healthcare, along with greater understanding of the Asian cultures and
beliefs about mental health with the emphasis on the connection between the mind and body.
From my personal experience, prior to my research, as an Asian American I have to admit
that I do feel the pressure to be a doctor, lawyer or an engineer, as it is assumed I am supposed to
be naturally good at math, science, technology, and concocting herbal remedies. I also feel like I
am labeled as a bad driver, especially because I am an Asian female, along with the pressure to
be petite, hard-working, dependent, obedient and submissive. Furthermore, Asian Americans are
depicted to speak bad English, have poor fashion sense, and that we all look conservative and
identical with our straight black hair. In reflection, I do have most of these characteristics that
Asian Americans are perceived to have, but not all of them. There are some truths to these
stereotypes, but it is just the general exaggerated images and beliefs of Asian Americans and
their cultural practices that are derived.
In reviewing the literature, I realized there was so much more involved with the Asian
Americans then I had imagined. Although the perception that education is highly valued in many

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traditional Asian cultures, we do not all achieve high academic success. The academic

achievement among various Asian groups is large, it tends to vary by generational status,
ethnicity, gender and socioeconomic status (Iwamasa, 2014). Nevertheless, Asian Americans
have done well in accomplishing the American dream of attaining a good education and
working and earning a good living. Many other ethnic and cultural groups formed a troublesome
myth entitling us as the model minority where other minority groups should follow; thereby,
enhancing the lack of attention to Asian Americans psychological and medical healthcare needs
(Iwamasa, 2014).
Regarding the Asian American socioeconomic status, where some Asian Americans may
be financially better off than other minority groups, they still are 1-1/2 times more likely to live
in poverty than White Americans (Iwamasa, 2014). Furthermore, in many Asian American
households, all those who are of the working age work one or more jobs outside the home,
resulting in a higher household income that further support the Asians are wealthy myth. For a
majority of Asian Americans, the biggest vulnerable barrier factor is the concern of their
immigration legal status (naturalized citizens, legal permanent residents, and undocumented
immigrants), where it takes the chief role of determining if they have access to social services
such as healthcare and jobs with benefits, or limit them from all access and rights (Derose,
Escarce, & Lurie, 2007).
Another factor is limited English proficiency, especially in America where English
predominates. It was found that Asian American adults and their children with limited English
proficiency are much less likely to have health insurance or source of care, and receive fewer
preventive care and doctors visits than those who speak English (Derose et al., 2007). Those
who were able to seek healthcare often times didnt understand their medical situation, and if an

ASIAN AMERICAN IMMIGRANTS HEALTH CARE VULNERABILIT

interpreter was provided, often times, the interpreter spoke English just well enough to

communicate with the provider but did not have the full grasp of the language. A quality
interpreter can be a rarity. This miscommunication brings up the issue of safety resulting from
an inability to understand care treatments and medication instructions, and can potentially lead to
harmful problems such as underdiagnoses or misdiagnoses.
Due to language barriers and cultural insensitivity, Asian American often times are
reluctant to seek care for fear of poor treatment or that it may jeopardize their immigration
application status for naturalization. Asian Americans can also be vulnerable by their appearance
(for example, wearing traditional dress), cultural and religious practices, or speaking with an
accent, which is a factor that can further influence their marginalization and stigmatism. These
are just a few more factors that render Asian American immigrants vulnerable. They are
vulnerable to deteriorating health as more and more come to the U.S. and adopt unhealthy habits
(consuming diet high in fat and calories, decrease physical activity), living in unhealthy
environments, and not having access to healthcare services. It is also noted that 10% of Asian
Americans, despite being petite and having lower body weight, are rapidly developing type 2
diabetes, which confirmed that obesity is not an important basis for diabetes in persons of Asian
descent (Joslin Diabetes Center, 2010). Another interesting fact is that most domestically born
Asian Americans who experienced violence, war, or economic oppression prior to their arrival in
the United States tend to experience psychological distress, but are too ashamed and embarrassed
to seek professional psychological care for fear they will shame their family (Iwamasa, 2014).
As the population becomes progressively diverse, it is increasingly imperative to address
health and healthcare disparities. Disparities in health and healthcare stagnantly affect the
overall health of the U.S., resulting in needless cost. Addressing these disparities will inevitably

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improve the Asian American peoples health by achieving improvements in overall health of the
population. A recent analysis estimates that overall, the U.S. economy loses $309 billion per
year due to health and healthcare disparities (The Henry J. Kaiser and Family Foundation, 2012).
From the healthcare perspective, Asian American immigrants have serious health implications
that can ultimately affect the health of our nation. Therefore, it is important for nurses to
implement focused interventions in reducing cultural insensitive disparities of the Asian cultures
via cultural competency training. Through these trainings, the nurses are able to effectively
provide assistance regarding access to healthcare, while remaining sensitive to language barriers
and awareness of the Asian cultures emphasis on cultural values such as interpersonal harmony,
loss of face, and the connection between the mind and body. By doing so, hopefully in the near
future we are able to effectively serve the vulnerable population of the Asian American
immigrants and take part in decreasing the preventable cost of disparities and one-by-one save
the lives of the vulnerable individuals, their families, and the nation as a whole.

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References

Centers for Disease Control and Prevention. (2014). Asian American Populations. Retrieved
from http://www.cdc.gov/minorityhealth/populations/REMP/asian.html
Derose, K. P., Escarce, J. J., & Lurie, N. (2007, September/October). Immigrants And Health
Care: Sources Of Vulnerability. HealthAffairs, 26(5), 1258-1268.
http://dx.doi.org/10.1377/hlthaff.26.5.1258
Iwamasa, G. Y. (2014). Recommendations for the Treatment of Asian-American/Pacific Islander
Populations. Retrieved from http://www.apa.org/pi/oema/resources/ethnicityhealth/asian-american/psychological-treatment.aspx
Joslin Diabetes Center (2010). Why Do People of Asian Descent Get Diabetes? Retrieved from
http://aadi.joslin.org/content/asian/why-are-asians-higher-risk-diabetes
The Henry J. Kaiser and Family Foundation (2012, December). FOCUS ON HEALTH CARE
DISPARITIES: KEY FACTS []. The Henry J. Kaiser Family Foundation, 1-9. Retrieved
from http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8396.pdf