Improving Health Among the AAPI Population

Asian Americans and Pacific Islanders (AAPIs) are the fastest growing group among all racial and ethnic groups across the country, growing by 35.2% since 2010.¹ According to the 2020 U.S. Census, there are 20.7 million AAPIs in the U.S., which makes up 6.2% of its total population. AAPIs are a diverse group that generally includes people from East Asia, Southeast Asia, South Asia, Hawaii, and other Pacific Islands.² 
 

Understanding health disparities  

Health disparities, as defined by the Centers for Disease Control and Prevention (CDC), are differences in the incidence, prevalence, and mortality of a disease and the related adverse health conditions that exist among specific population groups.³ 
 

Health disparities impact AAPI populations in numerous ways. Some reasons of how and why include:
 

• Language barrier – More than 70% of Asian Americans are foreign-born and may have limited English proficiency.⁴ This results in a lack of understanding of instructions from doctors’ offices. 
 

• Cultural beliefs – Many elderly AAPIs may prefer traditional medicine over western medicine. There is also a lack of understanding of the western healthcare system. 
 

• Low screening rates – Asian Americans have the lowest cancer screening rates and are often diagnosed late-stage5. AAPIs are also less likely to have blood pressure monitoring and pap smears.⁴ 
 

• Lack of data – There is an overall lack of data in studies specific to AAPIs. When data is available, AAPIs are often lumped into one group, making it hard to provide accurate interventions.^4,5 
 

• Lack of insurance – Pacific Islanders are less likely to have health insurance and more likely to be on Medicaid.⁶ There are also higher uninsured rates among AAPIs who are not U.S. citizens. 
 

Prevalent Diseases Among AAPIs 

According to the CDC, chronic diseases such as heart disease, cancer and diabetes are the leading causes of death and disability in the U.S. While this holds true among the AAPI community, hepatitis B, mental health issues, and tuberculosis are also prevalent.  
 

• Cancer – Cancer is the leading cause of death among Asian Americans.⁷ AAPIs have especially high prevalence of liver cancer and stomach cancer, being twice as likely to die from these compared with non-Hispanic whites.⁴  
 

• Cardiovascular disease – Heart disease is the second leading cause of death among Asian Americans.⁴ Filipinos have a higher prevalence of obesity and high blood pressure compared with other AAPI groups and non-Hispanic whites.⁴ 
 

• Diabetes – 20% of Asian Americans are affected by diabetes and an additional 32% have pre-diabetes.7 Diabetes is the fifth leading cause of death for AAPIs. 
 

• Hepatitis B – Asian Americans account for half of chronic hepatitis B cases in the U.S. An estimated one in 12 Asian Americans live with hepatitis B virus (HBV) infections. HBV is a known risk factor for liver and stomach cancer.⁵ 
 

• Mental health – Asian Americans are the only racial group where suicide is the leading cause of death among young adults aged 15-24.⁸ 
 

• Tuberculosis (TB) – Asians accounted for 35% of all TB cases in the U.S. in 2018. The rate of TB in Asians was 31 times higher and 40 times higher in Pacific Islanders than in non-Hispanic whites.^3,9 
 

Ways We Can Improve the Health Of AAPI Population 
 

• Improve Education in the AAPI Community – Educating AAPIs about the importance of regularly seeing a doctor, being screened, and understanding instructions is vital to help eliminate health disparities. With limited English proficiency in the elderly population, providing education and resources in their native language or by someone from the same culture is beneficial. 
 

• Support AAPIs & Fight Racism – AAPI mental health has worsened during the pandemic as hate crimes against Asians have skyrocketed.¹⁰ Helping support AAPIs by standing up against racism and showing solidarity helps prevent that. A strong sense of ethnic and communal identity is shown to have lower suicidal risks and higher resilience when faced with racial discrimination.¹¹ President Biden has acknowledged the issue by signing an Executive Order establishing an initiative to remove systemic barriers to promote equity, justice, and opportunity for the AAPI community.¹²
 

• More AAPI-specific Research – More data is needed in clinical trials specific for the AAPI community. The AAPI community is very diverse and providing data on individual AAPI subgroups will improve interventions and prevention for underrepresented individual subgroups instead of being lumped together.  
 

• Normalize Mental Health – In AAPI communities, there is a stigma around mental health. Only 20.8% of Asian adults with mental health illness received treatment in 202011. AAPIs are also more likely to report not receiving mental health treatment due to not wanting others to find out and fearing others’ negative opinions. While these issues may stem from long-lasting cultural norms, more discussions and resources about mental health will help normalize and allow AAPIs to openly accept mental health treatment. 

Sources
 1 Jones et al (2021, August 12). 2020 Census Illuminates Racial and Ethnic Composition of the Country. United States Census Bureau. https://rb.gy/ttdd6
  2 About the Topic of Race. (2022, March 1). United States Census Bureau. Retrieved May 3, 2023, from https://rb.gy/89616 
  3 Asians. (2020, September 14). Centers for Disease Control and Prevention. Retrieved May 3, 2023, from https://rb.gy/a18o0 
  4 Health Disparities Among Asian Americans and Pacific Islanders. (n.d.). Pfizer. Retrieved May 3, 2023, from https://rb.gy/o3ao5 
  5 The Center for Asian Health Engages Communities in Research to Reduce Asian American Health Disparities (2022, August 17). National Institute on Minority Health and Health Disparities. Retrieved May 3, 2023, from https://rb.gy/dwrm5
  6 Pillai et al. (2022, May 27). Health Care Disparities Among Asian, Native Hawaiian, and Other Pacific Islander (NHOPI) People. KFF. https://rb.gy/p3g4q
  7 Health Disparities. (n.d.). Asian American Health Initiative. Retrieved May 3, 2023, from https://rb.gy/m9lhv
  8 Noor-Oshiro, Amelia. (2021, April 23). Asian American young adults are the only racial group with suicide as their leading cause of death, so why is no one talking about this? The Conversation. https://rb.gy/uwm6l
  9 Native Hawaiians and Other Pacific Islanders. (2020, September 14). Centers for Disease Control and Prevention. Retrieved May 3, 2023, from https://rb.gy/4ky76
  10 Yam, Kimmy. (2022, January 31). Anti-Asian hate crimes increased 339 percent nationwide last year, report says. NBC News. https://rb.gy/blpqh
  11 Asian American and Pacific Islander. (n.d.). National Alliance on Mental Illness. Retrieved May 3, 2023, from https://rb.gy/ssdlg
  12 FACT SHEET: President Biden Establishes the White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders. (2021, May 28). The White House. Retrieved May 3, 2023, from https://rb.gy/9ut3w
 

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