Title

Debunking the Model Minority Myth: Preliminary Findings for a Community Health Needs Assessment for Asian American, Native Hawaiian, and Pacific Islander Health Disparities in Greater Washington DC

Authors

Adrienne N Poon MD MPH FACP,1 Ariel Le,2,3 Yeon Hee Kim PhD(c),3 Elika Veng,2 Hoang-Viet Tran MD MPH (c),1 Sameera Samudrala MPH (c)3 Amber Lee MPH,3 Mary Tom,3 Mark Edberg,2 Qing Zeng PhD,4,5 Stuart Nelson, MD FACP FACMI, 4,5 Hank Hoang PharmD3 1. Department of Medicine, School of Medicine and Health Sciences, The George Washington University 2. Milken Institute School of Public Health, George Washington University 3. OCA Greater Washington DC, APA Advocates (OCA-DC) 4. Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University 5. Biomedical Informatics Center, The George Washington University

Introduction

Despite the broad diversity of the Asian American and Native Hawaiian/Pacific Islander (AANHPI) communities— comprising over 50 ethnic groups, speaking more than 100 languages, and accounting for 7.7% of the U.S. population as the fastest growing racial and ethnic population in the nation— this population is often aggregated together in research. Such aggregation masks critical ethnicity-level nuances shaped by various socioeconomic factors, obscuring health disparities among specific ethnic groups. To address this, a community-based participatory research (CBPR) approach was used to develop an academic community partnership between George Washington University (GWU) and OCA Greater Washington, DC (OCA-DC), an AANHPI non-profit with a 50-year history of community partnerships in the region. This collaboration developed a local AANHPI health needs assessment to collect disaggregated data.

Methods

A community health needs assessment was jointly developed by OCA-DC and GWU academic partners. The 25-question GW IRB-approved survey assesses demographics, healthcare access, healthcare barriers, health behaviors, chronic health conditions, mental health, and social support. The survey was translated into multiple languages, including Chinese, Hindi, Japanese, Korean, Telugu, and Vietnamese. Dissemination began in October 2024 through community partners in the Greater Washington DC region, with data collection anticipated for one year. The AANHPI health equity network, led by OCA-DC, facilitates survey distribution through community partners and outreach coordinators. Preliminary descriptive results were compiled, with logistic regression planned for further analysis of future data.

Results

Since data collection began in Oct 2024, 123 participants have completed the survey. Demographics included age ranges of 18-29 (35.8%), 30-39 (10.6%), 40-49 (7.1%), 50-59 (14.6%), and 60 and above (22%); male sex (35.8%) and female sex (64.2%); and ethnicity of Asian Indian (23.4%), Chinese (39.5%), Filipino (10.5%), Japanese (1.6%), Korean (13.7%), Vietnamese ( 8.9%), Other Asian (1.6%), and other PI (0.8%). The majority had employer-sponsored or private insurance (78.7%), followed by public insurance (19.1%), and uninsured (2.2%). Those who did not have health insurance felt that it was unaffordable or had limited awareness. The highest reported chronic medical conditions include high cholesterol (20%), anxiety (17.5%), depression (14.2%), hypertension (12.5%), and diabetes (9.2%). 11.4% report not receiving appropriate and regular care for chronic conditions. Barriers to routine care included linguistic barriers (4.5%), no insurance (3.0%), transportation (10.4%), high costs (22.4%), preference for traditional medicine (4.5%), not feeling it necessary (14.9%), and not having time (25.5%). 92.9% of participants reported discrimination due to race/skin color.

Conclusion

Our preliminary results showed a diverse population of AANHPI communities in the Greater Washington DC region with chronic health conditions that include both cardiovascular and mental health burdens. For those with challenges to routine care, various barriers were identified. A majority of participants reported perceived racial discrimination. Further analyses will be conducted to assess the impact of perceived racial discrimination on health and health care for AANHPI community members. These preliminary findings are suggestive that further studies are needed to collect disaggregated data on AANHPI communities to identify community-level health disparities and improve barriers to healthcare.

References

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