Racism in the USA: ensuring Asian American health equity
The term “Asian American” carries a measure of controversy in trying to define an extraordinary mix of people, cultures, and languages. It is not a matter of semantics, but an issue of representation. Asian Americans include people with ancestry from east Asia, south Asia, southeast Asia, and in some instances Pacific Islanders or Native Hawaiians. Asian Americans constitute about 6·8% of the population of the USA and unlike any other ethnic or racial minority group, about two-thirds are foreign born and have entered the USA in the past 10 years. The largest Asian American subgroups are Chinese (4·2 million), followed by Filipino (3·6 million), Indian (3·3 million, and the fastest growing), Vietnamese (1·9 million), and Korean (1·8 million).
As a predominantly immigrant minority group, Asian Americans can face specific barriers to accessing health care such as residency requirements for Medicaid eligibility (health coverage for low-income Americans) or being more likely to be employed in jobs that do not cover private insurance. Language proficiency can also limit an individual's ability to navigate a challenging health-care system. In relation to educational attainment and income level, immigration status can vastly bifurcate health outcomes.
Health equity in the US demands recognition of the contributions that immigrants make to society, understanding and provision of appropriate responses to the different needs of groups and individuals, and the dismantling of racism and discrimination against Asian Americans.