U.S. Department of Health and Human Services Assistant Secretary for Planning and Evaluation: Health Insurance Coverage and Access to Care for Asian Americans, Native Hawaiians, and Pacific Islanders – Recent Trends and Key Challenges
The uninsured rate for the non-elderly Asian American, Native Hawaiian, and Pacific Islander (AANHPI) population decreased from 16.6 percent in 2010 to 6.2 percent in 2022, representing an increase of 4.6 million AANHPIs with coverage. This 63 percent reduction in the uninsured rate was the largest relative improvement in health care coverage among any racial or ethnic group during this time period. However, uninsured rates varied greatly among non-elderly AANHPI subgroups in 2022, ranging from 3.6 percent for Japanese Americans to 7.8 percent for Korean Americans and 12.4 percent for Native Hawaiians and Pacific Islanders. AANHPIs also enrolled in Marketplace health insurance coverage at rates far higher than their share of the overall population, with 9 percent of Marketplace plan selections compared to 6 percent of the population. More than 1.5 million AANHPIs selected Marketplace plans in 2023.
White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders: 25th Anniversary
In May 2024, The White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders celebrated its 25th anniversary in Washington DC. The Initiative was established in 1999 under the Clinton Administration and has continued its work through the Bush, Obama, Trump, and Biden Administrations, and is currently based at the U.S. Department of Health and Human Services. The current President’s Advisory Commission on Asian Americans, Native Hawaiians, and Pacific Islanders continues to make recommendations to the Biden Administration on data disaggregation, language access, immigration, civil rights, and economic opportunity.
U.S. Department of Health and Human Services: Language Access Plans
Following on its 2023 Department-level language access plan, the U.S. Department of Health and Human Services has released division-specific language access plans for 25 of its staff and operating divisions. For example, the Centers for Medicare & Medicaid Services plan repeats the guidance in the Department-level language access plan that “machine translation or other artificial intelligence applications, or software designed to convert written text from one language to another, will be used only with the involvement of a qualified human translator before the text reaches the intended audience.” This guidance applies to Medicare, Medical, and marketplace health plan websites, forms, and notices.
U.S. Department of Health and Human Services Office of Minority Health: Advancing Equity for Asian American and Native Hawaiian/Pacific Islander Communities in COVID-19 Response Efforts – Best Practice Resource Guides
These resource guides on data disaggregation, language access, and community partnerships were developed by the Office of Minority Health (OMH) as part of the implementation on the 2021 Presidential Memorandum Condemning and Combating Racism, Xenophobia and Intolerance Against Asians Americans and Pacific Islanders and now have been translated into Chinese, Korean, Vietnamese, Hawaiian, Samoan, and Marshallese. This is one of the first times that OMH materials have been translated into Hawaiian and Pacific Islander languages.
JAMA Network Open: Racial and Ethnic Disparities in COVID-19 Mortality
Sumibcay JRC, Kunichoff D, Bassett MT. Racial and ethnic disparities in COVID-19 mortality. JAMA Netw Open. 2024;7(5):e2411656
This analysis of COVID-19 mortality data from the National Center for Health Statistics from February 2020 to September 2023 reports that Native Hawaiian or Pacific Islander individuals had the third highest mortality rate among all racial and ethnic groups (after American Indian or Alaska Native, and Hispanic individuals) during that period, but the highest mortality rate during third surge from June to October 2021. The authors note that combining Native Hawaiian or Pacific Islander individuals with Asian individuals masked Native Hawaiian or Pacific Islander mortality risk, and caution against using a combined Asian and Pacific Islander categorization.
JAMA Network Open: COVID-19 Hospitalization in Hawaiʻi
Santi BM, Verhoef PA. COVID-19 hospitalization in Hawaiʻi and patterns of insurance coverage, race and ethnicity, and vaccination. JAMA Netw Open. 2024;7(5):e243696
This analysis of nearly 1,200 patients hospitalized for CVOID-19 at the Kaiser Permanente Moanalua Medical Center in Honolulu, Hawaiʻi between March 2020 and March 2022, including patients self-identifying as Pacific Islander, Asian, White, Native Hawaiian, Filipino, Samoan, Japanese, Hispanic. Chinese, American Indian and Alaska Native, Black, Korean, and Vietnamese. When adjusting for age, sex, medical co-morbidities, BMI, socioeconomic neighborhood status, and insurance status, Filipino patients had the highest likelihood to die in the hospital. Other research has identified language barriers, food instability, financial insecurity, a high proportion of frontline health workers or tourism industry employees, and higher rates of chronic disease as potential factors in this disparity.
JAMA Network Open: Understanding Disaggregated Race and Ethnicity Data
Quint JJ, Kaholokula J. Now that we are disaggregating race and ethnicity data, we need to start understanding what they mean. JAMA Netw Open. 2024;7(5):e243674
Disaggregating Asian, Native Hawaiian, and Pacific Islander data highlights health inequities in these populations, and allows for identification of determinants and barriers to optimal health outcomes. Since many individuals do not identify in just one group, it is recommended to use non-mutually exclusive classification of self-reported race and ethnicity (using alone or in combination categories). Site-specific data, such as from a single medical center, can be informative, but should be contextualized with population-based data, and other social and cultural contexts to understand the disparities.
JAMA Network Open: Disparities in Telemedicine Use Among Native Hawaiians and Pacific Islanders
Morenz AM, Reddy A, Hsu A, Le A, Wong ES, Liao JM. Disparities in telemedicine use among Native Hawaiian and Pacific Islander individuals insured through Medicaid. Health Aff Sch. 2024;2(5):qxae057
Washington State has the third largest population of Native Hawaiian and Pacific Islander (NHPI) individuals in the U.S., with 0.6% of the state’s population; however only 0.3% of physicians in the state identified as NHPI in 2020. Nationally, NHPI individuals insured by Medicaid have been shown to have worse access to care and less timely access to a checkup than White individuals. This analysis of 2020–2021 Medicaid claims reports that NHPI individuals were 38%–39% less likely to use any telemedicine than White individuals, after adjusting for patient- and area-level characteristics such as poverty, homelessness, and area- level lack of broadband and cellphone access. More research is needed to understand how characteristics such as English as a preferred spoken language or female sex impact telemedicine use among NHPI individuals.
JAMA Network Open: Asian, Native Hawaiian, and Pacific Islander Health Equity
Muramatsu N, Chin MH. Asian, Native Hawaiian, and Pacific Islander populations in the US – Moving from invisibility to health equity. JAMA Netw Open. 2024;7(5):e2411617
Disaggregating data is an initial step in advancing health equity. Native Hawaiian and Pacific Islander individuals are invisible statistically when aggregated with more numerous Asian individuals. Native Hawaiian and Pacific Islander individuals are invisible as a people when historical health policy ignores the colonialism and structural racism that led to today’s social disadvantages and health inequities. Grouping heterogeneous populations into a monolithic Asian category erases evidence of inequities and identification of subgroups who need more resources. This commentary calls for complementary quantitative data analysis, qualitative methods, and culturally appropriate narrative and storytelling, and an increase in the research workforce from minoritized communities who understand these lived experiences and perspectives, in order to hear the voices of minoritized communities and understand their histories of oppression.
National Academies of Sciences, Engineering, and Medicine: Ending Unequal Treatment – Strategies to Achieve Equitable Health Care and Optimal Health for All
This report follows up on the landmark 2003 Institute of Medicine report, Unequal Treatment, and finds that America has made little progress in advancing health care equity and that racial and ethnic inequity remain fundamental flaws in the U.S. health care system. The report presents 17 recommendations to intervene at every level of health and health care, that would generate accurate and timely data on inequities, equip health care systems and expand effective and sustainable interventions, invest in research and evidence generation to better identify and widely implement interventions that eliminate health care inequities, ensure adequate resources to enforce existing laws and build systems of accountability that explicitly focus on eliminating health care inequities and advancing health equity, and eliminate inequities in health care coverage, access, and quality.
Pew Research Center: Key Facts about Asian American Eligible Voters
15 million Asian Americans, or 6.1% of the eligible voting population, could vote in the November 2024 election. Asian Americans are more than 10% of the eligible voting population in Hawaii (55%), California (17%), Nevada (11%), and Washington (10%).
APIA Vote: AAPI Voter Demographics by Each State
These updated fact sheets provide data on eligible Asian American and Pacific Islander (AAPI) voters in each of the 50 states and the District of Columbia, including counties with the highest number of AAPI residents, and disaggregated data by Asian American, Native Hawaiian, and Pacific Islander subgroups, including needs for language assistance in voting among AAPI populations speaking primary languages other than English.
The Asian American Foundation: Social Tracking of Asian Americans in the U.S. (STAAUS) Index
This latest version of The Asian American Foundation’s annual survey, with over 6,200 respondents, continues to document high levels of anti-Asian hate, with 60% of Asian Americans reporting racial or religious discrimination and/or violence, 32% of reporting they were called a slur, 29% reporting they were verbally harassed or abused, 19% reporting cyberbullying, and 14% reporting being threatened with physical assault.
Nielsen: Reaching Asian American Audiences
This updated report on Asian American, Native Hawaiian, and Pacific Islander (AANHPI) audiences reports that only 17% of AANHPIs have paid subscriptions to digital news sites, but 53% regularly access free digital news sites, and 47% look at news articles referred by their social media channels. Korean, Chinese, and Vietnamese-speakers are more likely to trust their respective ethnic media. On average, AANHPIs spend an equal amount a time each week (about 17 hours/week) watching television and using apps and the internet to access content on their smartphones. YouTube and Netflix are the most watched streaming services on television, and Sling, Tubi, Netflix, Hulu, and YouTube are the most used streaming platforms on smartphones by AANHPIs.
Asian American Journalists Association, APIA Vote, and AAPI Data: Trusted Messengers and Priority Audiences
This survey found that 80% of Asian Americans get their news from television, 79% from social media, 76% from radio and podcasts, and 74% from print or digital news; 12% rely primarily on ethnic media.
AAPI Data: 2024 Asian American Voter Survey
AAPI Data has published the results of its 2024 Asian American Voter Survey with nearly 2,500 respondents, and includes data disaggregated for Chinese, Korean, Vietnamese, Asian Indian, Filipino, and Japanese voters. 90% of Asian American registered voters say they plan to vote for President, Congress and other offices this November but 42% of Asian American voters say they have not been contacted by either of the two major political parties this election season. Asian American voters ranked health care tied with inflations as the second most important issue, behind the economy; and the economy, inflation, and healthcare were the top three issues that would motivate their vote, regardless of any Presidential candidate.
NCAPIP represents Asian American, Native Hawaiian, and Pacific Islander physicians committed to the advancement of the health and well-being of their patients and communities. NCAPIP believes in shaping health care in America to meet this shared American goal of optimal health for all.