NCAPIP Policy Update April 2026

JAMA: Increases in Suicides and Overdoses During the 2023 Wildfires in Maui, Hawaiʻi.

This study found that the August 2023 Maui wildfires were associated with a dramatic spike in suicide and overdose deaths, adding to growing evidence that climate-related disasters carry serious behavioral health consequences. Analyzing a decade of vital statistics data, researchers found that August 2023 marked the highest monthly combined suicide and overdose death rate recorded in Maui over the entire study period of 120 months. After adjusting for trends and seasonality, the wildfires were associated with a 97% increase in suicide and overdose deaths in Maui and a 46% increase across all Hawaiian counties. This suggests that the impact extended beyond directly affected areas, possibly through displaced residents who migrated to neighboring islands or through indirect exposure among those with loved ones in the fire zone. Notably, the surge in Maui was driven primarily by suicides rather than overdoses. The findings underscore the urgent need to deploy behavioral health and suicide prevention resources rapidly during and after wildfire events, and to ensure those resources reach communities beyond the immediate disaster zone.

JAMA: Lung Cancer in Nonsmoking Individuals: A Review.

This review highlights the growing recognition of lung cancer in nonsmoking individuals, defined as those who have smoked fewer than 100 cigarettes in their lifetime, accounting for 15–20% of all lung cancer cases worldwide, In the U.S., incidence is significantly higher among females (14.4 to 20.8 per 100,000 person-years), compared to males (4.8 to 12.7 per 100,000 person-years). The age-adjusted incidence among Asian American females was 17.5 per 100,000 persons. In Taiwan, up to 83% of lung cancer among nonsmoking individuals are in women, Risk factors include radon exposure, air pollution, secondhand smoke, asbestos exposure, and a family history of lung cancer. The common misconception that lung cancer is almost exclusively a smoker’s disease can delay diagnosis, and current U.S. screening guidelines do not recommend low-dose computed tomographic (CT) scanning for nonsmokers. In Taiwan, a national early detection program began in 2022, with low-dose CT scans for nonsmoking individuals aged 45-74 for females and aged 50-74 for males. The Female Asian Nonsmoker Screening (FANS) Study (University of California San Francisco, University of California Davis, Stanford University, and Kaiser Permanente Northern California) is evaluating the potential benefits of screening for lung cancer among high-risk groups. Most lung cancers in this population are adenocarcinomas, and they carry significantly higher rates of targetable genomic alterations, such as EGFR mutations and ALK rearrangements, compared to those with a smoking history. Patients with these alterations who receive targeted tyrosine kinase inhibitors can achieve median survival exceeding three to five years, compared to one to two years without such alterations.

https://fansstudy.ucsf.edu/

Health Workforce

JAMA Network Open: Sponsorship and Career Advancement for Asian Medical Faculty

This study examined the barriers to career advancement faced by Asian American and Asian faculty in academic medicine. Despite representing 20.5% of U.S. medical school faculty, only 15.4% attain full professorship, and only 10.1% hold department chair positions, a disparity researchers describe as the “bamboo ceiling.” Intersectional identities across race, sex, nationality, immigration status, and educational background further exacerbate these disparities, Through focus groups with 32 mid-level Asian American and Asian faculty at a major academic medical center in 2024, the study found that cultural norms discouraging self-promotion, limited access to senior decision-makers, and intersecting identity-based challenges, including accent bias, immigration constraints, and gender, all contribute to stalled career advancement. A key finding was the confusion between mentorship and sponsorship: after receiving a clear definition of sponsorship as active advocacy (such as nominating colleagues for leadership roles, connecting them to high-impact networks, and creating tangible career opportunities), the share of participants who believed they had a sponsor dropped from 56% to 38%. Faculty called for transparent nomination processes, formalized sponsorship programs, and culturally informed leadership development as essential steps toward dismantling these systemic barriers.

JAMA Network Open: Multilingualism Among First-Year Resident Physicians

This study examined the language skills of over 107,000 first-year resident physicians in 2022-2024, finding that self-assessed multilingualism is widespread but unevenly distributed relative to patient need. Nearly three-quarters reported some non-English language ability, with 37% reporting advanced or native proficiency, a notable decline from 50% reported among residency applicants in 2013. This suggests that language diversity may be lost somewhere in the matching process. Hispanic-Latino and Asian first-year residents were far more likely to report advanced multilingual skills than White first-year residents, and those who grew up speaking a non-English language at home were nearly 14 times more likely to report advanced proficiency. However, a critical gap emerged when first-year resident physician language skills were compared against community needs: four of the five most widely spoken non-English languages in the U.S. (Spanish, Tagalog, Vietnamese, and Chinese) had among the lowest ratios of language-concordant physicians relative to the number of patients with limited English proficiency. On the other hand, the languages reported spoken by the highest number of first-year residents were Urdu, Punjabi, Telegu, Malayalam (and Kannada and other Dravidian languages), Tamil, Hebrew, Gujarati, and Arabic. The authors caution that even heritage language speakers should not be assumed ready for clinical language use without formal training and testing, and they call on institutions to better assess and develop the language resources of their trainees to ensure safe, equitable care for patients who are not proficient in English.

Health Equity

JGIM: Addressing Structural and Systemic Racism in Social and Health Care Systems to Advance Health Equity

Structural and systemic racism decreases access to opportunity structures for economic vitality, education, housing, justice, and health care, and directly exposes individuals to health risks including chronic stress, discrimination, and stigma. Racism segregates communities, leading to cumulative disadvantages and worse health. Actionable solutions can address structural racism to advance health equity in health care systems and social systems such as economic infrastructure, labor and employment, education, justice and civil rights law, media, immigration and foreign policy, and data and information.

JAMA Health Forum: Manifestations of Structural Racism and Inequities in Cardiovascular Health Across US Neighborhoods

This cross-sectional study used 2017-2018 Behavior Risk Factor Surveillance System and other Centers for Disease Control and Prevention data to apply a validated Structural Racism Effect Index (with domains of built environment, criminal justice, education, employment, housing, income and poverty, social cohesion, transportation, and wealth) to classify nearly 72,000 census tracts (97% of total U.S. census tracts) into quintiles of structural racism. Structural racism refers to the ways in which society perpetuates racial discrimination through intersecting and mutually reinforcing inequitable systems, which bolster discriminatory laws, policies, practices, and norms, leading to a differential distribution of resources and opportunities. Neighborhoods (census tracts) with the highest quintiles of structural racism had the highest prevalence of cardiovascular clinical risk factors (high blood pressure, obesity, and diabetes), the highest prevalence of cardiovascular behavioral risk factors (current cigarette smoking, no leisure time physical activity), and the highest prevalence of cardiovascular disease (coronary heart disease, stroke). While each structural racism domain was independently associated with a higher prevalence of cardiovascular risk factors and diseases, the income and poverty domain and education domain had the strongest correlations.

Immigration Issues

National Asian American and Pacific Islander Organizations and National Health Organizations Oppose Department of Homeland Security Proposed Public Charge Regulation

National Asian American and Pacific Islander organizations, including the Asian & Pacific Islander American Health Forum (joined by the National Council of Asian Pacific Islander Physicians), Association of Asian Pacific Community Health Organizations, National Council of Asian Pacific Americans, National Asian Pacific American Women’s Forum, and Asian Americans Advancing Justice submitted comments in December 2025 opposing the Department of Homeland Security’s proposed regulation. The proposed regulation would expand consideration of past or current receipt of any government-funded health or social services as a potential reason to deny an applicant legal permanent residence, while current law only considers receipt of cash benefits that reflect a current financial reliance on government assistance. National physician and health care organizations, including the American Medical Association, American Academy of Pediatrics, American Academy of Family Physicians, Society of General Internal Medicine, American College of Obstetricians and Gynecologists, American Hospital Association, America’s Essential Hospitals, Association of American Medical Colleges, Association for Community Affiliated Plans, and National Association of Community Health Centers, also submitted comments opposing DHS’ proposed regulation. It is expected that the regulation will be finalized later this spring, with legal challenges to be filed seeking to block its implementation.

U.S. Supreme Court: Oral Argument on Birthright Citizenship Executive Order 14160

On April 1, the U.S. Supreme Court is scheduled to hear oral argument in Trump v. Barbara, on the constitutionality of Executive Order 14160, which seeks to restrict birthright citizenship under the 14^th Amendment. The U.S. Supreme Court affirmed birthright citizenship for a Chinese American born in the U.S. with two non-citizen parents in the 1898 case Wong Kim Ark v. U.S. The Asian Law Caucus is among the legal organizations representing the parents and children challenging the executive order. The National Asian Pacific American Bar Association; Fred Korematsu Center for Law and Equality, Asian American Legal Defense and Education Fund and 65 Asian American community-based organizations; South Asian American Justice Collaborative and 30 South Asian community-based organizations and professional associations; and Chinese American Legal Defense Alliance filed amici briefs supporting the challenge. A decision by the U.S. Supreme Court is expected by late June.