Tuesday, September 28, 2021

Racism in the US: Ensuring Health Equity for Asian Americans

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Providing a comprehensive picture of the health of Asian Americans is complex, challenging, and incomplete. Only in the past decade has research on health outcomes and disparities among Asian Americans gained momentum. Scarce data can routinely obscure or minimise health disparities for ethnic and racial minorities. In a Correspondence, Nancy Krieger and colleagues point to the stunning and continued paucity of ethnic and racial data being collected for COVID-19 vaccination in the USA. In general, Asian Americans have historically been seemingly healthier than other groups and compared with the US general population. For example, overall cancer incidence is lower in Asian Americans than in non-Hispanic White people. However, Asian Americans are at increased risk for liver and stomach cancers and are the only group for whom cancer remains the leading cause of mortality. Type 2 diabetes is more prevalent in Asian Americans as a group (9%) compared with non-Hispanic Whites (7·2%), but it is substantially higher in subgroups of Asian Americans such as Filipino men (15·8%). Understanding such differences could inform the use of prevention or earlier screening strategies.Tailored public health strategies to improve health equity will be an important means to counter the so-called model minority myth—ie, the expectation of excelling socially and academically. Asian Americans are often portrayed as self-sufficient and resilient, and are the least likely of all ethnic groups to seek mental health treatment. Cultural pressures and feelings of shame or stigma, especially around mental health disorders, treatment for cancer, and previous trauma can be deterrents to seeking help. However, culturally competent care could be improved through some of the solidarity and impact of Asian Americans as health-care providers. About 17% of all US physicians identify as Asian American. Although over-represented in number, increasing visibility and obtaining more leadership positions within health care is an important goal. 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. © 2021 Elsevier Ltd. All rights reserved.

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DOI: https://doi.org/10.1016/S0140-6736(21)00769-8 Article InfoPublication HistoryIdentification

In the USA, Feb 2 is Groundhog Day, when the famous Punxsutawney, PA, groundhog’s sighting or absence of sighting of its shadow predicts how long winter will last. The phrase also now evokes thoughts of an endless time loop, following a 1993 comic film, in which an egotistical cynical weather reporter who is assigned to film the groundhog gets stuck in a time glitch, endlessly repeating the day. He escapes only by learning the errors of his ways, redeemed by self-reflection leading to self-improvement and finally authentic love for another person. Linked ArticlesMissing again: US racial and ethnic data for COVID-19 vaccination

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