Kristine Cecile Alarcon is the Communications and Storytelling Manager, Gabrielle Peñaranda is the Program Manager, Training and Technical Assistance, and Rosy Chang Weir is the Director of Research at the Association of Asian Pacific Community Health Organizations.
Community Health Centers that serve Asian Americans (AAs), Native Hawaiians, and Pacific Islanders (NH/PIs) provide innovative care for their patients. In an analysis the Association of Asian Pacific Community Health Organizations (AAPCHO) conducted earlier this year of federal data, we found that health centers serving AA and NH/PI communities have a higher proportion of patients with social risk factors than health centers across the nation.
Health centers serving AA and NH/PI communities have a higher proportion of limited English proficient, low-income, and Medicaid and publicly insured patients. AA and NH/PI health centers also provide a higher number of enabling services, which are non-clinical services that alleviate barriers to care of patients, or other non-clinical services that aim to increase access to health care and improve health outcomes. Enabling services allow for culturally and linguistically appropriate whole-person care, which can address the unique health disparities that AA, NH/PI, and other communities served at health centers face.
Asian Americans (AAs), Native Hawaiians, and Pacific Islanders (NH/PIs) are the fastest growing racial group in the United States
Asian Americans (AAs), Native Hawaiians, and Pacific Islanders (NH/PIs) have a wide variety of cultures, experiences, rich histories, and languages. People from the AA community have cultural roots from more than 20 countries in East and Southeast Asian and the Indian subcontinent. The NH/PI community are just as diverse with people having origins throughout the Pacific region, also referred to as Oceania, a geographically widespread region populated by people of diverse cultures and ethnicities across 14 countries and a sea of islands grouped into four geopolitical sub-regions. The sub-regions include Australia and New Zealand; Melanesia; Micronesia; and Polynesia. Despite this diversity, AA and NH/PI populations are often aggregated into one racial category, masking meaningful differences in health and social barriers to care between these subgroups.
AAs and NH/PIs are also the fastest growing racial group in the United States, Hawai’i, U.S. Territories, and Compact of Free Association Migrants (COFA) nations. Most AA and NH/PI populations can be found living in California, New York, Washington, Hawai’i, and Massachusetts. Between 2019 and 2020, AA and NH/PI populations had the largest growth (by raw numbers) in Florida, Kentucky, Virginia, Federated States of Micronesia, and Rhode Island. The states with the largest growth rate (by percentage) between 2019 and 2020 were Rhode Island, Florida, Arkansas, Federated States of Micronesia, and Alaska.
AAPCHO analysis finds health centers provide innovative care to AA and NH/PI patients
According to AAPCHO’s analysis of the 2020 Uniform Data System (UDS), AA and NH/PI-serving health centers provide innovative care for their patients. Key findings show that
- AA and NH/PI-serving health centers have a higher proportion of limited English proficient, low-income, and Medicaid and publicly insured patients; and
- AA and NH/PI health centers also provide a higher number of enabling services, which are non-clinical services that alleviate barriers to care of patients, or other non-clinical services that aim to increase access to health care and improve health outcomes.
The innovative care AA and NH/PI-serving health centers provide, like enabling services, can incorporate culturally and linguistically appropriate whole-person care. With whole-person care, providers can address the unique health disparities that AA, NH/PI, and other communities served at health centers face.
Whole-person care can help narrow health disparities in AA and NH/PI patients
Providing whole-person care is essential in addressing chronic and infectious conditions. Nationally, 36% of adult health center patients live with diabetes, and 21% live with hypertension. According to AAPCHO’s UDS data analysis, 25% of AA, 40% of NH, and 43% of PI patients are living with diabetes while 41% of AA, 45% of NH, and 46% of PI patients are living with hypertension. NH/PI patients have the highest rates of chronic disease, which can be largely attributed to socioeconomic disparities, structural discrimination, and pre-existing conditions.
For tuberculosis rates, NH/PI communities have the highest incidence rate (18.7 cases per 100,000 persons), while AA communities have the second highest rates (13.3 cases per 100,000 persons) across the nation. According to UDS data, the average tuberculosis rate was 3.0 cases per 100,000 persons at health centers across the nation. AA and NHPI-serving health centers also serve higher rates of hepatitis B patients compared to the national average with 3.4 cases per 100,00 persons for AAs and NH/PIs, 2.1 cases per 100,00 for NH/PIs. The average hepatitis B rate at health centers across the nation was 1.7 cases per 100,000 persons. These disparities demonstrate the unique health experiences that AAs and NH/PIs face and the need to provide whole-person care to provide unique and tailored care for AA and NH/PI patients.
AAPCHO recommendations for improving care at health centers
Given the unique experiences of the widely diverse AA and NH/PI population, AAPCHO recommends:
- Community-serving organizations, including health centers, adopt screening tools that assess social risk factors and disaggregated race and ethnicity data;
- Health centers tailor health and social services that reflect the needs for AA and NH/PI patients; and
- Community-serving organizations cultivate and sustain community and national partnerships that promote cross-sector partnerships and state and national networks, resources, and expertise.
This blog post is a summary of AAPCHO’s full report. For more information, listen to AAPCHO’s webinar. Stay connected with AAPCHO’s newsletter, Facebook, LinkedIn, Instagram, and Twitter as an analysis of the 2021 UDS data will be released in summer 2023. To learn more about AA and NH/PI-serving health centers, visit www.aapcho.org.
AAPCHO is a national association of community health organizations dedicated to promoting advocacy, collaboration and leadership that improves the health status and access of Asian Americans, Native Hawaiians, and Pacific Islanders in the United States, the U.S. territories, and Freely Associated States.