On March 8th, the Asian Pacific American Institute for Congressional Studies (APAICS) hosted a virtual Health Summit to discuss the current state of healthcare in the United States and how it impacts Asian Americans and Native Hawaiians/Pacific Islanders (AANHPIs). APAICS is "dedicated to promoting Asian American and Native Hawaiians/Pacific Islander participation and representation at all levels of the political process, from community service to elected office." The 2023 Health Summit featured speakers from the medical field, non-profits, corporate groups, and civil servants from all levels of government. As a member of the AANHPI community and someone heavily involved in public health and health policy, I learned a great deal from listening to the programming. I left armed with a greater dedication to supporting the health of AANHPIs and other underrepresented minorities.
In the first session, panelists spoke about the need for better representation of the AANHPI community’s ethnic diversity in clinical trials. Dr. Yanghee Woo explained how the underrepresentation of the ethnicities comprising the AANHPI community during clinical trials constrains the efficacy of drug therapies and treatments; patients of different ethnicities respond differently to drug treatments. It is imperative that clinical trials increase ethnic representation in order to best treat AANHPIs. A lack of commitment to representation also plagues research efforts to improve the detection and prevention of gastric cancer among AANHPIs; cancer is the leading cause of death among AANHPIs, and AANHPIs suffer from gastric cancer at disproportionately high rates compared to other racial groups. According to the panelists, a lack of information about clinical trials coming from trusted sources combined with language barriers further inhibits AANHPI representation. Without ethnic diversity, which is highly linked to genetic diversity, these treatments will not have the intended efficacy for all groups.
The second panel featured representatives from various sectors, many of whom are involved in community engagement and organizing. Throughout the conversation, speakers highlighted the importance of community-level engagement in healthcare. APAICS describes community engagement as a means to “address socio economic issues that are the root causes of many existing disparities in health equity…through a collaborative process, [wherein] members from the community, stakeholder organizations, and healthcare providers can work to identify needs most important to the community and pursue meaningful strategies to address those needs.” Isha Williams, the Head of Media Excellence and Head of Culturally Inclusive and Relevant Marketing at The Janssen Pharmaceutical Companies of Johnson and Johnson, identified how community-based partnerships can transform health care for underrepresented groups. These partnerships increase access and quality of health care through authentic, non-transactional engagement with the community. In short, such engagement requires community empowerment through supporting education, dedicating space to the input of the community, and recognizing how history has perpetuated systemic and institutional racism.
Continuing into the third panel was the theme of innovation in the healthcare industry. The panelists addressed how pharmacies can serve as an access point for primary health care services, as demonstrated through COVID-19 vaccine efforts and therapeutics distribution. In rural areas, pharmacies are especially critical when few other primary health care touchpoints are available in the community. Pharmacies have become effective in supporting the continuum of care for patients, often connecting them to other needed services. Of the services that pharmacies and primary care providers can facilitate is obesity screening for AANHPIs, an important topic among the panelists. Obesity is a major concern for AANHPIs in that compared to other racial and ethnic groups, AANHPIs are at a greater risk for developing chronic diseases at a lower Body Mass Index (BMI) level. Obesity is considered a risk factor and contributor to “to increased morbidity and mortality, most importantly from cardiovascular disease (CVD) and diabetes, but also from cancer and chronic diseases, including osteoarthritis, liver and kidney disease, sleep apnea, and depression” (Pi-Sunyer X, 2009). Because AANHPIs experience these risks at a lower BMI, the World Health Organization (WHO) redefined the BMI levels at which a person of AANHPI descent is considered overweight and obese, lowering the threshold from 25 and 30 to 23 and 27.5, respectively. Unfortunately, medical providers may not have this awareness, preventing AANHPIs from accessing obesity medication and thus preempting adverse health outcomes.
Finally, the last panel closed out the program with a discussion about empowering patients. One of the keys to empowering patients, AANHPIs and otherwise, is ensuring that language barriers do not impede care. Dr. Rita Kuwahara personally testified to the need for certified medical interpreters who have formal training to communicate medical terminology to patients who require a translator. Another important member of the care team is a patient navigator, someone who helps patients fully understand the practical implications of what a provider tells them, often connecting patients to other services. People who are AANHPIs themselves can effectively meet these needs since they can provide culturally-informed education to patients making decisions about their health.
In listening to the APAICS Health Summit, I came away with a greater understanding of the need for diverse representation of the AANHPI community in research, data, clinical trials, and advocacy. Between language barriers, socioeconomic limitations, and a lack of cultural competence, it is important for the government to better fund efforts that would solve these issues. These issues are also not unique to the AANHPI community, and we should acknowledge that solving these issues for our community through advocacy and practice will improve issues in health care that affect many groups.
Pi-Sunyer X. The medical risks of obesity. Postgrad Med. 2009 Nov;121(6):21-33. doi: 10.3810/pgm.2009.11.2074. PMID: 19940414; PMCID: PMC2879283.
Editor(s): Cathay L., Claudia S.
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