Anti-Asian hate's impact on the AANHPI communities is greater than we think

About 1 in 5 Asian Americans in California worried "all the time" or "often" about being a victim of a hate crime, with worries especially high among Filipino Americans, according to a new study.

The AAPI Data Project at UC Riverside and the UCLA Center for Health Policy Research (CHPR) recently released a comprehensive report revealing economic hardships, negative health outcomes and a rise in hate incidents experienced by Asian Americans, Native Hawaiians, and Pacific Islanders during the COVID-19 pandemic.

"California's investment to increase the available data on Asian American, Native Hawaiian, and Pacific Islander communities is essential in improving public understanding of the needs, barriers, and challenges that AA and NHPI communities face," said Karthick Ramakrishnan, professor of public policy at UC Riverside and founder of AAPI Data. "We hope that policymakers as well as those in charge of policy implementation will use the findings and recommendations in this report to create better programs and services that address the diversity in needs and challenges faced by AA and NHPI communities in California."

One of the key findings of the study, the Post-Pandemic Agenda for Community Well-being among Asian Americans, Native Hawaiians, and Pacific Islanders in Californiais that information about access to heath and mental health needs is not getting to the AANHPI communities resulting in poor medical outcomes and high suicide rates

Using data from UCLA CHPR's 2018–2021 California Health Interview Survey (CHIS), as well as the 2019 and 2021 American Community Survey, the study found that Asian Americans, Native Hawaiians, and Pacific Islanders experienced difficulties accessing health and mental health services, as well as affordable and quality housing, education, and food.

The impact was vast in health outcomes, with about 3 in 10 Asian Americans, Native Hawaiians, and Pacific Islanders in California reported difficulties in accessing health services, and 1 in 4 experiencing difficulties in accessing mental health services. Cost was the most common reason for difficulty in accessing health services, with 7 in 10 experiencing this financial burden, however a lack of knowledge about available options was the top reason for difficulty in accessing mental health services.

The Asian American and Native Hawaiian and Pacific Islander communities have grappled with a rise in violence in recent years—from the anti-Asian hate incidents that occurred during the pandemic to the recent back-to-back mass shootings in Monterey Park and Half Moon Bay. 

The 2021 CHIS, which added questions on attitudes about gun violence, found that Asian Americans and Native Hawaiians and Pacific Islanders reported the highest proportions of concern about gun violence: 66% of Native Hawaiians and Pacific Islanders and 65% of Asian Americans said they were "very worried" or "somewhat worried" about gun violence, more than double the percentage of white adults (30%).

Economic hardship was another overwhelming issue for Asian Americans, Native Hawaiians, and Pacific Islanders in California. Asian Americans, Native Hawaiians, and Pacific Islanders, each saw higher poverty rates in 2021, compared to 2019. According to the study, more than half of respondents indicated that they had difficulty accessing high-quality or affordable housing due to financial cost and 36% said they had difficulty accessing quality or affordable food.

"After studying the emotional and economic impacts brought on by the pandemic over the last three years, it's clear there is a significant burden on Asian American, Native Hawaiian, and Pacific Islander communities in California," Ninez A. Ponce, UCLA CHPR director and CHIS principal investigator, said. "These findings suggest an urgent need to address the gaps in access to health care, which have gotten perpetually worse as the pandemic continues to take a toll on this community."

Another major cause for concern is the ongoing issue of hate incidents and discrimination against the Asian American community. Data show 1 in 4 Asian Americans had ever been a victim of a hate crime or incident in their lifetime, and 1 in 5 said they worried all the time or often about being a victim.

To address racial injustices and economic inequities within the state's system, researchers suggest that policymakers act against such prejudices by creating a more equitable framework for Asian Americans, Native Hawaiians, and Pacific Islanders across the state.

Recommendations include a focus on addressing inequities across the mental health system, improving awareness and access to public and government programs, investing in culturally competent care and services, increasing partnerships between state and community-based organizations, building additional language access, and widening access to data on Asian American, Native Hawaiian and Pacific Islander communities.

The report is part of a series of reports by AAPI Data and the California Health Interview Survey focused on measuring the social, economic, and health impacts of the COVID-19 pandemic on Asian Americans, Native Hawaiians, and Pacific Islanders. The goal is to highlight the gaps in access to health, mental health, and social services for those communities.

"During the COVID-19 pandemic, our community faced not only a major increase in hate crimes and incidents, but struggled financially and could not access care," said California Assemblymember Phil Ting, chair of the Assembly Budget Committee.

"When I championed the API Equity Budget in 2021, we knew that the AAPI Data Project needed resourced to research our community's necessities. The recommendations from this report help us understand the hardships that the API community is facing, and helps us identify service gaps in order for the government and our community partners to address these needs."

Other highlights of the report:

HEALTH

• Between 2019 and 2021, Hispanics/Latinos and Asian Americans had statistically significant increases in reports of delays in health care due to system and provider barriers.
  
• By 2021, Asian Americans and NHPIs were more likely than Whites to rely on community-based health care. 
• About 3 in 10 Asian Americans in California reported difficulties in accessing health services, and cited financial cost, lack of awareness about options, lack of insurance, and limited English proficiency as the most salient challenges.
  
• Doctors, government health agencies, and friends/family remain by far the most trusted sources of medical information for Asian Americans. Only 37 percent of Asian Americans trusted social media apps for medical information.​
  

MENTAL HEALTH AND COMMUNITY WELL-BEING: 

• Suicide ideation increased between 2018/19 and 2020/21 for Asian Americans, as for many other groups, with increases especially pronounced among non-U.S. citizens.
  
• Yet the share of Asian Americans receiving mental health services did not change before and after the onset of COVID. 
  
• Major barriers for finding mental health services include lack of knowledge about available options, financial cost, lack of insurance, and limited options in their neighborhood. 
  
• Fear of gun violence is a significant contributor to community anxiety and the lack of well-being.
  
• Even before the 2023 shootings in Monterey Park and Half Moon Bay, California, Asian Americans and NHPIs were the groups most worried about becoming a victim of gun violence.
  

EXPERIENCES WITH HATE 

• One in 4 Asian Americans in California reported having ever experienced a hate crime or hate incident, with Southeast Asians reporting the highest levels of experiences with hate. 
  
• Among those who had ever experienced hate crimes or hate incidents, most had done so before 2020.
  
• Asian American men were significantly more likely than Asian American women to be threatened or harassed (16% vs.10%, respectively) and also more likely to have been mocked or had offensive physical gestures made towards them (15% vs. 9 %, respectively).
  
• About 1 in 5 Asian Americans in California worried "all the time" or "often" about being a victim of a hate crime, with worries especially high among Filipino Americans.
  

A mural in New York City.

SOCIAL DETERMINANTS

• Asian Americans, Native Hawaiians, and Pacific Islanders all saw higher poverty rates, and lower labor force participation rates, in 2021 than in 2019.
  
• The labor force participation rate for Indian Americans increased slightly between 2019 and 2021, while Chinese, Filipino, and Vietnamese Americans saw statistically significant decreases.
  
• The share of NHPI homeowners with mortgages who were burdened with housing cost (spending 30% or more of household income on housing) increased from 35% to 45% between 2019 to 2021.
  
• Asian Americans in California report relying mostly on friends or family members for assistance in accessing quality or affordable housing, with government agencies a distant second.
  
• About 2 in 5 Asian American respondents indicated that they had difficulty finding quality or affordable education, with financial cost as the most common reason across groups.
  

"AAPI Data's report, Impact of COVID-19 on Access to Health, Mental Health, and Social Services for Asian Americans, Native Hawaiians, and Pacific Islanders shines a bright light on the alarming health disparities of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) communities and point to the social determinants of health and mental health that we, California, must collectively and immediately address," said Nkauj Iab Yang, director of the California Commission on Asian and Pacific Islander American Affairs.

"Now, more than ever, we must work together to change state policies and programs to meet the needs of the AANHPI communities. This is life or death, and we cannot afford any more lives taken prematurely in order to take action."

EDITOR'S NOTE: For additional commentary, news and views from an AANHPI perspective, follow @DioknoEd on Twitter.