By: Ruby Liu
The Asian population in the United States increased tremendously in the last few decades. For example, the Asian population grew from 10.2 million to 14.7 million between 2000 and 2010. Moreover, about two-thirds of the Asian populations are foreign born, which consists primarily Chinese, Indian, Vietnamese, Philippines, and Korean immigrants. In general, these Asian immigrants are far less likely to have health insurance or use health care services than the U.S. born Asian-Americans. For the limited number of Asian immigrants who have access to health care services, the quality of health care service received is usually poorer.
One study has identified four different barriers that prevented Asian immigrants from fully accessing the U.S. health care system:
(1) Linguistic discordance between providers and patients. The immigrant’s limited English proficiency plays a major role in the quality of health care services received by the immigrants. Communication between the patient and physician is key to satisfactory medical diagnosis and treatment. Miscommunication can substantially increase the rate of incorrect diagnosis and inappropriate treatment. Many Asian immigrants are discouraged to visit doctors due to their language barrier. Some medical facilities may provide professional interpreting services; however, such facilities are rare and most patients are not able to afford the interpreting services. Furthermore, the quality of interpretation is also vital. Many immigrants rely on their family members, who usually lack the ability to understand the highly technical medical terminologies.
(2) Health-related beliefs and cultural incompetency of health systems. Some Asian immigrants hold certain health-related cultural beliefs that are perceived as being questionable by Western doctors. For example, many Asian immigrants believe in traditional oriental techniques such as acupuncture, cupping, coin rubbing, etc., which focus on restoring the balance and natural energy in the body as opposed to simply treating and relieving the temporary symptoms. These techniques often leave rashes, bruises or other marks on the patient’s skin, which can easily be diagnosed as skin infections or physical abuse by a Western-trained doctor. Also, many Asian immigrants prefer herbal treatment. However, some widely accepted herbs can sometimes have interactions with medicine prescribed by a Western doctor. It’s very challenging for an U.S. doctor to prescribe medications without knowing the full effects of the herbs used by their patients.
(3) Issues related to accessing health services. Asian immigrants’ legal status significantly limits their willingness and eligibility to participate health care services. For example, immigrants are not eligible for Medicaid unless they have been “lawful permanent residents” for at least five years. In other words, those immigrants who have a valid work visa but have not yet obtained a green card are ineligible for Medicaid. Also, undocumented immigrants are generally very hesitant about accessing the health care system due to their fear of being reported to the immigration authorities and being deported back to their home country. Some states are now considering of passing a law which mandates the health care providers to report any undocumented immigrants to government authorities.
(4) Discrimination in the health care system. Unfortunately, Asian-Americans continue to suffer discrimination in different areas including housing, employment, as well as health care. Asian immigrants are particularly disadvantaged due to their language ability and perceived legal status. Multiple studies have found that poorer English proficiency were positively associated with the experience of health care discrimination among a diverse group of Asians, and that Asian immigrants are more likely to perceive discrimination in health care settings than non-Hispanic Whites. Other studies have found that racial minorities are less likely to receive beneficial treatment and more likely to receive drastic or debilitating treatment. Consequently, this may lead to the Asian immigrants’ mistrust of the U.S. medical system.
Future advocates for health care should take into consideration all of these factors and increase the Asian immigrants’ access to the U.S health care system.
Juliana Clough, Sunmin Lee & David H. Chae, Barriers to Health Care Among Asian Immigrants in the United States: A Traditional Review, 24(1) J. Health Care for Poor and Underserved 384 (2013)