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Abstract: Asian immigrants in the U.S. are far less likely to have health insurance or use health care services than both U.S.-born Asians and non-Hispanic Whites. Furthermore, Asian immigrants who access the U.S. health care system are less likely than non-Hispanic Whites to receive high-quality services. This paper reviews four barriers faced by Asian immigrants to participating in the U.S. health care system fully: (1) linguistic discordance between providers and patients; (2) health-related beliefs and cultural incompetency of health systems; (3) issues related to accessing health services; and (4) discrimination in the health care system. Interventions to improve the health of Asian immigrants must address barriers experienced at multiple levels, including those that occur interpersonally and institutionally, as well as broader societal factors that affect health care access and quality.
Key words: Asian American, immigrant, health care access, health beliefs, discrimination, linguistic barriers.
The Asian population in the U.S. has experienced tremendous growth in recent decades. Between 2000 and 2010 alone, the Asian population grew from 10.2 million to 14.7 million, representing a growth rate of 43%.' Aside from the American Hispanic population, which grew at a similar rate between 2000 and 2010, Asians are the fastest-growing racial/ethnic group in the United States.1 Asian immigrants are also highly diverse, representing almost 50 nationalities, with most immigrants arriv- ing from India, China, Vietnam, the Philippines, and Korea.2 Furthermore, the Asian American population predominantly consists of immigrants, with just over 66% being foreign-born.1-3 At least 30% of each Asian ancestry group living in the U.S. is foreign- born, ranging from 39.7% of Japanese Americans to 84.2% of Malay Americans.3 While a majority of the Asian immigrant population has settled on the West Coast, Asian immigrants of many national ancestries can be found in all 50 U.S. states.2
Asian Americans are often perceived by the general public to be socioeconomi- cally successful, upwardly mobile, and unaffected by crime and dependence on social programs, commonly referred to as the model minority myth.4 While on aggregate, Asians have the highest median household income of any racial/ethnic group, and the percentage living below the federal poverty threshold only narrowly exceeds that of non-Hispanic Whites (12.5% vs. 12.3%),5 these broad observations ignore considerable heterogeneity within the Asian American population. For example,...