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Abstract: Background. The relatively new Chinatown of Brooklyn is medically underserved. A pilot assessment of the health needs of this community was conducted using Rapid Participatory Appraisal. Methods. In-depth interviews with health professionals and community members plus searches of national, state, and local electronic health databases were conducted taking into account multiple determinants of health. Results. Community organization, sociological factors, services, and policy were all partly responsible for unmet health needs, including the lack of an overall community structure related to health. Health concerns of all kinds were exacerbated by poverty, language barriers, immigration status, culture, and the need for acculturation. Significant health assets were present but were not adequate to address needs. Discussion. While each health concern had its own unique identifiable causes, the interaction of these concerns and the limitations of assets at all levels make solutions difficult.
Key words: Asian Americans, needs assessment, community-based participatory research (CBPR), multiple determinants of health, community health planning.
Within the Chinese population of the United States as well as between Chinese and other ethnic and racial groups, health disparities1 between groups distinguished in terms of income, immigration status, social class, disability,2 and place of birth3 have been documented. Poverty,4-9 limited English skills,3,4,6,7,10,11 lack of insurance, 7,12,13 cultural differences,4,5,7,13 and citizenship status are significant barriers to access and use of health services.12 Access to health care (including mental health services) is diminished for Chinese in the U.S.,4-8,12-14 although clear physical,6,9,15 mental,4-8,13,14 and social7,5,11,13 health needs exist.
A Chinatown began to grow in southwest Brooklyn about 25 years ago in the Sunset Park neighborhood. According to census data from 2000, Brooklyn's Chinatown is home to 34% of Chinese Americans in New York City,16 with a central section about one mile long by four to five blocks wide. The Chinatowns in Manhattan and Queens are older than Brooklyn's Chinatown, and the residents of those older Chinatowns generally originated in different regions of China. Chinese began moving to Brooklyn from the Manhattan Chinatown because Sunset Park was less crowded, provided easy access to public transportation, and presented a lower cost of living. Originally, many Brooklyn Chinese commuted to work in the Manhattan Chinatown, but as the Brooklyn Chinatown began to flourish, more residents started working there. Garment factories in...