Kohli: Addressing the unique health care needs of our AAPI communities

All too often our Asian-American and Pacific Islander (AAPI) communities are seen and described as a monolith. However, our AAPI neighbors, who comprise more than one-third of Santa Clara County’s population, embody a vast array of nationalities and languages that span roughly half the globe.

Their diversity in history, culture and lifestyle means AAPI communities also experience unique health care challenges. As we look ahead to serving the health care needs of these growing communities, it’s incumbent on us to understand the health issues they face. And though these communities share certain health challenges, such as an increased risk for cancer, heart disease and diabetes, taking a closer look at individual subgroups reveals a much more complex set of needs.

Thanks to an effort spearheaded by Supervisor Joe Simitian, Santa Clara County in 2017 commissioned a comprehensive health assessment of our various AAPI communities. From this assessment, we learned that: 1) Every one of these communities does indeed face significant barriers to accessing health care, and that 2) the challenges and needs vary from one community to the next.

Vietnamese Americans, for example, experience the highest rates of liver cancer, while Filipino Americans experience the highest premature birth rates. Asian Indian women have the highest age-adjusted breast cancer rates, while Japanese Americans are the highest proportion diagnosed with high blood pressure and high cholesterol.

The COVID-19 pandemic has further exposed health care inequalities faced by our AAPI communities and has highlighted a serious need to address these concerns. Add to that the rise in hate crimes and prejudicial acts of violence against our Asian-American residents and the need to act quickly takes on greater urgency.

In response to these challenges, Asian Americans for Community Involvement formed a partnership with the county to pilot the API Community Health Worker program, with the goal of training members of these communities to provide health education, wellness and referral services that specifically address each community’s unique health care needs. We envision a program where community health workers connect people to physicians who speak their language, or to exercise and nutrition classes taught by someone from their community.

That’s why Supervisor Simitian has also pushed for the API Community Health Worker program at the county. As he says, “First we had to figure out who had what needs in our diverse community. Now we’ve got to address them.”

This strategy has proven to be successful in the past, but we need the federal government’s support to fully expand the program to all our AAPI communities. We have asked for $1 million in funding over two years for the expansion of the API Community Health Worker program. In July 2021, Rep. Ro Khanna was successful in securing the inclusion of our funding request in a federal spending bill passed by the House of Representatives. We’re optimistic about the bill’s prospects in the Senate in the coming months.

Congressman Khanna said it well: “We’ve all seen how the pandemic has deepened existing inequalities in our health care system and fueled anti-Asian racism and xenophobia. One way to help confront these disparities and prejudices is to ensure that health providers have cultural knowledge of the populations they serve.”

Although this program relies on grassroots networks embedded in our neighborhoods, it also represents a concerted effort between community-based organizations, the county and our congressional representatives. We are encouraged by this commitment and hopeful that with county backing and the federal government’s support, we can continue to improve the health, wellness and resilience of Santa Clara County’s diverse communities as we emerge from the pandemic.

Sarita Kohli is the president and CEO of Asian Americans for Community Involvement.