Towards an Asian American, Native Hawaiian and Pacific Islander Health Agenda

Transcription

1 Towards an Asian American, Native Hawaiian and Pacific Islander Health Agenda Deeana Jang, JD Policy Director Asian & Pacific Islander American Health Forum Presentation for AAPCHO Conference March 10, 2008 Washington, DC 1

2 Overview Expansion of Health Care Coverage Language Access Improving Data on AA and NHPI Health 2

3 Access to Health Care Insurance coverage Immigrant status 3

4 Figure 2 Health Insurance Coverage of Nonelderly Asian Americans, Native Hawaiians and Pacific Islanders vs. Non-Hispanic Whites, Employer Other Private Medicaid or Other Public Uninsured White, Non- Hispanic 69% 7% 12% 12% Asian American 65% 8% 11% 17% Native Hawaiian and Pacific Islander 58% 4% 14% 24% DATA: March Current population Survey, 2004, 2005 and 2006, three-year pooled data. SOURCE: KFF and Urban Institute estimates 4

5 Figure 4 Health Coverage of Nonelderly Asian Americans, Native Hawaiians and Pacific Islanders, Employer Other Private Medicaid or Other Public Uninsured Korean 49% 12% 8% 31% Vietnamese 56% 6% 17% 21% Southeast Asian 57% 7% 19% 17% Native Hawaiian & Pacific Islander 58% 4% 14% 24% South Asian 58% 4% 18% 20% Chinese 62% 10% 11% 16% Asian Other 63% 8% 11% 19% ALL ASIANS 65% 8% 11% 17% Filipino 72% 4% 10% 14% Japanese 72% 11% 6% 12% 3rd Plus Generation 73% 7% 10% 11% Asian Indian 77% 7% 4% 12% NOTE: 3 rd Plus Generation includes Individuals who reported their and their parents country of birth as the US. DATA: March Current population Survey, 2004, 2005 and 2006, three-year pooled data. SOURCE: KFF and Urban Institute estimates 5

6 Figure 5 Percent of Nonelderly Adults with No Usual Source of Care by Health Insurance Status, Asian and Pacific Islander vs. White Non-Hispanic % Insured 52% 54% Uninsured 46% 49% 55% 9% 11% 11% 7% 13% 11% Non- Hispanic White All Asian and Pacific Islander Chinese Filipino Asian Indian NHPI and Other Asian* DATA: National Health Interview Survey, 2004, 2005 and 2006, three-year pooled data. SOURCE: KFF and Urban Institute estimates 6

7 Figure 2 Fair and Poor Health Status Among Asian American, Native Hawaiian and Pacific Islander Adults, % 15% 13% 12% 11% 11% 11% 10% 9% 9% 8% Vietnamese Southeast Asian Korean Asian Other All Asians Filipino Native Hawaiian and Pacific Islander Chinese Asian Indian 3rd Plus Generation NOTE: 3 rd Plus Generation includes Individuals who reported their and their parents country of birth as the US. Estimate for Other South Asian not stable. All Asians includes only those individuals who self-identified as Asian. DATA: March Current population Survey, 2004, 2005 and 2006, three-year pooled data. SOURCE: KFF and Urban Institute estimates Japanese 7

8 Limited English Proficiency More than a third of the Asian American population speaks English less than very well; A majority of six Asian American subgroups are LEP: Vietnamese (61%), Hmong (58%), Cambodian (53%), Laotian (52%), Bangladeshi (52%) and Taiwanese (51%); and More than one out of three Koreans, Chinese, Thai, Indonesians, and Malaysians speak English less than very well. 8

9 Language access issues Enforcement of civil rights laws Resources to pay for interpreters Interpreter certification Supply of qualified interpreters for AA and NHPI languages Supply of bilingual health professionals 9

10 Citizenship Status, % 8% 9% 10% 4% 13% 19% 33% 63% Non-Citizen 12+ yrs Non-Citizen 6-11 yrs Non-Citizen <6 yrs Naturalized Citizen Native Citizen 36% Asian Native Hawaiian/Pacific Islander 10

11 Nonelderly Health Coverage by Citizenship Status, Employer Other Private Medicaid or Other Public Uninsured 15% 17% 6% 42% 45% 49% 63% 13% 12% 4% 4% 12% 5% 41% 39% 34% US Citizen Non-Citizen 12+ yrs Non-Citizen 6-11 yrs Non-Citizen <6 yrs 11

12 Immigrant status issues Legal Immigrant Children s Health Improvement Act Citizenship Documentation Undocumented Pacific Islanders 12

13 Lack of data Data is not collected Data statistically unreliable Data not analyzed due to small sample size 13

14 Data Policy Recommendations Collect data minimally disaggregated by 1997 OMB revised standard, also include data on primary language spoken Surveys need translation into languages spoken by AA and NHPI Methods need to be developed to address sample size issues, e.g. oversampling, pooling, bridging datasets Support increased appropriations for the National Center for Health Statistics 14

15 Health Disparities legislation Health Equity and Accountability Act of 2007, H.R Minority Health Improvement and Health Disparity Elimination Act, S. 1576/H.R

16 Other opportunities National and state health care reform efforts Disease specific Appropriations including increased funding for community health centers and for new health centers in areas with significant AA and NHPI populations Administrative opportunities 16

17 Questions? Deeana Jang, Policy Director Asian & Pacific Islander American Health Forum 1828 L Street, NW, Suite 802 Washington, DC , x223 djang@apiahf.org 17