The New York City health department released a first-of-its-kind report Friday on the health of Asians and Pacific Islanders in the five boroughs, breaking down data not just by race but also by ancestry and ethnicity where possible.
Speaking in front of the Unisphere in Flushing Meadows-Corona Park Friday afternoon, city Health Commissioner Dr. Dave Chokshi said the report is an effort to recognize the diversity of the API community and to drill down on the ways that different groups are impacted by public health issues and barriers to health care access. With this knowledge, the city and health providers can glean important clues on how to approach these highly individual communities when it comes to lifestyle and medical habits, such as diets, smoking and preventative medicine such as vaccination.
“Today, I'm honored to lead a health department where everything we do is driven by health equity, even more so now that the New York City Board of Health officially has recognized our historic resolution that racism is a public health crisis,” said Chokshi, whose parents immigrated to the U.S. from India. “The results that we found through our research were revealing.”
The broad API category in New York City includes people from at least 48 countries, who speak many different languages and dialects. Chokshi emphasized that “API New Yorkers are not a monolith.”
When it comes to health access and outcomes, the report’s findings back this up. For instance, high blood pressure is less prevalent among API New Yorkers (23%) than the city’s population as a whole (28%). But within these communities, the rates of high blood pressure vary widely, ranging from 15% among Korean New Yorkers to 31% among Indians.
Similarly, only 14% of API adults in the city consume one or more sugary drinks per day, far less than the 23% of New York adult soda lovers overall. But once again, differences begin to emerge when you take a closer look across the API community. Only about 7% of people from Japan and other “underrepresented East Asian” countries are big soda drinkers, compared with 28% of Native Hawaiian and Pacific Islanders.
There is also room for the city health department to learn more about API habits and investigate further. For instance, the report found that nearly one in four API men in the city smoke cigarettes, compared with just 3% of API women, but it did not offer a breakdown by ethnicity. Among the city’s general population, about 15% of adult men smoke, compared with about 9% of adult women.
Language barriers are likely one of the biggest challenges when it comes to health care access for API New Yorkers – 69% of whom were born outside of the U.S. Nearly half of all API New Yorkers are Chinese, and among that group, 61% of households report limited English – that is, a household where no one over the age of five speaks English “very well.” But again, the group is not a monolith. Among Filipino New Yorkers, only about one in five households don’t speak English “very well.”
Asians and Pacific Islanders in the city have also led the way when it comes to vaccination against COVID-19. Currently, 94% of adults in the group are fully vaccinated, compared with 82% of the city’s adults overall. The at-least-one-dose vaccination rate among API adults has reached 99%. Chokshi emphasized that Asian New Yorkers have suffered a particular mental health toll from COVID-19 and that the city aims to do more to address that moving forward.
“Since the outbreak of COVID-19, the xenophobic sentiments and violent attacks against Asians and Pacific Islanders have brought renewed attention to the inequities and trauma experienced by this large group of New Yorkers,” he said.
But some API groups are also lagging behind in other types of preventive health. For instance, only about 37% of Chinese adults have ever been tested for HIV, compared with nearly two-thirds of the city’s overall adult population.
Linh An, executive director of the Chinese-American Family Alliance for Mental Health and a board member of the Charles B. Wang Community Health Center, said she is looking at ways to improve access to mental health care among the population she serves.
“There's just a lack of [mental health] clinicians, especially clinicians that speak a second language and understand the culture,” she said. “We’re trying to think through creative ways to build that [professional] pipeline.”
In the meantime, she said there are other options besides one-on-one therapy. “That also doesn't necessarily work because a lot of our families live in multi-generational households, so you don't have much privacy for tele-psychiatry,” An said.
Instead, she said her organization tries to offer “nonclinical spaces that are therapeutic,” such as support groups and community mental health workshops.
Chokshi said data from the report has already informed the city’s work on issues such as cancer screenings and that the health department aims to work with community groups to address issues it has raised moving forward.
New York City released its first comprehensive report on the health of Latino New Yorkers in 2017 and another on the health of older adults in 2019. “We’ll always have our eye on the groups, whether by race, ethnicity, age, or geographic location, where we need to pay a little bit of extra attention and also call for a spotlight on health inequities or gaps that need to be addressed,” Chokshi said.