Asian/Pacific Heritage Occupational Therapy Association

By Jyothi Gupta

Mission

The mission of the organization is to create a venue for occupational therapy practitioners who are committed to supporting Asian/Pacific practitioners and advancing a greater understanding of Asian/Pacific cultural issues affecting occupational therapy practice.

Contact: Jyothi Gupta, PhD, OTR/L, FAOTA; jgupta@stkate.edu

Key Facts on Asian Americans and Pacific Islanders (AAPI)

Asian Americans and Pacific Islanders (AAPI) are not a homogeneous group. They are diverse ethnic groups originating from approximately 28 different Asian countries from the Far East, Southeast Asia, and the Indian subcontinent; Pacific Islanders hail from 19 Pacific Island nations. AAPIs make up one of the fastest growing racial groups in the U.S and about a third of the one million legal immigrants who enter the U.S. annually. Nearly two thirds of AAPIs who reside in the U.S. are foreign-born.

• Demographics

Today there are 12 million AAPIs living in the U.S who represent 5% of the total population of the country. The distribution is as follows:

• Large group, more than 3 million each: Chinese (not including Taiwanese), Asian Indian, Filipino
• Mid-size group, between 1 and 2 million each: Vietnamese, Korean, Japanese
• Small group, less than 1 million each: Other Asian not specified, Pakistani, Cambodian, Thai, Laotian, Hmong, Taiwanese, Bangladeshi
• Very small group, below100,000 each: Burmese, Indonesian, Nepalese, Sri Lankan, Malaysian, Bhutanese, Mongolian, Okinawan, Singaporean
• Largest in numbers are Chinese and Asian Indians, and the smallest groups under 50,000 are Sri Lankan, Malaysian, Bhutanese, Mongolian, Okinawan. Singaporean is the smallest, at only 5,347.

v For a visual representation of demographics of AAPI in the U.S., click here.

• Languages

There are many different countries represented in this group, and each has its own dominant languages and many dialects. For instance, the subcontinent of India has 22 major languages written in 13 different scripts, with more than 720 dialects. The official Indian languages are Hindi (with approximately 420 million speakers) and English, which is also widely spoken. China has 8 major dialect groups and the official language that is spoken in Beijing is a form of Mandarin.

• Nearly one out of four AAPI students is Limited English Proficient and/or lives in a linguistically isolated household where parents have limited English proficiency.
• AAPIs who are not proficient in English may not communicate effectively with health care providers.

However because Asian Americans as a group are well educated, most do not experience language difficulties in the context of health care.

Education & Employment

• The Model Minority Myth: The danger of the model minority myth stereotype is that it assumes that all Asian Americans enjoy a high socioeconomic status, and are well educated and successfully integrated.
  • In 2013, the official poverty rate for the country was 14.5%, with 45.3 million Americans living in poverty. A comparison of Census Poverty data from 2013 revealed the following:

• The high school dropout rate among Southeast Asian Americans is staggering: 40% of Hmong, 38% of Laotian, and 35% of Cambodian populations do not complete high school. Only 14% of Native Hawaiians and Pacific Islanders 25 years of age and older have at least a bachelor’s degree, compared with 27% for the total population, and 49% of the Asian American population.
• Many Asian Americans have achieved the American Dream of earning a good education and having financial stability.
  • Asian Americans represent the largest numbers in the nation with a bachelor’s degree or more (49%) compared with the general U.S. population (28%), Whites (31%), Blacks (18%), and Hispanics (13%).
  • Asian Americans are the highest-income, best-educated, and fastest-growing racial group in the United States (Pew Research Center, 2013).
  • Median household income differs greatly by Asian group. For example, Asian Indian median income in 2012 was $96,782; for Bangladeshi, it was $44,293. Overall, Asian American median income is $66,000 compared with the income of the general population ($49,000) and Whites ($54,000).

Religious Affiliation

According to the Pew Research Center survey on Asian Americans:  

• Overall, 39% of Asian Americans say religion is very important in their lives, compared with 58% of the U.S. general public.
• In total, 26% of Asian Americans are unaffiliated, 22% are Protestant, 19% are Catholic, 14% are Buddhist, 10% are Hindu, 4% are Muslim, and 1% are Sikh. The breakdown is as follows:
  • About half of Chinese are unaffiliated
  • Most Filipinos are Catholic
  • About half of Indians are Hindu
  • Most Koreans are Protestant
  • Vietnamese are largely Buddhists
  • Among Japanese Americans, no single group is dominant—38% are Christian, 32% are unaffiliated, and 25% are Buddhist

General Cultural Attributes

Asian Americans trace their roots from many countries in the Far East, Southeast Asia, and the Indian subcontinent. Each country has its own unique history, culture, language, religious beliefs, economic and demographic traits, social and political values, and reasons for its citizens to come to America.

Despite the diversity, Asian Americans have some distinctive traits as a whole when compared with the U.S. general population:

• Collectivist attitude: Strong emphasis on family—Some of the most important things in life for Asian Americans are related to family:
  • More than half (54%) value a successful marriage
  • They are more likely than all American adults to be married (59% vs. 51%)
  • Children are less likely to have an unmarried mother (16% vs. 41% of general population)
  • Children are more likely to be raised in a household with two married parents (80% vs. 63%)
  • Two-thirds (67%) value parenting
  • Many have multi-generational households (28%)
  • Respect for parents—two-thirds say parents should have a lot or some influence in choosing one’s profession (66%) and spouse (61%)
  • Great value placed on harmony: More collectivist in beliefs and hence even with acculturation, most Asians place high value on family, which includes extended family.
  • Conformity to norms and social expectations is valued.
  • Work ethic: 93% describe people of their home countries living in the U.S. as hard working.
    • Parenting: Asian-American parents tend to put pressure on their children to do well in school. Education is seen as a means of improving social standing.
    • Check out Battle Hymn of the Tiger Mother, a comic memoir about strict parenting by Yale Law Professor Amy Chua that triggered a spirited national debate about cultural differences in parenting norms.

For more information see: Pew Research Center: The Rise of the Asian Americans

Health & Health Care

• Leading causes of death:
  • Cancer is the leading cause of death for AAPIs. Cervical cancer incidence rates are among the highest in the U.S. for Laotian, Samoan, Vietnamese, and Cambodian women.
  • Heart disease, stroke, and diabetes also rank high.
  • Hepatitis B chronically infects about 1.3–1.5 million people in the U.S., and AAPIs account for over half of the chronic hepatitis B cases and deaths.
  • In Hawaii, Asians, Native Hawaiians, and other Pacific Islanders age 20 years or older are more than two times as likely to have diagnosed diabetes as White residents of Hawaii of similar age.
  • Mental health problems in the Asian American community are disturbingly high, yet the services are inadequate.
    • Asian women aged 65 years and over have the highest suicide rate in the country compared with any other population in that age group. 
    • Asian American adolescent girls have the highest rates of depressive symptoms compared with girls of other ethnicities.
    • Southeast Asian refugees are at risk of post-traumatic stress disorder (PTSD) associated with trauma experienced before and after immigration to the United States.
    • Health care barriers:
      • Asian Americans with limited English proficiency have difficulties understanding the U.S. health care system, accessing health care services, and communicating with health care providers.
      • Many Asian Americans believe that their physicians do not understand their culture and values.
      • Varying cultural values and beliefs of disease sometimes put constraints on an individual from seeking proper care. Use of traditional medicine delays accessing health care and contributes to the diagnosis of diseases in the later stages, leading to untreatable conditions.

For more information: Centers for Disease Control: Asian Americans

National Library of Medicine: Asian American Health & Materials in Asian Languages

Education modules from Stanford University on Elder care

Health and Health Care for CHINESE-AMERICAN ELDERS

Health and Health Care for KOREAN-AMERICAN ELDERS

Health and Health Care for Filipino Elders

Health and Health Care for Asian Indian Elders

National Asian Pacific American Families Against Substance Abuse: Founded in 1988, NAPAFASA involves service providers, families, and youth in efforts to reach API communities to promote health and social justice and to reduce substance abuse and related problems.

Asian & Pacific Islander American Health Forum (APIAHF): Policy and Advocacy

The Association of Asian Pacific Community Health Organizations

National AAPI Mental Health Association convenes service providers, evaluators, and youth to identify best practice for AAPI groups.

Scholarly Journals

Journal of Asian American Studies (JAAS): Original scholarly articles about the multidimensional experiences of Asian Americans and Asians.

Journal of Immigrant and Minority Health: Peer-reviewed original research pertaining to immigrant health.

Asian American Journal of Psychology: Dedicated to research, practice, advocacy, education, and policy within Asian American psychology.

Journal of Transcultural Nursing: Peer-reviewed journal that offers theoretical approaches and current research findings that have direct implications for the delivery of culturally congruent health care and the preparation of health care professionals who will provide that care.

Medical Care: Original, peer-reviewed papers documenting the most current developments in the rapidly changing field of health care.