Voices from the Community:
Building Community Readiness to Improve
Asian American and Pacific Islander Health
Recommendations from Ethnic and Regional Strategy Sessions
APRIL 27-29, 2001
Action Steps for Conference Participants
Policy and Advocacy
Conduct community trainings on policy, advocacy and working with the government.
Create single sheet of policy recommendations as an advocacy tool.
Utilize current information and resources on “how to do policy and advocacy” and include listing and analysis of current issues that affect Asian Americans and Pacific Islanders.
Educate policy makers to recognize the diversity of Asian American and Pacific Islander communities and to be inclusive of all Asian Americans and Pacific Islanders.
Engage in more regular communication and visits between Asian American and Pacific Islander communities and elected officials; prepare guides for visits and background materials on policy priorities for Asian American and Pacific Islander communities.
Advocate for an “Asian American and Pacific Islander Health Awareness Week” recognized by the White House/Congress.
Meet with Department of Health and Human Services Regional Directors and Regional Offices in Regions V, VII and IX.
Collect testimonies from Limited English Proficient patients about violations of Title VI and denial of equal access to health care.
Create fact sheets about issues of medical interpretation both policymakers and for our communities.
Recruit trained bilingual staff and volunteers to provide transportation, interpretation, and translation services; organize regional language banks of qualified interpreters.
Identify and communicate Asian American and Pacific Islander community research priorities to the federal government.
Get Asian Americans and Pacific Islanders politically involved; link Asian American and Pacific Islander communities to the political process (e.g., civic education, involve elected officials in community events, voter registration, etc.).
Develop campaigns to educate policymakers to address the lack of funding and programs specific to Asian American and Pacific Islander women’ issues.
Include and address sensitive issues with social stigma such as mental health, domestic violence, drug abuse, HIV/AIDS, cancer, etc. in Asian American and Pacific Islander health programs.
Send APIAHF comments and changes to draft fact sheets, especially on issues of HIV/AIDS, sexuality, gender, adolescents, mental health, obesity, adjustment issues for immigrants, and nutrition.
Follow-through on recommendations discussed at strategy sessions through sending letters to policymakers, mobilization of leaders, holding advocates accountable.
Community Outreach and Education
Continue national and local networking to hear from all Asian American and Pacific Islander communities regarding their health issues; improve representation from geographic areas such as Region IX.
Educate the Asian American and Pacific Islander communities about managed care and teach people how to access health care and services under managed care.
Advocate for greater Asian American and Pacific Islander consumer awareness and education on patients’ rights to understand their care and their awareness of health issues.
Inform Asian American and Pacific Islander community members about the proposals for a Patients’ Bill of Rights.
Create more effective media coverage of Asian Americans and Pacific Islanders to educate about critical health issues and health disparities.
Encourage direct funding for educating Asian American and Pacific Islander communities.
Commit to ask more questions about terms and language that need more clarification during meetings and workshops.
Invite and reach out to Asian American and Pacific Islander student and professional organizations at future conferences.
Invite representatives from Asian American and Pacific Islander higher education organizations to future conferences.
Initiate community-level (junior high school level) youth-based programs.
Ethnic Specific Recommendations
Develop a comprehensive definition of “South Asian” and encourage service providers to use and explain the term with their communities.
Build a national coalition for South Asian health issues, strengthen the South Asian voice among the larger Asian American and Pacific Islander communities and identify strategies for maintaining a distinct South Asian voice.
Encourage South Asian community members to participate in the political process and in advocacy efforts at the local, state, and national levels.
Educate others about the Japanese American community because overall good health indicators hide persons in the community with serious health issues, e.g. recognize the profound impact of internment during World War II on physical and mental health and address long-term care needs.
Given the lack of community mobilization and infrastructure in the Korean American community on health issues, participants resolved to work together to develop and strengthen the existing networks of individuals and organizations, create an internet e-mail list, learn from each other, share resources and recruit additional participants.
Conduct a comprehensive national needs assessment of the Cambodian community that includes input from the community in the planning of the assessment as well as assurance that the outcomes will be returned to the Cambodian community in a form that is meaningful to them.
Make commitment to convene regularly as Pacific Islanders and work toward Pacific Islander specific conferences, goals and workplans; Pacific Islanders in the Pacific jurisdictions and on the mainland must commit to continuing the dialogue among each other and to identifying ways to work together.
Develop a committee or coalition to identify and discuss multiracial issues.
RECOMMENDATIONS TO POLICYMAKERS
Access and Quality
Address access to health care for the working poor; address barriers to affordable health insurance for adults.
Develop a simplified and coordinated system of health care for all.
Develop affordable health care for the self-employed and working uninsured and develop outreach and education materials on prevention and the importance of health insurance coverage.
Recognize and address the linguistic/cultural/financial barriers to accessing quality health care.
Address and eliminate health disparities among Asian American and Pacific Islander subgroups.
Consistently think about Asian Americans and Pacific Islanders as a diverse group of people with different cultures, languages and health needs.
Fund culturally appropriate and community-specific programs for Asian Americans and Pacific Islanders; disaggregate funding for specific Asian American and Pacific Islander communities.
Provide funding for reaching and educating Asian American and Pacific Islander communities.
Provide funding for prevention activities to organizations serving specific Southeast Asian populations.
Include Native Hawaiians and Pacific Islanders in federal programs.
The Health Care Financing Administration should ensure reimbursement through Medicaid, the State Children's Health Insurance Program and Medicare for translation and interpretation services.
The Health Care Finance Administration should lower threshold requirements for counties and providers to translate written documents for Limited English Proficient patients and consumers.
The Office of Civil Rights should implement activities to raise awareness about language access and civil rights, including translating the Policy Guidance Services for Limited English Proficient Individuals, a consumer education campaign, a media outreach campaign and trainings for health providers and for community-based organizations.
Provide more local and regional interpreter training programs; conduct outreach to current interpreters to offer training to improve the quality of medical interpreting.
Provide funding and capacity-building support for health interpreter organizations such as the Massachusetts Medical Interpreters Association and the California Health Interpreters Association.
The Department of Health and Human Services should provide funding for interpretation and translation training centers, e.g., in the Midwest.
Establish a standard for written translations (e.g. qualified translators, appropriate literacy and educational level, verification and back-translation, etc.).
Establish a centralized or national resource clearinghouse, including written, audio and audiovisual health resources in Asian and Pacific Islander languages; use the internet to increase access to such a clearinghouse.
Develop multilingual resource materials and curriculum on diverse health topics for Asian American and Pacific Islander communities.
Develop legislative standards for cultural competence.
Ensure that guidelines for cultural competency are adopted and implemented at the institutional level by all providers serving the Asian American and Pacific Islander communities, include staff training and outcome evaluation measures.
Data and Research
The Office of Management and Budget standards need enforcement and accountability.
Increase funding for data collection and database management by providers and government health departments.
The Center for Minority Health and Health Disparities at the National Institutes of Health should:
emphasize research in the Asian American and Pacific Islander communities;
use Asian Americans and Pacific Islanders as principal investigators in these studies, or at the very least, establish and utilize Asian American and Pacific Islander community advisory boards;
create priorities for funding regarding different racial and ethnic groups;
conduct and distribute subgroup analyses of health data.
Improve health data collected, analyzed and disseminated about Asian Americans and Pacific Islanders, including data and information about health-seeking behaviors and cultural facilitators to health promotion and disease prevention.
All federal programs and services should address the distinct needs of Asian American and Pacific Islander subpopulations, including the collection of baseline data and information and the conducting of community needs assessments (e.g., for underrepresented and underserved populations such as Southeast Asians, Hmong in the Midwest, Pacific Islanders, South Asians, etc.).
Collect data about specific populations and subgroups by geographic region, generations, gender, etc.
Data about Asian Americans and Pacific Islanders needs to be disaggregated.
Assess the impact of disaggregated data on Pacific Islanders and on Asian Americans; create data specific to the jurisdictions where health issues are concerned.
Use community input to develop culturally competent methods of data gathering.
Redefine “South Asian” in data collection efforts; require disaggregation by South Asian ethnic groups.
Collect more baseline data about the Hmong, especially in the Midwest and California.
Develop data on health disparities for Korean Americans and develop culturally and linguistically appropriate education materials to increase awareness in the community.
Collect data on the Vietnamese community and share the data with the community.
Recognize “locals” in Hawai’i in addition to racial/ethnic identification; ensure data collection, research and analysis by local researchers.
Continue to collect data on persons who identify as multiracial; more funding for research is needed for determining the prevalence of diseases among multiracial populations.
Include data about multiracial individuals in national directories, registries and surveillance systems (e.g., cancer, bone marrow donors, organ donors, HIV/AIDS, etc.)
As a policy, support local community-based initiatives that are priorities for Asian Americans and Pacific Islanders even where there may not be national data or applicability.
Allow more flexibility in and support the development of research methods that are more culturally appropriate for Asian American and Pacific Islander communities.
Provide skillsbuilding, technical assistance and training in research methods and grant writing.
Collaboration with Asian American and Pacific Islander Communities
Support community prevention services that engage community residents in taking more active roles in planning, implementation, evaluation and advocacy.
Government representatives should report specific results and next steps with clear timelines and workplans after gathering information from the Asian American and Pacific Islander communities.
Increase cultural competency of policymakers about Asian American and Pacific Islander communities and priority health issues.
Convene local forums with local policymakers and Asian American and Pacific Islander communities.
Conduct collaborative sessions and dialogues among Asian American and Pacific Islander communities.
Include representation and participation from underrepresented geographic regions at national and regional health conferences.
The federal government needs to involve and develop communications with spiritual leaders in the Pacific Islander communities.
Ask the Health Care Financing Administration to meet with APIAHF and community advocates to discuss how to ensure equal access to health care for Limited English Proficient patients and consumers.
Return land to Native Hawaiians.
Asian American and Pacific Islander Community Capacity-Building
Strengthen and develop Asian American and Pacific Islander community capacities, for example, by providing mini-grants to help develop skills and professional development.
Provide increased resources for capacity building in Asian American and Pacific Islander communities.
Centralize and pool together capacity-building resources for Asian Americans and Pacific Islanders.
Create a resource listing on a website to inform people of funding and grant opportunities.
Develop and distribute a listing or directory of culturally appropriate materials, resources and community-based providers for Asian Americans and Pacific Islanders.
Develop materials on multiracial populations (demographics, income, education, health issues, etc.).
Be mindful and inclusive of needs of special populations (e.g. non-U.S. affiliated Pacific Islanders, Pacific Islanders living in continental U.S., small populations with high incidence of specific diseases, etc.) when distributing funding for capacity building.
Recognize the need for larger grants to provide services to underrepresented populations because it takes more resources for outreach.
Recognize that programs cost more when implemented for more than one Asian American and Pacific Islander population, especially with different language needs.
Federal agencies should increase resources for capacity-building to increase collaboration between Pacific Islanders on the mainland and those in the Pacific Island jurisdictions.
The federal government should make training available to clarify the meaning of capacity-building and how it can be effectively utilized by Pacific Island communities.
Asian American and Pacific Islander organizations that are federally funded should report how Pacific Islanders specifically are served and provide data when requested.
Increase loan repayment and stipend programs for physicians who work at Federal Qualified Health Centers to promote immigrant and indigent care.
Advocate for professional development of health care professionals serving Asian Americans and Pacific Islanders.
Increase federal grants to minority students, including underrepresented Asian Americans and Pacific Islanders, in medical schools.
Fund fellowships that place youth in community-based organizations.
Provide funding to recruit health professionals and future policymakers from the Cambodian community, including youth.
Identify and recruit more multiracial mentors in health and policy advocacy.
Set aside specific funding (e.g. 25%) for young people.
Fund projects that address the gaps between youth and elderly.
Work to make academic institutions more inclusive; admit more Asian Americans and Pacific Islanders into institutions of higher education.
Colleges and universities should allocate more funding for Asian American and Pacific Islander student and cultural groups.
Scholarship and leadership development programs need to target and outreach to Asian American and Pacific Islander students.
RECOMMENDATIONS ON THE WHITE HOUSE INITIATIVE ON ASIAN AMERICANS AND PACIFIC ISLANDERS
Continue to publicize the Interim Report and the White House Initiative on Asian Americans and Pacific Islanders through national and local Asian and Pacific Islander Heritage Month (May) events.
Print and disseminate more copies of the Interim Report of the President's Advisory Commission on Asian Americans and Pacific Islanders.
Translate the Interim Report into Asian and Pacific Islander languages; make the report more accessible at a lower literacy level; break the report into focused, translated fact sheets.
Conduct rollout activities to educate the Asian American and Pacific Islander communities about the Interim Report; make trainings available on how to utilize the Interim Report.
Implement a marketing program in the ethnic media to announce the availability of the Interim Report.
Facilitate local community convenings to get further input and fill gaps in the Interim Report.
Maintain working relationships and dialogue with high-ranking officials in participating Federal departments and agencies; obtain formal responses to recommendations in the Interim Report and updates on implementation of their Fiscal Year 2001 plans.
DHHS Regional Offices should identify and convene designated staff who are responsible for the implementation of the White House Initiative and responding to the recommendations in the Interim Report to work with local Asian American and Pacific Islander communities to achieve the goals of the White House Initiative.
Institutionalize implementation of recommendations in Interim Report.
Disaggregate data in the department and agency inventories in the Interim Report.
Establish, fund and sustain local linkages with Asian American and Pacific Islander communities.
Conduct Town Hall meetings in the Midwest, Hawai'i and the Pacific.
Encourage political leaders, especially the President's Advisory Commission on Asian Americans and Pacific Islanders, to reach out to Asian American and Pacific Islander communities at large, not just identified community leaders.
Support similar initiatives and activities to improve the quality of life for Asian Americans and Pacific Islanders and increase their participation where they are underrepresented at the state and local levels.
Fill the Executive Director position at the White House Initiative on Asian Americans and Pacific Islanders as soon as possible.
Fill any future vacancies in the President's Advisory Commission on Asian Americans and Pacific Islanders as soon as possible.
Increase representation of Asian Americans and Pacific Islanders at every level of the federal government
APIAHF thanks all the conference participants, session facilitators and notetakers for contributing to these recommendations.
