Testimony for the CAPAC Forum on the White House Commission on Asian Americans and Pacific Islanders
January 13, 2004
Submitted by: Gem P. Daus, MA
Director of Policy
Asian and Pacific Islander American Health Forum
Thank you Representative Honda for inviting me to testify today.
The Asian and Pacific Islander American Health Forum (APIAHF) is a national advocacy organization founded in 1986. Our mission is to enable all Asian Americans and Pacific Islanders (AAPI) to attain the highest possible level of health and well being. To this end, we work very closely with the Department of Health and Human Services (HHS) and with community-based organizations around the country and in the U.S. Pacific territories.
We have been involved with the White House Initiative on AAPI since before the first executive order was issued in 1999. The initiative started in HHS. APIAHF, along with other national AAPI organizations worked with the agency to build an infrastructure that would prioritize the health needs of AAPI. APIAHF has stayed involved since, helping the agency develop an Action Agenda for AAPI Heath, providing input into their strategic plans, and drafting the recommendations of the first slate of commissioners.
Like many of the organizations testifying today, APIAHF is concerned about the intended move of the Initiative to the Department of Commerce. HHS is an appropriate home for the Initiative because of the two primary barriers to access and participation for AAPI — language and cultural incompetence. HHS, more than any other agency, has taken steps to mitigate these barriers. In 2001, HHS issued standards for Culturally and Linguistically Appropriate Services (CLAS). DHHS led the way in implementing the 1964 Civil Rights Act so that those who are limited English proficient (LEP) have meaningful access to government programs. Finally, the HHS Data Council and the National Committee on Vital Health Statistics have taken steps to improve the quality of data that is crucial in understanding our health.
As a government-wide initiative, HHS has led by example. Through HHS, the White House Initiative has been able to accomplish the comprehensive tracking of government programs to ensure that the needs of underserved and underrepresented AAPIs are recognized. A move to the Department of Commerce, or any other agency, risks the infrastructure, leadership and progress that the Initiative has made at HHS.
For example, we understand the commission's report on AAPI health has been in clearance for four months and the staff has been reassigned to other departments within the Department of Health and Human Services (HHS). While we commend the commission for prioritizing health, we at the Health Forum are interested in making sure that the recommendations made will, as Commissioner Carlotta said, be implemented and sustained . It is time to move beyond recommending that we need culturally competent programs, and start designing those programs, evaluating them, disseminating them. However, without staff and leadership, the value added by having a Presidential commission is lost and the recommendations have no staying power.
Now is not the time to lose momentum in the effort to address disparities in health in AAPI communities. An analysis of government funding for AAPI-specific health projects revealed that less than 2% of 1% of government grants (grants, not funds) from 1997 to 2000 were for AAPI specific projects. Furthermore, this study, published in the American Journal of Public Health, revealed that out of millions of citations in the medical literature database MEDLINE, fewer than 400 had data relevant to the health of AAPIs in the US. Clearly, we have a long way to go to make the commission's recommendations live.
A new report released by the Agency for Healthcare Research and Quality highlights the continuing lack of data and research on AAPI populations. The report states that there is much to learn and, more importantly, it states the belief that greater improvement is possible. The APIAHF believes in that possibility and expects the White House Initiative of AAPIs to do its part in improving the health and well-being of Asian Americans and Pacific Islanders.
Thank you.
[ The following comments were added at the forum after a draft copy of the health report was released. ]
In relation to the report that we received this morning, I want to commend the Commissioners for releasing the report and look forward to reading the final cleared version of the report.
In May 2003, I testified before this commission and made three recommendations. They were:
1) To be specific,
2) To be human, and
3) To be proud.
Having read that version in comparison to this version, I want to commend you for including more specific examples of the health disparities and making specific recommendations to address them.
In terms of my second recommendation — to be human — I want to commend you for citing some of the people you actually met in your townhall meetings around the country.
In terms of my third recommendation — to be proud — I want to commend you for being proud enough to mention the successes you found in your travels around the country.
Finally, I want to commend you also because the recommendations are pretty much in line with a lot of work that has gone on before. I recently reviewed the proceedings of the first Asian American Health Forum held in NYC in August 1986. I can tell you that we have made these recommendations before. We have acted and implemented and adjusted them as time has passed — in 1988, 1990, 1994, 1997, 2001 and we will again in May 2004 when we meet in Washington, DC.
I mention these past efforts to point out that what we also strive for is not just to make these recommendations, but also to make sure that they live. And in order to live, it is not just the community and not just individuals that have responsibility, but also the federal government.
However, in many of your recommendations, while we agree with them, the actors that you name are nongovernmental. I would submit that it is not the mission of this commission to name the responsibilities of community-based organizations or individuals, but to really look at the government and decide what actions the government can take to ameliorate the health conditions that plague our communities. This is where you can have the most impact.
Thank you.
