- Introduction:Shining the Light on Asian American, Native Hawaiian, and Pacific Islander Health
The United States’s diverse Asian American and Native Hawaiian and Pacific Islander (AA and NHPI) populations have grown faster than those of any other racial/ethnic group over the past three decades.*1,2 Out of the shadows and into the light, the health and health care issues faced by our AA and NHPI communities across the U.S., its territories, and freely associated states matter more and more to the vitality and future of the nation.3
In 2015, we mark the 30th anniversary of the Heckler Report,4 the seminal Report of the Secretary’s Task Force on Black and Minority Health documenting national health inequities by race and ethnicity, which led to the establishment of the Office of Minority Health by Congress in 1986.5 Notably, the report concluded that Asian/Pacific Islanders in aggregrate were healthier than any other racial group in the U.S. In this supplement, Ponce and colleagues† retrace the story of the first national AA and NHPI data initiatives and key milestones for data equity that were established as a direct response to this report, and specifically to dispel the so-called model minority myth, to strengthen AA and NHPI voices, and to advance federal efforts to promote health issues facing AA and NHPI communities. Indeed, the Heckler Report spawned the creation of two of our communties’ national institutions, the Asian & Pacific Islander American Health Forum (APIAHF) and the Association of Asian Pacific Community Health Organizations (AAPCHO).
Over the past 30 years, tremendous strides have been made in documenting and monitoring persistent and increasing health inequities disfavoring AAs and NHPIs and the critical steps needed to address gaps in the evidence base to focus on unequal health [End Page vii] by race, ethnicity, language, and other social determinants.6–11 Ko Chin and Caballero* present a community perspective on the leadership of Assistant Secretary for Health, Dr. Howard Koh, and his work in shepherding new national health equity initiatives, including the Patient Protection and Affordable Care Act of 2010, the reauthorization of the Office of Minority Health (OMH), the creation of the first national U.S. Department of Health and Human Services (HHS) Plan for Asian American, Native Hawaiian, and Pacific Islander Health,12 and the new HHS data standards for race, ethnicity, sex, primary language, and disability status from Section 4302 of the Affordable Care Act (ACA).13,14 In addition, the National Standards for Culturally and Linguistically Appropriate Service in Health and Health Care were updated in 2013 to provide a comprehensive framework of health and health care organizations for the delivery of culturally respectful and linguistically responsive care and services to all.15 We honor the heroes and transformative ideas that have worked to advance AA and NHPI health equity.16
Asian American and NHPI advocates, researchers, and community leaders have also made tremendous strides in building local and regional community coalitions to document health disparities and advance health equity on behalf of our diverse communities over the past decades.17,18 In this supplement, Trinh-Shevrin and colleagues† present the critical need to shift the public health paradigm from a biomedical health framework to a population health equity framework in order to address the relevant health issues facing Asian Americans and other underserved communities of color. Other articles showcase innovative and creative stakeholder coalitions‡§¶ and community-academic partnerships**†† that are being implemented for disease prevention and health promotion in AA and NHPI communities across the continental U.S., Hawaii, and the Pacific Islands. The articles also document the critical roles of communities, environment, historical and political forces for advancing health equity. Health topic areas explored [End Page viii] in this supplement include childhood obesity,*†‡ diabetes and cardiovascular disease,§¶ cancer, and mental health.**
The community-based studies and interventions in this issue underscore the critical need to adapt evidence-based strategies to the community where they are adopted to fit the socio-cultural context of AAs and NHPIs. They also highlight the value of sub-population research. Community-based studies or interventions focused on...