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Connective Issues: A UMass Chan diversity and inclusion blog

Understanding the need for equity and inclusion in medicine for Asian American and Pacific Islander communities

Tuesday, May 03, 2022
By:  Janjay Innis

In 1979, Congress declared Asian American and Pacific Islander Heritage Week in May and 11 years later expanded it to a month-long celebration. Like other months that uplift ethnic groups and their rich cultural heritage, this month celebrates the ways Asian Americans and Pacific Islanders have enriched the fabric of the United States.   


Celebrations, however, are incomplete without reflection and as we embark onthis year’s celebration, we should acknowledge negative stereotypes and misconceptions and their effect on the Asian American and Pacific Islander community. We should also consider the concerted efforts to do better.    

The first recorded history of Asian immigration to North America was of Filipinos escaping forced labor and enslavement in the 16th century. The 1850s saw a subsequent wave as Asian immigrants provided labor for the California gold rush and the transcontinental railroad. As low wages and economic troubles plagued Americans, blame was placed on the Chinese and led to the “yellow peril” trope and the passing of the Chinese Exclusion Act that placed a 21-year immigration ban on the Chinese.     

Japanese and Korean immigration began in the 1880s to replace Chinese laborers prompting many to make the U.S. their home, but as growing tensions between the U.S. and Japan heightened in the1940s it led to the labeling of Japanese Americans as enemies in a place that was rightfully their home. The Civil Rights Movement liberalized strict immigration laws, making room for southeast Asian refugees and other Pacific Islanders.  

Despite this long history of discrimination, Asian Americans have thrived, making significant contributions to American culture and economy. Yet, barriers to equity and inclusion still exist. As anti-Asian racism took root through name-calling, fear mongering and violence during the COVID-19 pandemic, it gave rise to the sentiment of Asian Americans as perpetual foreigners.  

The way we talk about health of Asians and their role in medicine can also serve as a barrier to equity and inclusion. The “model minority” myth, which portrays Asian Americans as high socio-economic achievers who lack nothing, creates a roadblock to members of this community receiving preventative health care services.  

Xiaoduo Fan, MD, MPH, professor of psychiatry, illuminated this through his work addressing mental health and racism in the Asian community. In his 2018 study published in Asian Psychiatry, Dr. Fan found racial disparities in mental health care between Asian American and white patients. Fan attributed the lack of recognition of mental health disorders and the underuse of mental health services in the Asian community as due in part to the “lack of cultural competency” in the health care community. Cultural competency in mental wellness considers traditional and religious beliefs as well as language barriers as factors in delivering preventive care.  

The model minority myth also generalizes Asian Americans as a monolith without consideration of the individual ethnic groups and their diverse socio-economic needs when, according to Fan, “Asians are the most economically divided racial/ethnic group.” 

As generalizations persist, it leads to the omission of Asian Americans as part of those underrepresented in medicine and renders invisible the reality that Asian representation in leadership across major institutions and organizations is low or almost nonexistent.   

Last June, Fan presented a talk, “Anti-Asian racism in the context of academic medicine,” to faculty at UMass Chan. He laid out diversity, equity and inclusion strategies to address anti-Asian racism and suggested that stakeholders acknowledge racism, create spaces to openly discusses the social realities of the Asian community, invest in programs to address anti-Asian racism, and increase the availability of Asian role models and mentors. 

We cannot uplift the cultures that have enriched the United States without paying attention to the holistic well-being of the people who drive the culture. As we celebrate Asian American and Pacific Islander Heritage Month, let us work for diversity, equity and inclusion, recognize that this work is nuanced, give room for the marginalized to speak and make changes with humility and mutuality.