Caring for Our Nation’s Asian American, Native Hawaiian, and Pacific Islander Older Americans

Posted on May 25, 2016 by J. Nadine Gracia, MD, MSCE, Former Deputy Assistant Secretary for Minority Health

In many families, there comes a time when our parents are no longer be able to care for themselves independently and require assistance to handle their daily activities. In several cultures, including Asian heritage, caring for aging parents is a rite of passage. For many individuals of Asian, Native Hawaiian, and Pacific Islander descent, respecting and caring for one's parents, also referred to as filial piety, is an important family value that extends across many cultures and generations.

During Asian American and Pacific Islander Heritage Month in May, and also in recognition of Older Americans Month, the U.S. Department of Health and Human Services (HHS) Office of Minority Health will highlight initiatives underway to help Asian American, Native Hawaiian, and Pacific Islander (AANHPI) communities achieve optimal health.

AANHPI populations represent a diverse group of communities and often suffer barriers to quality health care because of lack of access to affordable health coverage, as well as cultural and language differences – such as limited English proficiency, immigration status, and lack of culturally and linguistically appropriate health and social services. As a result, an estimated 18.1 percent of Asian Americans and Pacific Islanders are uninsured, compared with 16.3 percent of all Americans.1 And health concerns such as higher rates of hepatitis B virus infection, stomach and liver cancers, and suicide in AAPI women over the age of 65 can have devastating effects on the families and caregivers of older AAPI Americans.

As our nation grows older and more diverse, issues of aging and the challenges associated with caring for aging parents become more pronounced in AANHPI communities. The number of Asians, Native Hawaiians, and Pacific Islanders over age 65 is expected to grow to 2.5 million by 2020 and 7.6 million by 2050, from fewer than one million in 2000.2 And nearly three-quarters of the 17.3 million Asians in the United States were born abroad. One of the most important strategies to address the needs of this growing population is providing care and services that are culturally and linguistically appropriate.

Raising awareness of and promoting the adoption and implementation of the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care is a priority of the Office of Minority Health to improve the health of AANHPI populations and to support caregivers. Culturally and linguistically appropriate services are respectful of and responsive to the cultural health beliefs and practices, preferred languages, health literacy levels, and communication needs of diverse individuals and communities. As public health and health care providers and organizations implement these principles they also help improve the quality of services and close the gap in health disparities which are prevalent in AANHPI communities.

We recognize that the children of aging parents who are called upon to serve as caregivers also need information and resources to help ease their parent’s transition into a new phase of life. When this day comes, it is important to understand how to step into the role of caregiver, as a family member or health care professional, to provide aging adults with the best care possible.

To help facilitate conversations at the point of care, the National Institute on Aging offers a booklet on effective health care provider-patient communication called Talking with Your Older Patient. This resource, which also offers a handbook on working with diverse older patients, offers practical tips to help clinicians achieve meaningful and effective communication with older patients.

The Administration for Community Living (ACL) promotes well-being for older individuals by providing services and programs designed to help them live independently in their homes and communities. All older Americans and their family caregivers are eligible to receive services through the Older Americans Act (OAA) and Aging Network. The Administration on Aging within ACL gives specific attention to those individuals who are in the greatest economic and social need, including racial and ethnic minority seniors.

Our nation’s older AANHPI Americans have contributed much to this country. Let us do our best to ensure that they and their families have the resources they need to enrich their lives and our communities for years to come. As President Obama has said, "We must maximize the contributions of our seniors and ensure they have the resources and support they need to thrive and to keep shaping the future of the country they love."

For more information on efforts to expand opportunity for AANHPI communities, visit the White House Initiative on Asian Americans and Pacific Islanders. To learn more about the health of AANHPI communities, visit the HHS Office of Minority Health website.

J. Nadine Gracia, MD, MSCE, is the Former Deputy Assistant Secretary for Minority Health and the Director of the Office of Minority Health at the U.S. Department of Health and Human Services. reference
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