Strengthening Chinese-American Health Coalitions: Mobilizing Chinese-Americans

Policy Problem

Chinese-Americans, like most minorities, experience difficulties in access to healthcare, and thus increased rates of disease. These barriers to access can be summarized under three categories: Lack of English competency, lack of health insurance, and deficiencies in cultural competency in healthcare providers. In all, Asian-Americans, not just Chinese-Americans, stand out as the least well-served group by the healthcare system of the United States.

Current efforts to address the issue have come from CAHCs, which often take the form of community-based Federally Qualified Health Centers (FQHCs) that provide basic medical services regardless of ability to pay. Among low-income minority communities, FQHCs have been shown to provide comprehensive, culturally competent healthcare at comparable quality to traditional hospitals. Nonetheless, only 28 out of 1,131 FQHCs serve a patient population of 20% or more Asian-Americans.

The OMH has traditionally only provided grant funding to FQHCs that address specific health issues, such as HIV/AIDS or childhood trauma. Organizations that aim to address minority access to basic medical services must seek out Partnership Grants, which are unspecified five-year block grants that are worth around $400,000. However, only six Partnership Grant proposals were funded in 2017 and none of the grantees were FQHCs.

This places CAHCs that seek to address issues in Chinese-American access to basic medical services at a major disadvantage. A lack of issue-specific focus disqualifies them from specialized grant funding, and competition for Partnership Grants is fierce; any US-based organization that aims to address minority health equity through one of four general routes can apply. Indeed, two of 2017 grantees were universities.

Another issue troubling CAHCs is the recruitment of culturally competent medical providers, who are themselves often bilingual and bicultural. In addition to a national physician shortage, Asian-American physicians are disproportionally skewed in geography; on the West Coast, where the majority of low-income Chinese-Americans reside, there are about 314 Asian-American patients for each Asian-American physician, compared to about 105 Asian-American patients for each Asian-American physicians in Midwest. Despite their efforts, there aren’t enough culturally competent physicians to serve the low-income Chinese-American population.

The OMH has aimed to promote linguistic and cultural competence by establishing national guidelines on competent care and providing online training modules for professionals seeking to provide competent care. Yet there appears to be no relationship between the recruitment efforts of CAHCs and the training efforts of OMH, despite the possible synergistic effects on both provider recruitment and training quality.