How Our “One-Size-Fits-All” Approach to Healthcare Fails Southeast Asian American Patients

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One of the watershed moments in my development as an AANHPI race advocate happened at ECAASU in 2003. I was still a student activist, and president of my on-campus Asian American political group. That ECAASU was my first Asian American student conference, and my first real opportunity to interact with politically conscious Asian Americans outside of the gates of my Ivory Tower.

The only workshop I remember is the poorly attended workshop on AANHPI healthcare disparities I attended because mental health disparities were a growing issue on my campus. I emerged undeniably woken up.

An enduring problem for AANHPI racial discourse is the homogenizing effect that results from how the mainstream talks about us, and also from how some of us talk about ourselves. We paint the AANHPI identity with the broad brush of “sameness”, and in so doing we commit two unforgivable sins: 1) we universalize the narratives of East (and to a far lesser degree, South) Asian Americans as if they are wholly representative of the AANHPI identity; and 2) we shortchange the Southeast Asian American, Native Hawaiian and Pacific Islander members of our vibrant and diverse AANHPI community.

As evidence of this mainstream instinct towards AANHPI homogenization, we need look no further than Nicholas Kristof’s recent column in the New York Times, which patronizingly lauded Asian Americans as universally high-achieving. We also need look no further than the angst expressed by Governor Jerry Brown when he vetoed a widely popular California state bill that would have required sophisticated ethnic disaggregation of demographic data for AANHPI people. To date, most AANHPI racial data is aggregated during collection and analysis.

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Suicide rate of Bhutanese Americans twice national rate, highest among any refugee population

Bhutanese American Tara Gurung and her husband. Tara's father, Ram Gurung, counseled fellow refugees from committing suicide. However, after moving to the United States with his wife and two adult daughters, Ram Gurung committed suicide last year at the age of 73. (Photo credit: Ryan Lessard, NHPR)
Bhutanese American Tara Gurung and her husband. Tara’s father, Ram Gurung, counseled fellow refugees from committing suicide. However, after moving to the United States with his wife and two adult daughters, Ram Gurung committed suicide last year at the age of 73. (Photo credit: Ryan Lessard, NHPR)

Despite the precepts of the Model Minority Myth, not all Asian American & Pacific Islanders (AAPI) in the United States arrived as wealthy, middle-class East Asian entrepreneurs to pursue graduate degrees or to start small businesses. According to statistics published yesterday by the Center for American Progress, one-fifth of AAPI who received permanent resident status in 2012 did so as refugees or asylees; yet this population — many of whom can trace their ethnic heritage to Southeast Asia — struggles for visibility against the backdrop of the larger AAPI community. This invisibility is exacerbated by the absence of disaggregated data for the AAPI community along ethnic lines, which can reveal the unique sociopolitical iniquities that plague Southeast Asian Americans.

According to the United Nations, America is home to approximately 70,000 Bhutanese Americans, representing less than 0.5% of the AAPI population. Bhutanese Americans are ethnically derived from the small land-locked country of Bhutan, a small country in the Himalayas bordered by the two much larger nations of China and India. In the 1980’s, thousands of Bhutanese were forced out of Bhutan during a period of countrywide political turmoil (many expelled Bhutanese were targeted due to their non-Tibetan origins), and were forced to relocate to temporary refugee camps in the neighbouring country of Nepal; some subsequently accepted permanent relocation to the United States as political refugees starting in 2008.

Currently, the Bhutanese American population is concentrated in several states including Texas, Arizona, and New York. In New Hampshire, the state’s population of 2000 Bhutanese Americans represent 65% of the state’s total refugee population.

And shockingly, our country’s small, young, and underserved population of Bhutanese American refugees suffer among the country’s highest rates of PTSD, depression, and suicide — the latter of which is nearly twice that of national suicide rates — indicating a clear failure of America’s existing healthcare and social services programs to adequately address and support Bhutanese Americans.

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