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Battling Structural Racism Against Asians in the United States: Call for Public Health to Make the ‘Invisible’ Visible

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Battling Structural Racism Against Asians in the United States: Call for Public Health to Make the ‘Invisible’ Visible

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1. Why Are Asians Invisible in the United States?

Asia” is a European concept that artificially imposes uniformity on diverse groups.

Originating from Ancient Greek, the term “Asia” imposes uniformity on the others - lands, peoples, and cultures - beyond the east border of the Western world. Home to more than half the world’s population, Asia includes approximately 50 countries with hundreds of languages, many religions (e.g., Hinduism, Islam, Buddhism), and countless social norms. In the United States, Asians are the most rapidly growing immigrant group, with 2 out of 3 Asians being immigrants, and are estimated to exceed Hispanics by 2065. They originate from East Asia (e.g., Chinese), Southeast Asia (e.g., Thai, Vietnamese), and South Asia (e.g., Indians). Each region has many ethnicities with distinct physical features and complex histories of dominance and oppression within and across ethnicities that predate U.S. history by thousands of years. Yet, these heterogeneous populations are lumped together by the term “Asia.” Health datasets usually do not disaggregate these populations, masking health disparities. Viewed as monolithic, Asian individuals are too often confused with another Asian person with totally different skillsets or physical appearances, facilitating a discriminatory bamboo ceiling for career advancement to leadership positions.Subhuman caricatures, offensive words, and images of Asians that originate from historic events like wars (e.g., “Japs”, “Chinks”, “gooks”; fetishized or sexualized images of Asian women) predispose Asians to violence.

2. The history of structural racism against Asians in the United States is untold.

The United States has a long history of viewing Asians as “perpetual foreigners” since the arrival of the first wave of Chinese immigrants in the 1850s. Xenophobia led to the Chinese Exclusion Act of 1882, the first and only U.S. immigration law that targeted all people of a specific ethnic or national origin. On February 19, 1942, Executive Order 9066 authorized more than 110,000 persons of Japanese ancestry, regardless of US citizenship, to be forcibly removed from their homes, careers, and communities in the western United States to live in American concentration camps, despite no evidence of espionage. Japanese people who underwent physical, mental, and material traumas of incarceration kept silent and seldom talked about the shame of “camp” even with their children. Many of their offspring did not know much about their experience until dedicated groups of individuals advocated for justice decades later.

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Battling Structural Racism Against Asians in the United States: Call for Public Health to Make the ‘Invisible’ Visible

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Author manuscript; available in PMC 2023 Jan 1.

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1. Methods:

We calculated the percentage of blacks reporting discrimination in several domains, including health care. We used logistic regression to compare the black-white difference in odds of discrimination, and among blacks only to examine variation by socioeconomic status, gender, and neighborhood racial composition.

2. Principal findings:

About one-third of blacks (32 percent) reported experiencing discrimination in clinical encounters, while 22 percent avoided seeking health care for themselves or family members due to anticipated discrimination. A majority of black adults reported experiencing discrimination in employment (57 percent in obtaining equal pay/promotions; 56 percent in applying for jobs), police interactions (60 percent reported being stopped/unfairly treated by police), and hearing microaggressions (52 percent) and racial slurs (51 percent). In adjusted models, blacks had significantly higher odds than whites of reporting discrimination in every domain. Among blacks, having a college degree was associated with higher odds of experiencing overall institutional discrimination.

3. Conclusions:

The extent of reported discrimination across several areas of life suggests a broad pattern of discrimination against blacks in America, beyond isolated experiences. Black-white disparities exist on nearly all dimensions of experiences with public and private institutions, including health care and the police. Evidence of systemic discrimination suggests a need for more active institutional interventions to address racism in policy and practice.

4. keywords:

African Americans; black Americans; discrimination; racial disparities in health and health care; racism; social determinants of health; survey research.