The alarming rise in racism, violence, and harassment against Asian American Pacific Islanders (AAPIs), exacerbated this past year by the COVID-19 pandemic, is leaving short- and long-term impacts on public health in its wake.

Over 3,000 cases of COVID-19-related hate and violence against individuals of Asian descent have been reported in the United States since March 2020, according to Asian Americans Advancing Justice–Los Angeles.

Carle Illinois College of Medicine explores the recent discrimination and attacks, and its health impacts with David Chih, founding director of the Asian American Cultural Center at the University of Illinois Urbana-Champaign, and Teresa Mok, a licensed clinical psychologist in Urbana, Ill.

David Chih

Can you describe the current situation involving racism, discrimination, microaggressions, and/or attacks affecting the Asian-American community?

Almost 40 percent of Americans say it has become more common for people to express racist views toward Asians since the pandemic began, according to Pew Research Center. The Center for Public Integrity reports that more than 30 percent of Americans have witnessed COVID-19 bias against Asians, and 60 percent of Asian Americans have seen the same behavior.

The United Nations Secretary-General said in May 2020, “the pandemic continues to unleash a tsunami of hate and xenophobia, scapegoating, and scare-mongering” and urged governments to “act now to strengthen the immunity of our societies against the virus of hate.” Unfortunately, that did not happen in the United States.

Racism here is generally understood as a Black-White issue. Asian Americans are often rendered invisible in this narrative, so it can be easy to overlook the fact that, although anti-Asian violence and discrimination are getting mainstream media attention now, this has been pervasive throughout the history of Asians in this country dating back hundreds of years.

What are specific health effects that can result from the recent or past incidents of discrimination, racism, microaggressions, and physical attacks against people of Asian or Pacific Island heritage?

Teresa Mok

Some common health effects include heightened fear, stress, anxiety, uncertainty, grief, depression, and PTSD. One might experience such effects not only as a victim of racism, but also experience secondary trauma from hearing, reading, or witnessing such actions. Some patients may also be experiencing generational trauma if their family has fled a country due to war, religious persecution, or hardship, which may magnify the stressors they are currently experiencing.

What barriers exist within the health care system for AAPIs?

  • Culturally responsive services: Some AAPIs, particularly the elderly, may have limited English proficiency. Interpreter services are helpful, but patients may fear that an interpreter will not respect their confidentiality within the larger AAPI community.
  • Health literacy: Navigating complex health care systems is especially difficult when English is not one’s first language. Challenges include the ability to read and comprehend health content, drug labels, health education fliers, physician consent forms and directions, and appointment reminders.
  • Beliefs regarding disease: Immigrants may hold different beliefs about health care and only seek help when symptoms are severe and therefore are more difficult to treat.
  • Health insurance: Insurance is a major barrier to accessing care. Many AAPIs lack adequate health insurance.

What more can be done to offer support to those affected by these acts?

Support can come in the form of validating what has happened, including naming the behaviors as racist. Scholars and researchers can continue to document and analyze these incidents and their effects on Asian American communities across the United States. Please report all bias-motivated incidents that occur within the University of Illinois Urbana-Champaign community to the Bias Assessment and Response Team, bart.illinois.edu.

How can health care workers care for individuals within communities where racism and discrimination have taken a toll?

First, be aware of how caring for individuals takes place within a larger system, which involves acknowledging multiple sociocultural factors like race, ethnicity, gender, sexual orientation, and socioeconomic status. Health care workers need to recognize the diversity within the Asian American community, including generational status, language preference, and certain cultural values that may be of particular importance to this racial group. Such values might include interpersonal harmony, loss of face, and filial piety – all of which might speak to how physical and psychological distress are communicated and treated.

It can also be helpful to acknowledge the wide diversity of the AAPI community. Practitioners need to be aware of inaccurate historical stereotypes and myths of AAPIs and assess their own stereotypes of these groups so as not to make assumptions about a patient’s experiences and history.

What role can physicians and other health professionals play in finding creative solutions to health issues related to anti-Asian racism?

At the individual level, acknowledge the reality of AAPIs experiencing discrimination and ask patients about racism as it affects their health and illnesses, including mental health. At a broader level, work to help build and enrich greater community health support systems, prevention and outreach to at-risk communities, which would include new immigrants, low income, and limited-English-language subpopulations. Practitioners also can acknowledge, value, and research Eastern traditions including acupuncture, Chinese traditional medicine, and Ayurveda to consider how these techniques or concepts might be productively integrated with Western medicine.

What other remedies are available, or should become available to bring greater awareness to these issues?

Recognize that the absence of Asian Americans from narratives about social problems in this country contributes to the problem because this lack of attention communicates that this group does not face many barriers to success. We need to ensure culturally and linguistically sensitive services for survivors, victims, and their families at both the national and local levels.  

  • David Chih, Ph.D., is the founding director of the Asian American Cultural Center at the University of Illinois Urbana-Champaign. For over 30 years, David has focused on issues of diversity and inclusion with particular emphasis on Asian American and international student communities. 
  • Teresa Mok, Ph.D., is a licensed clinical psychologist in Urbana, Ill., where she maintains an adult-focused private practice. Her research interests center around Asian American mental health issues, including gender roles and stereotypes, media images, identity development and the integration of multiple social identities.

Resources and Events:

  • Click here to see a statement by the Asian Pacific American Medical Student Association at Carle Illinois College of Medicine on the issue of racism against Asian Americans.
  • Report acts of intolerance at UIUC here.
  • Learn more about the impact of microaggressions on a person’s health here.
  • Learn how to be an effective ally here.
  • Chih and Mok from AACC will present a virtual program, “Anti-Asian Racism, Xenophobia, & COVID-19,” on March 24, from 7 to 8 p.m. Register here.
  • Asian Americans Advancing Justice-Chicago is offering a free interactive training, “Bystander Intervention Training to Stop Anti-Asian/American and Xenophobic Harassment,” on Friday, April 9, from 2 to 3 p.m. Register here.

This interview is part of Carle Illinois’ “Racism as a Health Crisis” series. We recognize the negative effects that the COVID-19 pandemic has on communities of color and other marginalized groups. We also recognize the negative impact of racial microaggressions on mental health. We stand against racism in all its forms and are committed to deploy the tremendous power of innovative thinking in our college to address it. More information on Carle Illinois’ commitment to diversity and inclusion can be found here.