State agencies collaborating with community-based organizations (CBOs) and investing in culturally competent care will improve health outcomes for Asian American (AA) and Native Hawaiian and Pacific Islander (NHPI) communities in California, according to a newly released policy report by AAPI Data, in partnership with the UCLA Center for Health Policy Research.
The report also highlights disparities in access to and utilization of physical health, mental health, and social services by these communities, and provides recommendations for addressing these issues.
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Investing in state-to-local care coordination and culturally competent mental health resources
Of the 13% of Asian Americans in California who reported needing help for emotional, mental, or addiction problems in the past year, only 46% sought help and received treatment.
The report says that California should strengthen coordination among state and local behavioral health departments, health insurance providers, primary care physicians, mental health practitioners, community-based organizations, and mental health consumers. This would include more efficiently sharing mental health services and resources through, for example, a community mental health services directory for AA and NHPI communities at the county or local level. This would provide a centralized resource to help community organizations and hospitals identify mental health service providers with language and cultural competency.
“State-to-local coordination could help to develop standardized performance measures that would assess outcomes including whether AA and NHPI consumers have strengthened their support network, feel a sense of belonging … through accessing mental health care,” the report says.
Supporting families and caregivers with in-language support to address financial, physical, and mental hardships associated with caregiving
In the past year, about 54% of Asian Americans in California experienced some financial stress due to caregiving, and 11% suffered physical or mental health problems as a caregiver. Korean and South Asian Americans were significantly more likely to report negative physical or mental health impacts from caregiving compared to Asian Americans in general.
The report says supporting caregivers should involve the specific cultural and linguistic needs of AA and NHPI communities. It recommends expanding and uniformly implementing in-language support available from the California Caregiver Resource Centers (CRCs), as some of these centers have limited language resources, in order to address language barrier issues.
Improve awareness and access to public and government programs to increase utilization
NHPI seniors were least likely to be enrolled in Medicare, and Asian American seniors were less likely than White seniors to be enrolled in Medicare. NHPI communities were also less likely to be enrolled in Medi-Cal compared to other racial and ethnic groups.
According to the report, state agencies and departments should fund effective outreach and education plans to AA and NHPI communities to increase awareness of state and county programs like Medi-Cal, Medicare, Covered California, CalFresh, and the upcoming California vs. Hate Resource Line and Network that will be implemented by Fall 2022.
The report states that working with community-based organizations to build capacity and expertise in navigating the public benefits systems gives access to a network of trusted voices and experts that can rapidly share important information with diverse communities and languages that make up AA and NHPI populations.
The report also points out the need for bilingual navigators who can provide in-language assistance to navigate complicated applications and processes to access these services.
Invest in increasing language access capacity by creating job opportunities for multilingual immigrants to become certified interpreters
The report says expanding language access capacity should be connected with other key community needs, such as workforce development. Creating job opportunities for multilingual immigrants to become certified interpreters not only expands language access capacity, but also addresses the lack of interpreter capacity for languages of limited dispersion in California.
“When combined with community legal interpreter banks or other interpreter banks that can coordinate the dispatching of live interpreters, this solution turns non-English language skills into a workforce asset and career opportunity for immigrants,” the report states.
The report also recommends enforcing stronger state and more localized requirements for language access services.
Increase opportunities for government partnerships with trusted CBOs to promote new initiatives or public health information
State agencies and departments should increase partnerships and funding for the trusted voices of AA and NHPI community-based organizations to continue providing culturally and linguistically appropriate services to improve the health and mental health outcomes of AA and NHPI communities in California.
“While we rely on AA and NHPI community-based organizations to continue providing care and developing advocates and leaders, they are underfunded and underinvested … Many AA and NHPI community-based organizations have a track record of being able to build a strong network of services, effectively respond to urgent matters, and ensure relevant information are delivered effectively,” the report states.
Implement and expand data disaggregation efforts to create more timely and accurate data on AA and NHPI communities to better implement new policies and programs
State departments, such as the Department of Public Health (CDPH), Department of Health Care Services (DHCS), Department of Civil Rights (DCR), and Department of Social Services (DSS), should develop a standard collection and tabulation of demographic information to aid in evaluating and addressing health, mental health, and social services disparities. The collection should include disaggregated AA and NHPI population data.
“State agencies and departments should engage with AA and NHPI leaders and researchers to look for opportunities to prioritize publicly reporting disaggregated AA and NHPI health, mental health, and social services data and how to share the data safely to impact policy to increase utilization and reduce health disparities,” the report says. “In addition, state agencies and departments should conduct annual trainings and webinars with stakeholders on how to access their data systems.”