Faculty Research Spotlight
Hyunwoo Yoon, School of Social Work
Closing the Health Disparity Gap for Asian Americans
“As Principal Investigator, I will examine a model that integrates individual and environmental dimensions in healthcare access among Asian Americans, using a sample that reflects cultural, ethnic, and linguistic diversities.”
The United States has made it a national priority to eliminate disparities in health and healthcare access for U.S. residents. While some have been successfully reduced, disparities continue to be more pronounced among racial and ethnic minorities, in particular those with limited English proficiency. This also leads to poorer health within this population. My recent work has been focused on understanding and reducing the health disparities gap, particularly among Asian Americans, an often misunderstood group.
Reports based on national surveys suggest that Asian Americans are better positioned than other racial/ethnic groups in both general health status and healthcare access. However, this representation of Asian Americans as a “model minority” may be misleading because national surveys generally include only those Asian Americans who can speak English. In reality, our Asian American population includes a large number of foreign-born immigrants with limited English proficiency. Because this group is often excluded from national surveys, their healthcare access problems are also underestimated.
My research project is designed to help close the health disparity gap for Asian Americans. "Improving Access to Healthcare in Asian Americans: The Role of Individual and Contextual Factors” is funded by the National Institutes of Health (NIH) and the National Institute on Aging (NIA) Resource Centers for Minority Aging Research. As Principal Investigator, I will examine a model that integrates individual and environmental dimensions in healthcare access among Asian Americans, using a sample that reflects cultural, ethnic, and linguistic diversities.
The approach of my project is based on two main premises. First, immigration-related factors are a unique vulnerability of Asian Americans that pose significant risk to health and healthcare. These factors include life course immigration trauma, resilience, country of birth, length of stay in the U.S., English proficiency, and acculturation. Second, environmental contexts strongly influence healthcare access. Putting health and healthcare into environmental contexts, such as neighborhood and community characteristics, helps us predict and remediate health/healthcare disparities for Asian Americans.
My project will capitalize on existing survey data based on the “Asian American Quality of Life (AAQoL) Survey” funded by the City of Austin in 2015, which my mentor and I collected. A total of 2,609 Asian American individuals participated, including 640 Chinese (24.5%), 574 Asian Indians (22%), 471 Koreans (18.1%), 513 Vietnamese (19.7%), 265 Filipinos (10.2%), and 146 individuals from other Asian groups (5.6%). The fact that among a total of 2,609 survey participants, almost half (48.5%) used non-English versions of the survey questionnaire indicates that culturally and linguistically sensitive approaches enabled many individuals who are conventionally unrepresented in national surveys to be included.
Using GIS technology, I will link existing survey data to census data showing the percentage of Asian Americans in the neighborhood and their poverty level and community resource data showing accessibility to health care facilities in the community. With this data, I will be able to examine the effects of neighborhood predictors on health and healthcare access.
This approach incorporates new ways of defining neighborhoods, assessing community resources and environmental infrastructure, and integrating person-level factors with environmental contexts. Findings from the project will not only improve the knowledge base but also provide practical implications, including (1) identification of subgroups at greater risk, (2) exploration of individual and environmental factors to be used in community health promotion efforts, and (3) suggestions for community-based interventions. The overall approach and findings will inform plans to effectively address health inequities, providing implications for millions of Asian Americans with linguistic barriers.
Dr. Yoon is a fellow of the Mental Health and Substance Abuse Program from Substance Abuse and Mental Health Services Administration (SAMHSA).