Asian Americans, Native Hawaiians, and Pacific Islanders in California experienced a rise in economic hardships during the pandemic

Using data from UCLA CHPR's 2018–2021 California Health Interview Survey (CHIS), as well as the 2019 and 2021 American Community Survey, the study found that Asian Americans, Native Hawaiians, and Pacific Islanders experienced difficulties accessing health and mental health services, as well as affordable and quality housing, education, and food. 

The impact was vast in health outcomes, with about 3 in 10 Asian Americans, Native Hawaiians, and Pacific Islanders in California reporting difficulties in accessing health services, and 1 in 4 experiencing difficulties in accessing mental health services. Cost was the most common reason for difficulty in accessing health services, with 7 in 10 experiencing this financial burden, however a lack of knowledge about available options was the top reason for difficulty in accessing mental health services.

The Asian American and Native Hawaiian and Pacific Islander communities have grappled with a rise in violence in recent years – from the anti-Asian hate incidents that occurred during the pandemic to the recent back-to-back mass shootings in Monterey Park and Half Moon Bay. The 2021 CHIS, which added questions on attitudes about gun violence, found that Asian Americans and Native Hawaiians and Pacific Islanders reported the highest proportions of concern about gun violence: 66% of Native Hawaiians and Pacific Islanders and 65% of Asian Americans said they were “very worried” or “somewhat worried” about gun violence, more than double the percentage of white adults (30%).

Economic hardship was another overwhelming issue for Asian Americans, Native Hawaiians, and Pacific Islanders in California. Asian Americans, Native Hawaiians, and Pacific Islanders, each saw higher poverty rates in 2021, compared to 2019. According to the study, more than half of respondents indicated that they had difficulty accessing high-quality or affordable housing due to financial cost and 36% said they had difficulty accessing quality or affordable food.

“California’s investment to increase the available data on Asian American, Native Hawaiian, and Pacific Islander communities is essential in improving public understanding of the needs, barriers, and challenges that AA and NHPI communities face,” said Karthick Ramakrishnan, professor of public policy at UC Riverside and founder of AAPI Data. “We hope that policymakers as well as those in charge of policy implementation will use the findings and recommendations in this report to create better programs and services that address the diversity in needs and challenges faced by AA and NHPI communities in California.” 

“After studying the emotional and economic impacts brought on by the pandemic over the last three years, it’s clear there is a significant burden on Asian American, Native Hawaiian, and Pacific Islander communities in California,” said Dr. Ninez A. Ponce, UCLA CHPR director, CHIS principal investigator, and professor and chair of health policy and management at UCLA Fielding. “These findings suggest an urgent need to address the gaps in access to health care, which have gotten perpetually worse as the pandemic continues to take a toll on this community.”

Another major cause for concern is the ongoing issue of hate incidents and discrimination against the Asian American community. Data show 1 in 4 Asian Americans had ever been a victim of a hate crime or incident in their lifetime, and 1 in 5 said they worried all the time or often about being a victim. 

To address racial injustices and economic inequities within the state’s system, researchers suggest that policymakers act against such prejudices by creating a more equitable framework for Asian Americans, Native Hawaiians, and Pacific Islanders across the state.

Recommendations include a focus on addressing inequities across the mental health system, improving awareness and access to public and government programs, investing in culturally competent care and services, increasing partnerships between state and community-based organizations, building additional language access, and widening access to data on Asian American, Native Hawaiian and Pacific Islander communities. 

The report is part of a series of reports by AAPI Data and the California Health Interview Survey focused on measuring the social, economic, and health impacts of the COVID-19 pandemic on Asian Americans, Native Hawaiians, and Pacific Islanders. The goal is to highlight the gaps in access to health, mental health, and social services for those communities. 

“During the COVID-19 pandemic, our community faced not only a major increase in hate crimes and incidents, but struggled financially and could not access care,” said California Assemblymember Phil Ting, Chair of the Assembly Budget Committee. “When I championed the API Equity Budget in 2021, we knew that the AAPI Data Project needed resources to research our community’s necessities. The recommendations from this report help us understand the hardships that the API community is facing, and helps us identify service gaps in order for the government and our community partners to address these needs.” 

“AAPI Data’s report, Impact of COVID-19 on Access to Health, Mental Health, and Social Services for Asian Americans, Native Hawaiians, and Pacific Islanders shines a bright light on the alarming health disparities of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) communities and point to the social determinants of health and mental health that we, California, must collectively and immediately address,” said Nkauj Iab Yang, Director of the California Commission on Asian and Pacific Islander American Affairs. “Now, more than ever, we must work together to change state policies and programs to meet the needs of the AANHPI communities. This is life or death, and we cannot afford any more lives taken prematurely in order to take action. The California Commission on Asian and Pacific Islander American Affairs will continue to build key state partnerships with AANHPI Californians to transform public policies for all Californians.”

“Asian American and Pacific Islander communities continue to be severely impacted by inequities that exist in our health care system, and the research by AAPI Data further demonstrates that we have a long way to go to improve access to care, linguistically and culturally appropriate outreach and education, and overall cost of care for community members seeking physical and mental health care services,” said Kiran Sangwan-Savage, Executive Director of the California Pan-Ethnic Health Network. 

The California Health Interview Survey has also introduced a new 2021 Public Use File (PUF) for the Asian American, Native Hawaiian, and Pacific Islander (AANHPI) Community Needs Survey that contains a set of questions assessing experiences among the AANHPI population in California. The 2021 AANHPI Community Needs Survey PUF is available by application at no cost. ​

By Vanessa Villafuerte for the UCLA FSPH Center for Health Policy Research