By Megan J. Shen
There is a common myth that Asians in the U.S. are successful and free from racial bias. This is often referred to as the ‘model minority’ myth.
This myth is not only inaccurate and a gross overgeneralization, but it also hurts public health efforts to address health inequities among Asians in the U.S.
As a research professor at Weill Cornell Medicine specializing in health disparities, this myth has always bothered me. Traditionally, research efforts to address health inequities only extend to those minority groups defined as underserved. This designation is almost exclusively extended to Blacks or African Americans, Hispanics or Latinos, American Indians or Alaska Natives, Native Hawaiians, and Pacific Islanders. In other words, most Asian and Asian American populations are entirely excluded.
The model minority myth contributes to this issue. And categorizing the population monolithically as “Asian” obfuscates how widely diverse, and, in some cases, underserved, it is.
In fact, in my own experience working with underserved populations in New York City, some of the worst-off are low-wage Chinese and Chinese American individuals. These individuals often have lower educational levels, limited health literacy, and housing conditions that pose higher health risks compared to the average American. Some of our most impoverished immigrants coming into the city are of South or East Asian descent, from countries such as Thailand, Vietnam, and parts of China.
And often it is difficult to understand and address the disparities present among these populations, because Asians are rarely prioritized as underserved, and, consequently, are not the focus of research or added resources, such as special clinical services or outreach programs designed to deliver needed care within communities.
In short, we can’t design tools or services to serve these largely underserved communities if we don’t prioritize them as underserved and seek to understand their unique healthcare needs and barriers.
A major issue with the model minority myth is that it assumes all Asian Americans are of a higher economic class. However, income inequality has been shown to be rising rapidly among Asian Americans. In fact, among all racial and ethnic minorities, including Blacks and Hispanics/Latinos, Asian Americans have the highest level of income inequality. The richest Asians in America earned almost eleven times as much as the poorest Asians in 2016. But average incomes hide this disparity. The richest Asians skew the average, which may create the appearance that all Asians are doing well economically, which is not the case.
The landscape for health and economic opportunities looks very different for Asians of lower socioeconomic status and lower education levels than those faring well with educational attainment, literacy, and English fluency. Combining all Asians into a single group when looking at data for Asians covers up major health inequities. And it allows the persistence of the model minority myth to extend to public health, at the expense of Asian wellness and, ultimately, Asian lives.
When Asians are lumped together and thus excluded from being considered as more at risk for health issues, serious health inequities occur. Take cancer, for example. Asian-born women in the United States have a much higher risk of dying from breast cancer than U.S.-born Asian women. And among Asian American men, lung cancer remains a leading cause of death. These health disparities extend to lower rates of engaging in health behaviors, such as screening for colorectal cancer, or taking immunizations to guard against cervical cancer.
What these data reveal is that various factors, such as educational level, economic status, immigrant status, language barriers, health literacy, and cultural beliefs all come in to play and put various subgroups of Asians in the U.S. at high risk of disease and death from those diseases. This is a public health problem that must be addressed.
The model minority myth is hiding massive health disparities among the large and varying Asian community in the U.S. To address this, we must do three things.
First, we have to stop lumping all Asians into a single category. Instead, public health institutions, researchers, and funding agencies need to differentiate and better understand the broader Asian community by examining its subgroups.
Second, we need to prioritize public health and funding efforts to understand and address these massive health disparities. Looking at factors beyond simply race and ethnicity, such as income level, educational level, and literacy levels, may start to reveal the nuances of the disparities at play.
Finally, we must eliminate the ‘model minority’ myth among Asians. Just as there is no model or average American, there is no model or average minority. Each individual, and certainly each subgroup, has its own unique nuances, vulnerabilities, and strengths that must be addressed and acknowledged.
The model minority myth is causing Asians in the U.S. to lose out on necessary health care. And this, in turn, is costing their lives.
This is too high of a price to pay. We must dispel this myth to progress the public health needs of Asian and Asian American individuals.
Megan J Shen, Ph.D., is an Assistant Professor of Psychology in Medicine at Weill Cornell Medical College in the Division of Geriatrics and Palliative Medicine, the Director of the Communications Core at the Cornell Center for Research on End-of-Life Care, and an alum of the Op-Ed Project.