Social Determinants of Health Among Rural Asian and Pacific Islander Populations


Overall, rural Asian and Pacific Islander (AAPI) residents fared better on most socioeconomic and health indicators in 2016 than did rural non-Hispanic White residents. AAPI residents tend to live in counties with more healthcare resources and higher rates of health insurance, and analyses developed by the Centers for Disease Control and Prevention suggest that AAPI populations have better health outcomes. However, this overall picture must be balanced by local assessments of individual populations.

Grouping Asian and Pacific Island populations without regard to differences in cultures and origins is problematic. Researchers are beginning to distinguish more carefully between Asian American populations comprised of immigrants and their descendants and Indigenous populations from the U.S. and its territories such as Hawaiian and Other Pacific Islander (HOPI) groups. The small size of some of these population groups presents a challenge to routine public health surveillance. While the National Health and Nutrition Examination Survey recently highlighted its additional sampling of Asian Americans, it has not yet extended this strategy to HOPI populations and may never be able to do so because of their small numbers. Research examining subpopulations within the Asian category is equally needed and equally difficult. The situation of small immigrant groups who may have had minority status within their countries of origin, such as the Hmong, will differ from that of highly educated professionals.

Given the diversity of AAPI populations, state and territorial public health authorities are best situated for the responsibility of monitoring the health of these potentially vulnerable groups. Funding from federal or philanthropic sources may be needed for periodic in-depth studies of health and health behavior in rural AAPI communities. Interventions, if appropriate, will need to be tailored to the distinct background and culture of each group.

Rural and Minority Health Research Center
Janice Probst, Fozia Ajmal