Field Lessons: Chinese immigrants face huge challenges in getting access to health care

Chinese Americans may be the fastest growing group of Asian Americans, but despite that growth, it’s still a group that doesn’t readily turn to medical safety net programs for health care — especially in Los Angeles County. I had assumed it was the lack of information that was keeping many Chinese Americans unaware of such programs when I started my fellowship project. But after three months of research and reporting for my 2016 California Fellowship series, I’ve found the situation is much more complicated than just a lack of information.

There remains a disconnect, with the public health department failing to keep up with changes in the Chinese American community, and a lack of collaboration by different local organizations involved with the Chinese American community.

For journalists who want to cover the health care challenges facing this group in the future, here are some tips I have learned over the few months.

The current situation

Los Angeles County’s safety net program, My Health LA, had fewer than 0.9 percent of its sign-ups from the local Chinese American community in 2015, while Chinese Americans made up around 4.5 percent of the total population in the county. Departments such as the Los Angeles County’s Register Office and the Department of Public Health are encouraging more Chinese Americans to apply for the safety net program. Most of the effort to get Chinese American enrolled in the safety net program has focused on translation and language assistance so far.

As my reporting found, however, many Chinese community members are not aware of the information sheets and translation service provided by the county government. The Chinese American community here has a strong interpersonal communication pattern and their unique social media tools, such as WeChat. Outreach efforts need to acknowledge this. The lack of attention on the networks used by newly arrived Chinese American community members was one of the most concerning discoveries I made during my reporting.

Second, the Chinese American community is a hugely diverse community, one that varies based on members’ different sub-cultural backgrounds, the length of time spent living in the United States, and different financial situations.

There have been a few nonprofits and community service groups for specific sub-groups within the Chinese American community, like the American Traditional Chinese Medicine Society, Chinatown Service Center, and so on. Many of these groups dispense medical information and resources, but many of them have yet to start collaborating.

Third, helping new Chinese Americans with the U.S. medical system literacy is essential. Prior to live in the U.S., Chinese immigrants were dealing with a totally different kind of medical system, with government-sponsored universal health care or more expensive private health insurance. It is difficult to navigate the health care system even for a native U.S. citizen, let alone new immigrants. It may not be enough to translate information flyers; Chinese-speaking language assistants could prove far more effective. 

Lessons learned

As a member of the Chinese American community, I used to think that I know a few things about my community. However, as my understanding of the situation deepened while producing my special report, I came across more new things and problems that I didn’t expect.

Keep your distance and stay objective.

My fellowship project was in part spurred by my personal frustration with the U.S. medical system. As my reporting continued, however, the emotional attachments I formed with subjects could be problematic. It’s hard not to feel close to the story when those involved have a similar background as you. Yet, any such story should be based on adequate data from trustworthy outlets. Here are some of the databases that I found of great use while reporting on immigrant population issues:

• Date entry from the U.S. Census Bureau for population data.
• The immigration population data interactive project by the Migration Policy Institute, a nonprofit policy research institute based in Washington, D.C.
• Asian & Pacific Islander American Health Forum’s database on the community’s general health situation and health care issues.

Keep up with the latest legislative changes.

It is really important for reporters who want to focus on immigrant health care to follow the policy changes. The best way to get to know all the relevant health care policies, according to my experience, is by talking to nonprofit organizations or health care advocacy groups. Here is a short list that I found of great use when covering Asian Americans and Pacific Islanders’ health care issues in the Los Angeles area:

• Asian American Advancing Justice
• Asian & Pacific Islander American Health Forum
• Chinatown Service Center
• Buddhist Tzu Chi Medical Foundation
• Chinese Christian Herald Christian Health Center

The language barrier

Fluency in Chinese dialects can be essential in covering health care issues in immigrant communities, especially when you’re trying to reach real community members and patients with medical needs. Even for the Chinese American community, there are so many different dialects and sub-cultural groups to navigate.

The lesson I have learned from producing this special series is to never take it for granted that you have an understanding of the immigrant community you’re reporting on. It is very important to keep an open mind to the issues you think you’re familiar with. Sometimes, it’s a huge help to talk to another community’s organizations and members for a different perspective and new information. For example, I talked to Hispanic health care advocacy groups to learn more about the legislative changes that expanded California’s Medicaid program to low-income undocumented children.

Looking toward the future

Chinese Americans low utilization rate of public health care in Los Angeles is a situation in which language help is essential yet inadequate. After my series aired, the challenges remain: How to get community members more crucial information so they can receive health care when they need it.

There’s still a long way to go, but the Chinese American community needs such information while making their health care coverage choices. Meanwhile, more help when it comes to U.S. health care literacy and collaboration among different groups could go a long ways.

[Photo by Getty Images/Peter Parks.]