Special Projects Fund

Data Collection Fuels Advocacy Efforts for Culturally Competent Care

ore than 3.8 million Asian American and Pacific Islanders (AAPI) live in California, representing the state’s second fastest growing population group. While the government collects information about this group’s health care needs, the use of the broad demographic category “Asian and Pacific Islander” masks very real differences in status among different AAPI groups. 

The Association of Asian Pacific Community Health Organizations (AAPCHO) is working with its member clinics to ensure that these health disparities do not go unnoticed. 

“As a whole, AAPI women in California experience rates of breast and cervical cancer that are lower than the overall population,” said Jeffrey Caballero, AAPCHO executive director. “However, among Vietnamese women these rates are as much as 14 times higher than the statewide rate, indicating a significant problem that needs to be addressed. With this data in hand, so much more work can be done.”

AAPCHO received a three-year, $130,000 grant from TCWF in January 2002 to develop a common dataset designed to monitor health status and utilization trends of AAPI subgroups served by community health centers. Working with member clinics from San Francisco, Oakland, Los Angeles and San Diego, AAPCHO also hopes to show that the culturally competent care provided by its members results in more effective use of services and improved health outcomes. Ultimately, AAPCHO believes such services will result in lower health care costs.

Key to providing culturally competent care is the provision of what AAPCHO refers to as “enabling services” designed to reduce or eliminate access barriers. This includes a range of services, including translation assistance and services to provide links between Eastern and Western medical traditions. Many AAPI communities maintain their reliance on traditional healers for assistance and spiritual counseling. These relationships provide opportunities for healers to function almost like case managers, providing appropriate referrals to community clinics for services.

Despite the important role that enabling services can play in eliminating health disparities, such services are rarely eligible for reimbursement from private insurance or government health programs. 

“Clinics who see many AAPI clients must divert resources from other areas to provide these vital services,” said AAPCHO’s Caballero. 

By demonstrating that enabling services are a cost-effective means of reaching AAPI clients, AAPCHO hopes that insurers will reconsider their reimbursement policies. AAPCHO has advocated for additional federal funding for translation services at heavily impacted clinics. 

“With the government’s Uniform Data Set, there is no way to paint a picture of a specific Asian community’s health,” said Cristina Regalado, TCWF program director for the Special Projects Fund. “AAPCHO’s work is vitally important to help communities target services appropriately and build the capacity of community-based providers. By knowing more about who is accessing care, culturally competent services can be provided.”

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