Racism is preventing young South and East Asians from seeking medical care

Experiences of discrimination and racism keep young Asians from accessing health services, according to research from the University of Auckland.

Dr Roshini Peirez-John.
Dr Roshini Peirez-John led the research.

Experiences of discrimination and racism keep young Asians from accessing health services, according to a study just published in the New Zealand Medical Journal (4 February).

Other factors, such as poverty and a lack of social support also have an impact on access to healthcare, especially for people from some parts of Asia.

Contrary to the view, Asians have good access to healthcare in Aotearoa, one- in- five Asian secondary school students surveyed in 2019 did not access healthcare when they needed it in the previous year, known as ‘foregone healthcare’.

Students who forgo healthcare are known to be at higher risk of physical and mental health problems.

The New Zealand Youth19 survey included nearly 2000 Asian secondary school students. Results from Youth19 show students who experience discrimination by healthcare professionals and unfair treatment by teachers are more likely to forgo healthcare. The study shows East Asian students are especially likely to forgo healthcare.

There were differences between East Asians* and South Asians** in not being able to get healthcare:

  • East Asian students were especially likely to experience forgone health care when they came from poor communities, were bullied in school, and didn’t have someone in their family to talk about their worries or spend enough time with family.
  • South Asian students who didn’t always feel safe in their neighbourhood and didn’t have someone in the family to talk about their worries also were more likely to forgo healthcare.

"Factors like poverty, discrimination and a lack of social support are making it really difficult for Asian teens to access healthcare,” says Associate

Professor Peiris-John, a senior lecturer in epidemiology and the co-director of the University of Auckland's Centre for Asian and Ethnic Minority Health Research and Evaluation. 

“Asian youth need to be able to talk about health issues with their families to understand how to access healthcare – because it can be complicated, expensive, discriminatory and scary to negotiate alone,” she says.

Dr Peiris-John and her co- authors’ recommendations include:

  • delivery of health service interventions, such as enhanced cultural competency training for health providers and the co-designing of these interventions with young people to address discrimination and racism in healthcare.
  • strengthening social support for young people in community settings and developing healthy supportive relationships in schools
  • supporting families to understand how healthcare systems work in New Zealand, so they can support their children to access healthcare when they need it
  • free healthcare for teens in schools and communities
  • disaggregating youth data for the overall Asian group into East Asian and South Asian, or ideally at the specific Asian ethnicity level. By doing so, policymakers and planners would be able to better measure health issues and appropriately target responses.

The authors also note that, while Māori and Pasifika youth are not the focus of this paper, the findings should be seen within the broader context of New Zealand’s pattern of inequity and discrimination when compared to Pākehā/New Zealand European students.

Associate Professor Roshini Peiris-John is a co-investigator of the Youth19 study and the Asian lead of the Adolescent Health Research Group at the University of Auckland. The Youth19 study is co-led by Associate Professor Terryann Clark, of University of Auckland and Associate Professor Terry Fleming, of Victoria University and other colleagues from the Universities of Auckland, Victoria and Otago.

* Based on the World Bank definitions of East Asia, ethnicities with origins from Brunei, Cambodia, China, Hong Kong, Indonesia, Japan, North Korea, South Korea, Laos, Macao, Malaysia, Mongolia, Myanmar, Philippines, Singapore, Taiwan, Thailand, and Vietnam were included.

** Based on the World Bank definitions of East Asia, ethnicities with origins from Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka were included.

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