Asian and Pacific Islander health care providers are stressed, live in fear. They need help. | Opinion

By Ann M. Nguyen and Nathan Stewart

It’s time to check in on our health care providers, especially those of Asian and Pacific Islander descent.

We are entering the third year of the COVID-19 pandemic, and New Jersey still has a long way to go to curb the virus. On Jan. 11, Gov. Phil Murphy reinstated the public health emergency, which reactivates resources to address the omicron variant surge.

In the news, we have heard about rising hospitalizations. At its peak in mid-January, New Jersey hospitalizations were 1.5 times higher than the national average. We have also heard about expanded options for COVID-19 testing, but what the public is not hearing enough about is the wellbeing of our health care providers.

We are specifically calling attention to the mental health of Asian and Pacific Islander (API) providers, as we are now also two years into surges in anti-Asian hate.

Anti-Asian hate has recently been brought back into the national conversation with the death of Michelle Go in a New York City subway station, and as we approach the one-year anniversary of the spa shootings in Atlanta.

API providers have been working in high-stress, highly variable environments with the added fear and trauma of anti-Asian hate. A national survey found that Asians are more stressed about anti-Asian hate than COVID-19. This is a cause for concern.

The mental health burden is two-fold. First is the burden of the work, which is depleting and burning out providers. As frontline workers contract the virus, they must call out sick for multiple days. For example, on February 2, there were at least 14,206 confirmed COVID cases among health care staff in long-term care facilities. Other providers have left the field or retired early. Traveling nurses are pursuing opportunities in different states.

Second is the burden of anti-Asian hate. Xenophobic COVID-19 framing by government officials led to a rise in anti-Asian sentiment, leading to threats and acts of violence. API providers are fielding racial slurs from patients and microaggressions from colleagues and higher-ups.

New York State ranked second after California among states experiencing anti-Asian discrimination. New Jersey ranked in the top ten. It is important to note that these numbers only reflect documented incidents of discrimination.

API providers make up a sizable 12% of the New Jersey health care workforce. Addressing burnout from the pandemic compounded by workplace discrimination is critical to preventing the continued loss of providers.

To appropriately address the mental health needs of API providers, however, we need to recognize the specific needs of ethnic communities (e.g., South Asian, Chinese) and tailor support, as there are known differences in health outcomes and COVID-19 experiences between API ethnic subgroups. Unfortunately, there is no comprehensive provider data that disaggregates by ethnicity.

Rutgers Institute for Health, Health Care Policy and Aging Research (IFH) work to fill these gaps in API knowledge and translate this knowledge into action. IFH houses the Rutgers Asian Resource Center for Minority Aging Research (RCMAR), a National Institutes of Health research center advancing research on trauma, stress, and resilience in API populations. The New Jersey Practice-Based Research Network at IFH is also proposing a survey to assess burnout and resiliency in API providers.

Investment in API providers and the API community at large is needed, as APIs are the fastest-growing minority group in the U.S.

In the past 10 years, less than 1% of National Institutes of Health funding has been awarded to projects focused on U.S. APIs. Gov. Murphy recently signed legislation to recognize Asian American and Pacific Islander history and heritage in the K-12 education curriculum, and in November 2021 established the Asian American Pacific Islander Commission within the Department of State to develop policies to address the social and economic needs of the growing API communities in New Jersey. These are steps in the right direction. But more efforts are needed to quantify and address API discrimination.

Specific action to support and protect our API providers is yet to be seen. The continued loss of API providers due to accelerated burnout only perpetuates existing inequalities in our health care system. We must act now to check in on and support our API providers.

Ann M. Nguyen, Ph.D. MPH is an assistant research professor and implementation scientist at the Rutgers Center for State Health Policy. She is also the director of the New Jersey Practice-Based Research Network at the Rutgers Institute for Health, Health Care Policy and Aging Research.

Nathan Stewart, MS, is a research coordinator at the Rutgers Institute for Health, Health Care Policy and Aging Research.

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