U.S. Department of Health and Human Services Plan for Asian American, Native Hawaiian, and Pacific Islander Health

This  plan contains the measurable objectives that the Department of Health and Human Services will pursue to raise the visibility of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) health issues, health care, and human services disparities. This plan is meant to be a first step in elevating AANHPI issues across the Department under the leadership of the Assistant Secretary for Health, Dr. Howard Koh.  Four overall-arching health issues have been identified that support Departmental objectives to improve the well-being of AANHPIs. These goals include how the Department will carry out its plan to prevent, treat and control Hepatitis B infections in AANHPI communities, work to improve reporting of data, foster workforce diversity by developing workforce pipelines for AAs and NHPIs, and address some of the key health issues that specifically impact NH and PI populations.

The plan was developed as part of the White House Initiative on Asian Americans and Pacific Islanders, which aims to improve quality of life and opportunities for Asian American and Pacific Islander participation in federal programs.

The following are the implementation strategies for the four goals:

Goal 1: Prevent, treat and control Hepatitis B Viral (HBV) infections in AANHPI communities

• Develop and implement a national education campaign designed to increase awareness about HBV, educate the public about risk factors, and encourage testing of those at risk through a HBV public service announcement (PSA) which will be aired in metropolitan areas with significant Asian American populations. The PSA will be translated into Chinese, Vietnamese and Korean for relevant in-language programming.
• Explore data from the U.S. Behavioral Risk Factor Surveillance Survey to obtain baseline data for a developmental Healthy People 2020 objective about the percentage of AANHPI who have been tested for HBV infection.
• Provide support for AANHPI community based organizations to:
  1. Develop targeted outreach programs designed to reach specific populations at risk with HBV through culturally sensitive and linguistically appropriate evidence based interventions.
  2. Encourage applications for health disparities research and community-based participatory research interventions that target early detection and prevention of HBV in medically underserved AANHPI communities.
  3. Develop and disseminate educational materials in a variety of AANHPI languages.
  4. Partner with AANHPI organizations to educate their members about chronic viral hepatitis.
• Continue to support successful interventions and its dissemination of best practices in other communities.
• Train health care providers to screen AANHPI patients living in HBV endemic regions with HBsAg (hepatitis B surface antigen) as an indicator of chronic HBV.

Goal 2: Improve data collection in AANHPI communities

• Work with HHS 4302 Workgroup on the full implementation of section 4302 of the Affordable Care Act regarding data collection on race, ethnicity, sex, primary language and disability status. This will provide an opportunity to obtain disaggregated data on AA, NH & PI communities.
• Enhance the quality of data collected within Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use & Health (NSDUH) for AANHPI populations.
• Continue oversampling of Asian Americans in the National Center for Health Statistics’ (NCHS) National Health Interview Survey (NHIS).
• Include an oversampling of Asian Americans in 2011-14 National Health and Nutrition Examination Survey (NHANES).
• Develop improved tools for accessing and analyzing vital statistics and survey data for small populations.

Goal 3: Align the health workforce with the needs of the AANHPI communities

• Identify AANHPIs to train and educate peers on health issues pertaining to this population using existing HHS infrastructures and innovative outreach.
• Include a clause to emphasize outreach to NHPI populations in the SAMHSA’s Minority Fellows Program (MFP), which provides stipends to doctoral level students to increase the number of culturally competent behavioral health professionals.
• Work with AANHPI communities to increase applications from AANHPIs in the National Institutes of Health (NIH) and Health Resources and Services Administration (HRSA) Loan Repayment Programs (LRP).
• Support community-based participatory research on cultural and linguistic competency training for the health care workforce and effects on health care quality and patient satisfaction.
• Support research on the association between health care workforce composition with respect to race, ethnicity, and language spoken and patient satisfaction of AANHPI and study the effects of adjustments to workforce composition on the health care quality and patient satisfaction of AANHPI and to ascertain additional ways to enhance the quality of health care and patient satisfaction.

Goal 4: Improve health conditions and access to health care services for Native Hawaiians and Pacific Islanders

• Catalogue culturally appropriate/sensitive promising practices (not yet evaluated) which address non- communicable diseases within the United States Associated Pacific Islands (USAPI).
• Work with the Pacific Islands Health Officers Association to identify one to three priority non-communicable diseases (NCD) for each USAPI.
• Identify gaps and opportunities to increase outreach and recruitment and deliver trainings via Webinar and/or in-person to assist National Breast and Cervical Cancer Early Detection Program (NBCCEDP) grantees in increasing outreach and breast and cervical cancer screening among underserved AANHPI communities.
• As part of NBCCEDP, provide support for underinsured and uninsured AANHPI women to complete annual clinical breast and mammography exams per established clinical guidelines to improve the early detection of breast cancer in Native Hawaiian and other Pacific Islander women
• Provide support for patient navigators to support outreach and case management.
• Provide technical assistance and training on specific public health concerns to local and territorial public health entities to enhance their surveillance and response capacity.
• Continue support for development and use of computer based Chronic Disease Electronic Management System (CDEMS) among USAPI healthcare systems. CDEMS is a flexible database for tracking any chronic condition and can easily be adapted to the unique needs of the USAPI. CDEMS provides consistent and standardized organization of patient/population data to help monitor and track chronic disease. An additional strategy includes the establishment of a USAPI regional-based CDEMS support network that provides training, technical assistance and trouble-shooting for participating jurisdictions.
• Link with ongoing efforts to reduce the burden of diabetes and TB co-morbidity within the USAPI.
• Promote efforts to provide a third dose of MMR vaccine to students in highly affected schools.
• Ensure that catch-up vaccination campaigns are being done in highly affected areas.
• Provide education and training on mumps prevention and control to healthcare providers in clinics and hospitals, school nurses, daycare providers, community leaders, and minority group leaders.
• Support high quality laboratory test platforms in Guam and Yap.

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