October 1, 2014

Health disparities and Electronic Medical Records

I have been thinking in my personal life about electronic medical records (EMR.) A number of friends are doctors who service multiple hospitals, and they sometimes encounter different systems at each hospital (if the hospitals even have electronic medical records.)

As a privacy advocate, it might be weird for me to be advocating electronic medical records because of the potential hazards, but as a patient, it is much, much easier to have continuity of care with EMR. I don’t have to drag a paper printout of my test results with me to each new doctor. When I was insured via Kaiser, it literally took minutes from the time I walked from my doctor down to the pharmacy below for my prescription to be filled. The doctor had ordered the Rx while I was with her, and sent it electronically. It was truly a beautiful streamlined feat that I still wonder at. Like pressing the Staples “Easy” button.

Not being a medical professional, I don’t have to worry if I’m repeating back the precise medical jargon that was fed to me before. For patients who have limited English proficiency (LEP), it is easier than having family members serve as sometimes imperfect translators each and every visit. This doesn’t negate the need for each doctor or specialist to ask questions, but it can be helpful for establishing and cross-checking prior medical history. And it’s important for EMRs to be tailored to specific communities – recommendations for best practices are outlined by HHS and Partnership for Women and Families.

Obviously, having a nationwide EMR system exposes a ridiculous amount of HIPAA data to hackers, and there would have to be the most stringent measures taken to protect patient safety. However, there are already certain nationwide EMR systems such as the one used by the Department of Veterans’ Affairs, which was one of the early adopters of EMR. Despite some of the ways in which the VA is currently broken, the agency deserves kudos on this count. Doctors actually point to the VA EMR system as a model of efficiency even compared to systems at top university hospitals. (That the VA system and the Department of Defense systems don’t talk to each other is a whole other story.)

The same way that I can get a prescription filled in different cities because my information and insurance is in the system, it would be great if not only veterans, but all Americans, could see healthcare practitioners who understand their medical histories without having to wait for the home institution or doctor’s office to fax over information.

I could even see a system that has translations of diseases, causes, symptoms, and treatments that a patient could look over. This isn’t perfect because not all patients are necessarily literate in their native languages, but it could help to overcome some of the barriers. Obviously we still want more culturally and linguistically competent providers and translators at hospitals, but this is a way of bridging the divide. We can make tech work to increase voter participation and allow people to cast ballots in their native languages, why not to improve health outcomes?

–Caroline

Ferguson riots

[Written August 11th. This is as much an update for friends and family as it is a perspective from someone who is new to town.]

So I moved to St. Louis 6 weeks ago. Been out of town for about 3 of those weeks. Let’s count it as 3 weeks on the ground. Everyone is very friendly, strangers talk to you on the street. My A/C broke and my neighbors who I had only ever met once before offered me the use of both of their fans. (We only needed one for the bedroom.) Then I bumped into a new neighbor whom I had never met, and she offered to lend me her fans. Overall, St. Louis is great.

Everyone talked about the racial divide, the Delmar divide. We saw glimpses of it here and there. Fireworks in Forest Park and the 2 separate stops for folks coming from the East side and the West side. White and black divided by railcars moving in different directions. I was in Los Angeles, the site of racial riots in 1992, this weekend for the OCA convention when the Mike Brown shooting happened. Picking me up from the airport this weekend there was a police blockade. Now the cops are throwing tear gas bombs in Ferguson and shooting rubber bullets. My AFLCIO coworkers were at the FTAA in Miami in 2003 when they got shot with rubber bullets. They hurt. And actually were moved off the non-lethal list of weaponry. Last night a Walmart was looted and a gas station went up in flames. This is real and this is live. Here’s a good article about why Ferguson, why riots: http://www.stltoday.com/lifestyles/relationships-and-special-occasions/parenting/aisha-sultan/why-ferguson-burned-explaining-st-louis-area-riot-to-kids/article_725f501f-ba21-538a-acaf-f00221add91d.html

Brown’s own family members have said the destruction in their hometown is salt in their wounds. When peaceful protests turn to a city’s self immolation, there is no justice for anyone. What’s left is a community used to being unheard, roiling in the wake of a deadly police shooting. A powder keg of unemployment and poverty, of neglect and frustration, and those willing to exploit a tragedy for personal gain.

–Caroline

“Where are you ‘from, from?’”

A recent campaign organized by Harvard students called “I, Too, Am Harvard,” has sparked discussions of racial comments and the diverse experiences people of color face.

The campaign highlights black Harvard students’ experiences of fleeting racial comments based on stereotypes associated with being black on a university campus. Originally organized as a play stemming from interviews with members of the black Harvard community, the campaign has expanded to a photo series, where black students hold up signs with statements such as “Can you read?” and “You’re lucky to be black…so easy to get into college!” to illustrate these stinging comments made by classmates, friends and others.

“Our voices often go unheard on this campus, our experiences are devalued, our presence is questioned—this project is our way of speaking back, of claiming this campus, of standing up to say: We are here. This place is ours. We, TOO, are Harvard,” read the description of the campaign’s Tumblr page.

Harvard, where black students make up 11 percent of the class of 2017, has responded positively to the campaign, according to a recent USA Today article.

Although the campaign focused on Harvard’s black community, a recent New York Times article explored how subtle comments like those highlighted at Harvard can have bigger racial and ethnic implications on minority groups. The article showcased some Asian stereotypes, such as hiring “the Asian computer programmer because you think he’s going to be a good programmer because he’s Asian.”

Others in the Asian-American community have also addressed similar issues of ethnic identity and origin. Wong Fu Productions, a California-based film production company run by three Asian-Americans, recently posted a video skit called “Accidental Racism,” where coworkers of different ethnicities probe each other about their ethnicity and origin.

In the skit, one of the actors asks her Asian-American coworker, “Where are you from, from though?,” to which he responds, “If you’re asking me where my family is from—China, I guess.” It is also interesting that the Asian-American coworker then asks another man from Kentucky the same types of racial comments without realizing the similarities and stereotypical undertones.

Another video series from ISAtv, a YouTube channel focused on issues of the Asian-American community, called “Level: Asian,” follows two Asian-American brothers as they explore what being Asian means to different people. In their most recent video, they ask UCLA students about the Asian college lifestyle and the question, “Do you think all Asians go to good colleges?”

Have you ever been asked about your ethnicity and been offended by someone’s probing question of “No, where are you actually from?” Or do these questions not bother you? Can these comments be considered “racism 2.0” as one source in the recent New York Times article labeled it? Or do these questions stem from genuine curiosity from someone who may not be as familiar or aware of your culture as you are?

Jayna Omaye recently earned a master’s degree in journalism from Northwestern University. As a student reporter, she previously covered politics, immigration and demographics in Washington, D.C. for a number of national media outlets, including USA Today, McClatchy, MarketWatch and the Military Times.

Follow her on Twitter: @JaynaOmaye

Living vs dead Chinatowns, gentrification & elections

AALDEF, the NYC based Asian American civil rights organization, has a new report out about the rate of gentrification in Chinatowns in NYC, Boston, and Philadelphia. (I guess DC was just a lost cause.) In conjunction with the discussion of this article, I want to propose the idea of “living” (these three cities, Chicago, San Francisco) versus “dead” Chinatowns (DC.) In my mind, when I walk the streets of a given Chinatown, “living” connotes active engagement and residency by the Chinese American community versus the slick, big box retail feel of Washington, DC Chinatown, which most Chinese Americans fled decades ago for Montgomery County, MD, and Fairfax, VA. The shops in DC Chinatown are adorned in bright signs with Chinese characters, but have very little daily relevance to Chinese or Chinese American culture, such as the skateboard shop, the Ann Taylor, and the Legal Seafood.

It’s a very read-worthy report, and I’ve gone on the walking tour of Boston Chinatown where you can see how highway I-93 literally cuts through the enclave, with a half-sheared building standing mute but providing powerful testimony to interesting municipal planning. The report illuminated that the AAPI population in Boston Chinatown went from 70% in 1990 to 46% in 2010. Philadelphia Chinatown has been encroached upon by developers, and was under threat from a proposed casino for a significant period. NYC Chinatown was at one point overtaking Little Italy, but now with the New Museum and the gentrification of the Bowery, is being pressed upon by towering luxury apartment buildings. Not to mention, Park Row, a residential community adjacent to South Chinatown, and nearby commercial buildings (shops and restaurants) have been under the shadow of 9/11 for 12 years, with limited access for a substantial period of time (9/11 cleanup), depressing retail sales. To this day, there are armed police stations that guard the entrance path to Park Row.

San Francisco Chinatown has managed to thrive due to a high intra-ethnicity turnover rate, and Chicago Chinatown (of which, really, there are 3 – historic Chinatown, “new” Argyle (largely Vietnamese-Chinese American) Chinatown, and “new new” Chinatown, which is across the street from historic Chinatown, and includes a number of residential properties that have lured second and third generation Chinese Americans back to the city center. (There is some small degree of this happening in other cities as well, but in my mind, Chicago has done a better job than most.)

The reason that I keep rotating back to this issue of whether Chinese Americans who have “made it” come back is because it is also a large part of why “living” Chinatowns become essentially “dead” Chinatowns. Moving out of Chinatown and to the suburbs is intrinsically seen as one of the markers of success for first, second, and third generation Chinese Americans. This is antithetical to keeping Chinatowns vibrant. This is separate from biased and discriminatory urban planning decisions hatched in concert with the stereotypically greedy developers. And it absolutely doesn’t discount folks who want to stay but get pushed out – I’m just bringing this up because it’s also a real thing.

Don’t get me wrong – DC Chinatown/Verizon Center is more bustling and lively than a decade ago, and is now an economic engine and one of the hearts of the city, but the business owners by and large do not live there. Although the DC AAPI population has risen 60% since 2000, according to the 2010 Census.

In NYC, the press of developers on the boundaries of Chinatown has caused friends who have lived, breathed, and worked in Chinatown for decades to move to Harlem, where elected officials like City Councilor Melissa Mark-Vivitero have noticed the increase of AAPIs. This follows on a previous out-migration to Queens (Flushing, Woodside, etc.), Brooklyn (where there is another Chinatown), New Jersey, Long Island, Westchester, and Connecticut.

So how do we keep the living nature of Chinatowns across the country? The report proposes several solutions: reinforcing and constructing more low-income housing, subsidizing local small businesses, prioritizing green spaces, strengthening the links between satellite Asian Am enclaves in the suburbs to the Chinatown cores, and engaging in dialogue with traditional community land owners like the family associations. All of these are great, and I’m going to a step further.

What I’m fundamentally saying is that keeping Chinatown affordable and full of vitality is partially dependent upon the people in elected office. They hold hearings and have influence over city planning to varying degrees. Former At-Large Boston City Councilor Sam Yoon came out of the fight to keep one Boston Chinatown. Michelle Wu and Suzanne Lee are running for city council in Boston (different seats.) Philadelphia has yet to elect a progressive AAPI city councilmember, whereas SF has a plethora of AAPI electeds (and folks in the pipelines to run when the inevitable term limits hit.) AAAF Greater Chicago helped get Alderman Ameya Pawar, the first AAPI alderman ever in Chicago, elected in 2011. Progress is slow, but steady.

Not that AAPI candidates are necessarily going to be informed about the community’s issues, or even live in the Chinatown district. It is incumbent upon the community and those who work to keep living, breathing Chinatowns to educate candidates and elected officials, regardless of their ethnicity. Because we all need allies and champions in this effort, and sometimes people surprise you.

–Caroline

AAPIs a Crucial Vote

Asian American vote for Democratic President

Although pundits and commentators have attributed Barack Obama’s victory in 2012 to support from the Hispanic and African American communities, many have overlooked the critical role that Asian Americans played in that election. That year, President Obama won 73 percent of the Asian American vote, up from 62 percent in 2008. Asian Americans supported Obama in greater margins than any voter group except African Americans.

While Asian Americans currently only comprise 5 percent of the U.S. population, their numbers are predicted to swell to 9 percent by 2050. Furthermore, in swing states like Nevada and Virginia, Asian Americans already wield significant voting strength. As of the 2010 Census, Asian Americans form approximately 7 percent of Nevada’s population and 6 percent of Virginia’s. In other swing states, like North Carolina and Florida, the growth of the Asian American community outpaces the national average.

Even in non-swing states with high Asian American populations, their votes can be very influential in primary elections. For example, Hillary Clinton’s victory over President Obama in the 2008 Democratic primaries in California, where Asian Americans comprise 8 percent of the Democratic electorate, was largely due to the 3-1 margin of support she garnered from that bloc.

As the 2016 presidential race begins to heat up, Republican and Democratic strategists will undoubtedly focus more attention on this crucial voting bloc.

– Michael Dee

A dialogue on n+1’s “White Indians” piece

Editor’s note: In reading n+1’s “White Indians,” I had my own thoughts and solicited the opinions of two Indian American friends, who agreed to have our dialogue published as long as they were anonymized. Let’s call them J and T. This is by no means meant to symbolize what all Indian Americans or all Asian Americans think; what follows is real talk about race, hip hop, arts and culture, and politics amongst friends.:

“White Indians” argues that South Asian Americans are a “safe” minority to have on-screen, that “no color is safer than South Asian brown. No minority presence in the US is more reassuring, or less likely to get angry or acknowledge your antiblack racism.”

C: My initial take was that as well written as the article is, I have mixed feelings because the editors (including editor Nikil Saval) don’t talk about the current mainstream or the conflation of South Asian American with the scary terrorist. Conflicted about a lot of it, but the handling of Bobby Jindal and Nikki Haley is spot on. Have noticed and cheered rise of desis on tv.

J: Thank you for sending this provocative article. I completely agree with your assessment of it esp. about Muslim-Americans. I too have mixed feelings, particularly about the caustic writing style. It kind of put me in a funk reading it in the morning. It was kind of all over the place and written from a masculine perspective. Why didn’t he mention The Mindy Project? asked K. One error that I’d point out is that Vijay Prashad actually says that the folks who came through the highly skilled labor pool were from middle-class families in India, not wealthy elites. Prof. Pras(h)ad was referenced in a poorly edited documentary “Not a Feather But a Dot.”

T: I actually thought it was very well-written, though after a while it did come off as ranting. That’s the point where I think it lost an overall thesis to the whole piece. However, I do agree with a lot of the points brought up, it’s all stuff I’ve heard in various places since college, just collated.

I agree with his point about Desi actors, but at the same time, I’m conflicted b/c I know a lot of them. They struggle for roles, because diverse roles don’t often exist for south asian actors — the reason the Outsourced people were so excited was, even though they were stereotyped roles, they were LEAD roles, something a lot of those actors have strived for for a long, long time and rarely gotten a shot at. And in the arts, Desis gravitate towards being performers, but not as much towards directing and producing, i.e. decision-making that would open up more opportunities for non-white actors. So essentially, they take what they can get, and I don’t think you can fault them for it. Kind of similar to Hattie McDaniel…..people always gave her crap about taking stereotyped black “mammie” roles, but at the same time, she won an OSCAR as a black woman in the 1930’s. You have to give her credit for that.

There actually are a lot of indian americans (younger) that Identify more with hip-hop culture and not so much the whiteness — but these are the kids of working class families, not the ones that grew up in affluent, “whiter” suburbs. Also — there are a lot of younger Indians leaning to the right, the ones who grew up in more affluent suburbs and all want to open their own businesses, or who are culturally sheltered and think gay marriage is gross….

J: Yeah, one of my young 18 year old cousins is a mini-Republican in the making, all about entrepreneurship, and grew up in predominantly white affluent suburbs. hip-hop is no longer black, urban, or low-income in its roots anymore – it’s global, and there are plenty of people of all races who identify with it, both as listeners and producers.

T: My point about the hip hop was not so much about identifying with blacks (look at most of Irvine, CA as an illustration — hip hop oriented but still very, very Asian). A better way of saying it is that there’s a contingent of young Desis who are not white-identifying, usually from less affluent backgrounds.

C: I think there is a subset of any minority that is not white or mainstream identifying. 626 and Garden City CA is a good example too. How does this compare with the diaspora experience?

Actually, if you don’t mind, this is a pretty educational dialogue. Would it be ok to post this dialogue, with names stripped out if you prefer, to the aaa fund blog?

T: I’m fine if you post the comments, i’ll leave it up to J.

J: Sure, no names please.

–Caroline

In Mike We Trust

Ed. note This Op-Ed by Kal Penn appeared in the May 10 edition of India Abroad

I first worked with Congressman Mike Honda when I was a White House aide to President Obama, working on issues related to young Americans and the Asian American and Pacific Islander community. In a sea of chaos that is Congress, it was always refreshing to see Mike go to bat for his constituents, and to join the President in standing up for young people and community members in a way that most members of Congress did not.

Having worked alongside Mike in both policy and politics, I am proud to endorse him for his re-election to Congress in 2014. Washington, DC, can be sort of a crazy place. To many of us, it’s unfathomable that there is opposition to commonsense issues like access to health care, comprehensive immigration reform, and education. And we often look to our leaders to see how they intend to engage on those issues we care about.

As the Congressman representing the innovative spirit and drive of Silicon Valley, as chair of the Congressional Asian Pacific American Caucus for an unprecedented seven years, and now as chair emeritus; as a member of the powerful Appropriations Committee, it’s rare and refreshing that Mike really moves and lives by the conviction that every one of us deserve an opportunity and a voice.

As a young person, that kind of leadership was refreshing to see.

On health care, Mike and CAPAC worked with the Congressional Black and Hispanic caucuses to include critical provisions that tackled health disparities in the President’s final historic health- care reform legislation of 2009.

On immigration, over the previous three Congresses as chair, and now as chair of CAPAC’s Immigration Task Force, Mike has led the constant drumbeat to pass a comprehensive immigration reform that leaves no one behind. He believes in an immigration system that is inclusive, family- based and humane, and invests in America’s future.

On education, he worked to dispel the model minority myth, and to push for greater resources flowing to colleges and universities that serve underserved Asian American and Pacific Islander students.

Mike’s record speaks volumes to his character. He has continued to push for issues that are critical, regardless of whether there is existing political appetite for it amongst his peers in Congress; essentially, he has helped to create the tenable space for much of the action we have seen.

His advocacy for social justice and serving communities that do not have a voice is unparalleled. Mike grew up behind barbed wire in a Japanese-American internment camp, even as his father served in the United States Military Intelligence Service during World War II.

As a young boy, he learned that being Japanese carried a negative connotation in America. But he knows that the reason Japanese Americans were unjustly and illtreated was because no one in Washington said no.

Today, Mike continues to be an unwavering opponent of hate speech and bullying perpetrated against all communities, regardless of creed, race, gender, sexuality, disability, country of origin, and immigration status.

Mike has been a friend and mentor to many young leaders, artists, business folks, and innovators. I know that he will continue to deliver that which is just and best for his constituents and for this nation.

– Kal Penn

Should Immigrants Have the Right to Vote?

Should you have to be a US citizen to be able to vote?

NYC is now considering allowing any resident to vote if he or she”s been living in the US legally for over 6 months.

What do you think?   My view:  because they have established ties to the community, it makes sense to allow committed, long-term immigrants (i.e., greencard holders) to vote in local elections, but we should be careful about going further than that.

— Gautam Dutta

Mayor Vincent C. Gray Swears in New Members of the DC Commission on Asian and Pacific Islander Affairs

Editor’s Note: The below is a re-posting of “Mayor Vincent C. Gray Swears in New Members of the DC Commission on Asian and Pacific Islander Affairs” from our friends at the DC Commission on Asian and Pacific Islander Affairs.



For Immediate Release
February 11, 2013

Contact: Andrew Chang
Phone: (202) 727-5560
Email: andrew.chang@dc.gov

Mayor Vincent C. Gray Swears in New Members of the DC Commission on Asian and Pacific Islander Affairs

The Commission Advises the Mayor and Advocates for the Interests of the Asian and Pacific Islander Community

(Washington, DC) – Mayor Vincent C. Gray administered the oath of office to nine newly-appointed community members and 10 government agency ex-officio members of the District’s Commission on Asian and Pacific Islander Affairs during a ceremony at the John A. Wilson Building on February 8, 2013.

“The District of Columbia is proactive in engaging and meeting the needs of the Asian American and Pacific Islander community, and working to ensure uniform and adequate language access,” said Mayor Gray. “The commissioners and ex-officio members sworn in earlier today now join us in these efforts by working with District government agencies to ensure that the community can access services in a timely matter.”

Commission members meet monthly with Soohyun “Julie” Koo, the Director of the Office on Asian and Pacific Islander Affairs, to hear updates on programs, initiatives, issues, and to report back from their respective neighborhood or agency, as well as to discuss best practices to better serve the Asian American and Pacific Islander community.

Following the swearing-in ceremony, the Office on Asian and Pacific Islander Affairs held a Lunar New Year themed reception to honor the Commission, with over 100 government officials, community leaders, and guests in attendance.

“As the Office on Asian and Pacific Islander Affairs moves forward in working with other District agencies and the community to address issues such as language and cultural barriers that may be a hindrance, these new commission members with diverse backgrounds will bring unique experience and perspectives,” said Director Koo.

“I am deeply honored to be chosen and confirmed as a commissioner to the DC Commission on Asian and Pacific Islander Affairs. It is a role that will give me the opportunity to serve my city and provide a voice for the DC AAPI community as the city makes decisions affecting their lives. I hope to live up to the example that was set by the commissioners before me and help move this city forward for all those who call it home,” said Nicholas Lepham, a newly-appointed commissioner.

The DC Commission on Asian and Pacific Islander Affairs was established on August 12, 1986 with the signing of Mayoral Order 86-130. Each commissioner is appointed and serves without compensation. The nine public members are: Dana Tai Soon Burgess, Christopher Y. Chan, Simone E. Jacobson, Eugene D. Kinlow, Nicholas C. Lepham, Lawrence T. Liu, Ajay K. Ojha, Sapna D. Pandya, and Laura Shin.

The 10 ex-officio non-voting government representatives chosen by the Mayor are: Yi-Ru Chen (Homeland Security and Emergency Management Agency), Elizabeth P. DeBarros (Department of Employment Services), Dennis O. Gobantes (Fire and Emergency Medical Services Department), Matthew Green (Department of Consumer and Regulatory Affairs), Sonia P. Gutierrez (Department of Housing and Community Development), William O. Howland, Jr. (Department of Public Works), Garret Lum (Department of Health), John Stokes (Department of Parks and Recreation), Sakina B. Thompson (Department of Human Services), and Leeann Turner (Metropolitan Police Department).

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Republicans try to rebrand as not the party of hate and exclusion

Well, the GOP leaders have met and spoken. They have decided to try to avoid the topic of rape and how they sound when discussing “legitimate” versions of rape (oh, wait but New Mexico GOP legislators just introduced a bill to prohibit victims of rape and incest fro getting abortions.) They also decided that they needed to sound less like “angry white men.”

From yahoo news:

First, they said Republicans must work on improving their tone when taking their ideas to the American people. For example, when discussing immigration, maybe presidential candidates should avoid phrases like “self-deportation” (Mitt Romney) and “anchor babies” (Michele Bachmann).

Henry Barbour said some in the party can appear “hostile” to certain constituencies with the rhetoric they use. The party must increase communication training for candidates, he said.

“There are certainly too many times when we’ve had candidates who have come across as hostile, and that’s not really helpful when you’re trying to win elections,” Barbour said.

Robert Bennett, chairman of the Ohio Republican Party, was even more blunt.

“We need to understand that we can’t come off as a bunch of angry white men,” he said.

Good luck with that one, gents.

–Caroline