Asian and Pacific Islander healthcare providers are stressed and living in fear. You need help. | opinion

By Ann M. Nguyen and Nathan Stewart

It’s time to check with our healthcare providers, particularly those of Asian and Pacific Islanders.

As we enter the third year of the COVID-19 pandemic, New Jersey still has a long way to go to contain the virus. On January 11, Gov. Phil Murphy reinstated a public health emergency, reactivating resources to handle the Omicron variant surge.

In the news we heard about the increase in hospital admissions. At their peak in mid-January, New Jersey hospital admissions were 1.5 times the national average. We’ve also heard about expanded options for COVID-19 testing, but what the public doesn’t hear enough about is the well-being of our healthcare providers.

We draw particular attention to the mental health of Asian and Pacific Islanders (API) as we have also had an increase in hatred against Asians for the past two years now.

Anti-Asian hatred was recently brought back into the national conversation with the death of Michelle Go in a New York City subway station and the approaching anniversary of the Atlanta spa shooting.

API providers have operated in highly stressed, highly variable environments with the added fear and trauma of anti-Asian hatred. A national poll found Asians more stressed out about anti-Asian hatred than COVID-19. This is a cause for concern.

The psychological burden is twofold. First, the burden of labor that exhausts and burns out vendors. As frontline workers contract the virus, they have to call in sick for several days. For example, as of February 2, there were at least 14,206 confirmed cases of COVID among healthcare workers in long-term care facilities. Other providers have left the field or withdrew prematurely. Traveling nurses are pursuing opportunities in different states.

Second is the burden of anti-Asian hatred. The xenophobic framing of COVID-19 by government officials led to a surge in anti-Asian sentiment, prompting threats and acts of violence. API providers defend themselves against racist insults from patients and micro-aggression from colleagues and supervisors.

New York State ranked second only to California among states affected by anti-Asian discrimination. New Jersey was among the top ten. It is important to note that these figures only reflect documented incidents of discrimination.

API providers make up a sizable number of 12% of healthcare workers in New Jersey. Tackling burnout from the pandemic, compounded by workplace discrimination, is critical to preventing the ongoing loss of providers.

However, to adequately address the mental health needs of API providers, 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 gives ethnic subgroups. Unfortunately, there is no comprehensive vendor data disaggregated by ethnicity.

The Rutgers Institute for Health, Health Care Policy and Aging Research (IFH) is working to fill these gaps in API knowledge and put that knowledge into action. The IFH is home to the Rutgers Asian Resource Center for Minority Aging Research (RCMAR), a National Institutes of Health research center that advances research on trauma, stress, and resilience in API populations. The New Jersey Practice-Based Research Network at IFH also proposes a survey to assess API vendor burnout and resilience.

Investment in API providers and the API community at large is needed as APIs are the fastest growing minority in the US

Over the past 10 years, less than 1% of National Institutes of Health funding has gone to projects focused on US drugs. Governor Murphy recently signed legislation recognizing the history and heritage of Asian American and Pacific Islanders in the K-12 education curriculum and in November 2021 established the Asian American Pacific Islander Commission within the State Department to provide policies to address the social and economic Develop needs of the growing API communities in New Jersey. These are steps in the right direction. However, more effort is needed to quantify and address API discrimination.

Concrete measures to support and protect our API providers are still pending. The continued loss of API providers to accelerated burnout only perpetuates existing inequalities in our healthcare system. We must act now to review and support our API providers.

Ann M. Nguyen, Ph.D. MPH is an Assistant Professor and Implementation Scientist at the Rutgers Center for State Health Policy. She is also 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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