We Are Not All “Model”: Health of Older Asian Refugees in the United States

Abstract

AbstractThis chapter describes the health status and social determinants of health of older Asian-origin refugees resettled in the USA. Older refugees form 4% of global refugees, and younger refugees grow older. Until recently, the USA had the world’s largest refugee resettlement program and accepted refugees from all regions. Refugees undergo pretravel health screening and are connected with health services in their resettlement destination with the help of voluntary agencies and government funding. Refugees receive US government resettlement support for 8 months, after which they must become self-sufficient. Many older refugees depend on public assistance. Although Asians in the USA are stereotyped as a model minority, older Asian refugees experience health disparities due to low income, race discrimination, and forcible displacement. They have a greater burden of chronic physical and mental health conditions and unaddressed trauma. They face barriers accessing the US health care system including difficulty gaining health insurance, costs, language gaps, unfamiliarity with the system, and lack of culturally competent and trauma-informed care providers. Many older Asian refugees have lower income, education, English proficiency, food insecurity, and shortages of affordable housing. They greatly depend on family. They experience isolation and loneliness. Older Asians were more affected by the COVID-19 pandemic, including being targeted for ethnic hate crimes. Strengths include strong family ties, community self-help, and nonprofit organizations that effectively serve marginalized groups. Structural solutions for older Asian refugees’ situation are discussed and recommended.KeywordsOlder Asian refugeesOlder refugees’ healthUSA