Asian-American Children With Disabilities

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BY H. BARRY WALDMAN , DDS, MPH, PhD & STEVEN P PERLMAN, DDS, MScD, DHL “The total population of Asian Americans grew by 46 percent from 2000 to 2010, which constituted the largest increase of any major racial group during that period.”1

INTRODUCTION
Hispanic, black and Asian mothers make up the majority of births in the United States at this time. It is evident that nationwide, white Americans will become a minority within about three decades and will “…be reliant on younger minorities and immigrants for our future demographic and economic growth.”2 Nevertheless, the dramatic proportional increase in the numbers of Asian residents is overshadowed by the magnitude of the continuing numerical increase of Hispanic residents in the country.

“More than half of the growth in the total population of the United States between 2000 and 2010 was due to the increase in the Hispanic population.”3
For example, between 2010 and the next census in 2020, the Census Bureau projects that the Asian population will increase by about four million residents, compared to an increase of about 13 million Hispanics. During this period, the Asian population component of total population will increase from 4.7 percent to 5.6 percent. By comparison, the Hispanic component of the total population will increase from 16.3 percent to 19.1 percent (see Table 1).

SOME SPECIFICS
Nevertheless, Asians recently passed Hispanics as the largest group of new immigrants to the United States. The educational credentials of these recent arrivals are striking. More than six-in-ten (61 percent) adults ages 25 to 64 who have come from Asia in recent years have at least a bachelor’s degree. This is double the share among recent non-Asian arrivals, and almost surely makes the recent Asian arrivals the most highly educated cohort of immigrants in U.S. history.5
• The six largest Asian-American groups by country of origin—Chinese Americans, Filipino Americans, Indian Americans, Vietnamese Americans, Korean Americans and Japanese
Americans comprise at least 83 percent of the total Asian population in the U.S.5
• A large proportion of these six groups, ranging from 18.5 percent Asian Indians to 43.2 percent of Filipinos reside in California. Almost a quarter (23.9 percent) of Japanese Americans resides in Hawaii (see Graph 1).
• “Asian Americans are the highestincome, best-educated and fastestgrowing racial group in the United States. They are more satisfied than the general public with their lives, finances and the direction of the country, and they place more value than other Americans do on marriage, parenthood, hard work and career success.” 5
• A century ago, most Asian Americans were low-skilled, low-wage laborers crowded into ethnic enclaves and targets of official discrimination. “Today they are the most likely of any major racial or ethnic group in America to live in mixed neighborhoods and to marry across racial lines. 37 percent of all recent Asian-American brides married a non-Asian groom.” 5
• The basic demographics of these groups are different on many measures. For example, Indian Americans lead all other groups by a significant margin in their levels of income and education.
Seven-in-ten Indian-American adults ages 25 and older have a college degree, compared with about half of Americans of Korean, Chinese, Filipino and Japanese ancestry, and about a quarter of Vietnamese Americans.5
• Americans with Korean, Vietnamese, Chinese and “other U.S. Asians” origins have higher poverty rates than does the U.S. general public, while those with Indian, Japanese and Filipino origins have lower proportions. (“Other U.S. Asians” are a diverse population that includes numerous subgroups of less than a million people. Seven of these subgroups number more than 100,000 people -Bangladeshis, Burmese, Cambodians, Hmong, Laotians, Pakistanis and Thais.)5

CHILDREN WITH DISABILITIES
The Census Bureau 2011 American Community Survey reported that an estimated 6.4 percent of Asian-Americans (956,000 residents) had one or more severe disabilities, including 65,000 children (2.0 percent of Asian children) less than 18 years of age. (Note: Among Asian alone children in combination with one or more other races, the Census Bureau reported that there were an estimated 100,700 youngsters (or 2.2 percent) with severe disabilities.) The overall rate of Asian-Americans of all ages with severe disabilities was the lowest compared to all other U.S. race/ethnicity populations, which ranged from Hispanics (8.4 percent) to highest levels for whites (12.5 percent), blacks (13.9 percent) and American Indians/Alaska Natives (16.3 percent). 6 Among the states (for which data are available) the proportion of Asian children with severe disabilities ranged from less than 2 percent in eleven states (AZ, CA, GA, IL, LA, MI, NJ, NY, TX, VA, WA) to 4.6 percent in Kansas and 4.8 percent in Oregon – with almost 19,000 Asian children with disabilities in California (see Table 2).

FACTS, REALITIES AND COMMENTARY
Many Southeast Asian American families are underrepresented among recipients of special education and social services for people with developmental disabilities. Community-based participatory methods are effective for eliciting root causes of health inequities in marginalized
communities. Outreach to community based organizations and an inclusive research practice identify social and cultural reasons for low service uptake and provide a pathway for the community to improve services for persons with developmental disabilities. 7
Asian Americans with disabilities face multiple barriers to employment, including stigma within their own ethnic community and even within their own families, making them one of the most underemployed groups. Asian Americans with disabilities (including physical and intellectual
disabilities) are less likely to be employed than non-Asians with disabilities. Asian Americans with disabilities who also lack English proficiency are reported to have the most significant labor market disparity, with only 9 percent of non-English-speaking Asian Americans employed—a lower rate than any other racial group. Among non-English-speakers of Mexican descent with disabilities, the U.S. employment rate was 13.5 percent.

Non-English-speaking Asian American women with disabilities recorded the lowest employment rate (7 percent) of any comparison group.8 The Affordable Care Act expands access to preventive care and can help reduce health disparities for Asian American and Pacific Islanders (AAPI) by helping to prevent many diseases that have a disproportionate impact on this group. Recommended preventive services covered without cost-sharing under the health care law include well-child visits, blood pressure and cholesterol screenings, Pap smears and mammograms for women and flu shots for children and adults. An estimated 2.7 million AAPI with private insurance currently have access to expanded preventive services with no cost-sharing because of the health care law. In addition, young AAPI and adults under age 26 who would have been uninsured now have coverage under their parent’s employer-sponsored or individually purchased health plan. This means that more than 97,000 Asian Americans have gained coverage. 9 The increasing minority populations, in particular the Hispanic population with disabilities, may overshadow the relatively smaller number and proportion of Asian children with severe disabilities.

Nevertheless, Asian children with disabilities are a component of the increasing numbers of youngsters who reside in our communities and are in need of services of local providers. The cumulative numbers of minority youngsters (and adults) with special needs are essential in developing legislative support for the needed health and related services for minority populations. •

ABOUT THE AUTHORS:
H. Barry Waldman, DDS, MPH, PhD – Distinguished Teaching Professor, Department of General Dentistry at Stony Brook University, NY; Email:h.waldman@stonybrook.edu
Steven P. Perlman, DDS, MScD, DHL (Hon) – Global Clinical Director, Special Olympics, Special Smiles and Clinical Professor of Pediatric Dentistry, The Boston University Goldman School of Dental Medicine, Private pediatric dentistry practice – Lynn MA. Misha Garey, DDS is Director of Dental Services at the Orange Grove Center

References
1. Census Bureau. Facts for Features – Asian/Pacific American Heritage Month: May 2011. Web site: http://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb11-
ff06.html Accessed August 29, 2013.
2. Centers for Disease Control and Prevention. Health United States 2011. Available from: http://www.cdc.gov/nchs/data/hus/hus12.pdf Accessed July 10, 2013.
3. Ennis SR, Rios-Vargas M, Albert NG. Census Bureau, Hispanic Population 2010. Available from: http://www.census.gov/prod/cen2010/briefs/c2010br-04.pdf Accessed August 22, 2013.
4. U.S. Census Bureau. Population projections 2015-2060. Accessed from: http://www.census/gov/population/projections /files/summary/NP2012-T4.xls Accessed August 22, 2013.
5. Hoeffel EM, Rastogi S, Kim MO, Shahid H. Pew Foundation. The rise of Asian Americans. Web site: http://www.pewsocialtrends.org/2012/06/19/the-rise-of-asian-americans/ Accessed August 30, 2013.
6. U.S. Census Bureau. 2011 American Community Survey. Website: http://factfinder2.census.gov Accessed August 21, 2013.
7. Baker DL, Miller E, Dang MT, Yaangh CS, Hansen RL. Developing culturally responsive approaches with Southeast Asian American families experiencing developmental disabilities.
Pediatrics, 2010;126 Suppl 3:S146-50.
8. Ha J. Among disabled job seekers, Asian Americans fare worst. January 2013. Web site: http://iamkoream.com/january-issue-amongdisabled-job-seekers-asian-americans-fare-worst Accessed August 30, 2013.
9. Choi JK. Initiate on Asian American and Pacific Islanders: Removing obstacles to care for Asian Americans and Pacific Islanders. Web site: http://www.whitehouse.gov/blog/2013/05/
23/removing-obstacles-care-asian-americans-and-pacific-islanders Accessed August 30, 2013.

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