Surviving at the Intersections- Barriers to Health for API Women

Published: Thursday, April 26th, 2012

Surviving at the Intersections- Barriers to Health for API Women
by Shivana Jorawar, Esq., National Asian Pacific American Women’s Forum

The National Asian Pacific American Women’s Forum is proudly taking part in the Health Equity Can’t Wait! blog carnival celebrating National Minority Health Month. Participating bloggers are health, consumer, women’s rights, and provider advocates committed to promoting health equity.  You can find all the posts for the carnival here.

I am a woman, a first-generation American, and a person of color. I was raised by immigrant parents of South Asian descent who cared for me in the best possible way. As a person surviving at the intersection of many oppressions- sexism, racism, classism, and xenophobia- I know very intimately that a person’s wellbeing is impacted by the identities she carries. I also know that these identities can collude to create insurmountable predicaments.

This rings especially true in regards to health, one of the most basic human needs. When health care services are unaffordable, administered in culturally incompetent ways, and discriminate based on sex and gender, many people are shut out from receiving the care they need to live fully and with dignity. Shamefully, and unsurprisingly, it is the most vulnerable people who run up against the most barriers to health.

An Asian American or Pacific Islander (API) immigrant woman, for example, may be burdened by multiple structural discriminations. She may find that there aren’t any medical staff who can speak a language she understands. She may be further burdened by the sky-high costs of her doctor’s visit because her insurance company essentially charges her for being a woman- since pregnancy, domestic violence, and c-sections are considered “preexisting conditions.” Moreover, taboos around sex in her community may make her unaware of or reluctant to use contraception, elevating her risk for unplanned pregnancy.

And, of course, there is also interpersonal discrimination. She may not be given quality care or may be uncomfortable visiting a doctor’s office because of racist and anti-immigrant feelings toward her. She may even be burdened by a unique stereotyping faced by API community members- the myth of the model minority. That is, despite the fact that many API communities are struggling, we are lumped together under the blanket assumption that we are healthy, educated, and economically prosperous. As a result, many healthcare providers and policymakers are blind to the health concerns of API women.

At least in part due to the above barriers, API women can experience significant health disparities. For example, the rate of cervical cancer among Vietnamese Americans is five times higher than that for white women, representing the highest rate for any ethnic group.[1]

Recognizing the tangled web woven by the multiple oppressions we face, and in an effort to keep API women from getting caught in it, the National Asian Pacific American Women’s Forum (NAPAWF) is working to ensure that healthcare is delivered to our communities in culturally-competent ways that do not discriminate based on race, class, sex, gender, or sexual orientation. This is why we support the Health Equity and Accountability Act, or HEAA, introduced by leaders of the Congressional Black Caucus, the Congressional Hispanic Caucus, and the Congressional Asian Pacific American Caucus, in collaboration with local communities and national health groups, to combat health care disparities. Building on the foundation of the Affordable Care Act, HEAA will improve the quality of care for immigrant women of color by making it easier to identify disparities through comprehensive data collection, ensuring workforce diversity, and making available culturally and linguistically appropriate health care services. 

If we are to improve health outcomes for communities like mine, we need solutions that take into account that we are not one-dimensional people. We are multi-faceted, and we need solutions that address our needs as whole people, affected by each identity we carry.


Shivana Jorawar is the Law Students for Reproductive Justice Fellow at the National Asian Pacific American Women’s Forum. To contact Shivana, please e-mail

For PDF version of Shivana’s article, click here


[1] National Asian Pacific American Women’s Forum, Reclaiming Choice, Broadening the Movement: Sexual and Reproductive Justice and Asian Pacific American Women, An Agenda for Action, 2005

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