The Asian American population has doubled in size from 2000 to 2019 and is estimated to reach more than 46 million by 2060 in the U.S. (Budiman & Ruiz, 2021). In North Carolina, the Asian American population has grown by 85% from 2000 to 2010, ranking the third highest rate among all states (Asian Americans in North Carolina, n.d.). Despite this growth, little is understood about Asian Americans and their experiences with trauma and adverse childhood experiences (ACEs) due to the lack of data disaggregation (Yang & Dinh, n.d.). The model minority myth, a stereotype about Asian Americans’ achievements that erases the large disparities within this non-monolithic group further implicates a need for investigation and interventions for this population (Blackburn, 2019).
ACEs are events that occur during childhood and include experiencing abuse, witnessing violence, or growing up with substance use, mental illness, and parental instability (Centers for Disease Control and Prevention, 2020). Among college students, Asian American Pacific Islanders experienced disproportionately higher rates of ACEs compared to their white counterparts (Sieben et al, 2021). Asian American communities also experience ACEs linked with historical trauma and racism as well; trauma related to major historical events and the increasing anti-Asian hate crimes have decreased health outcomes for this population (Cai & Lee, 2022; Stop AAPI Hate, 2021).
Trauma and ACEs have had negative implications for Asian Americans, especially as it relates to mental health outcomes and general wellbeing (Mental Health America, n.d.). In the US, 15% of Asian Americans reported having a mental illness but only 20% received treatment, lower than 66% of the general population (Mental Health America, n.d.). In North Carolina specifically, the most recent 2021 Behavioral Risk Factor Surveillance System (BRFSS) shows that Asian Americans ranked 2nd in regards to highest rates of depression (2020). The increasing Asian American population in the US, the disproportionately higher rates of depression and ACEs, and the historical and intergenerational influences of trauma all show a need to address both ACEs and their impacts on the Asian American community.
Public Health Framework
Primary prevention includes initiatives that prevent the disease or illness before it actually happens. According to the Trauma-Informed Philanthropy published by the Philanthropy Network Greater Philadelphia, this may include initiatives that include training and education (2016). Our project approaches primary prevention through the educational campaign on ACEs and trauma that we will create in conjunction with local partners such as NCAAT.
Secondary prevention strategies include those that reduce the impact of the illness and is driven mainly by screening and early detection of the disease. Our project aims to increase ACE screening at pediatric and adolescent primary care spaces to accomplish this. Moreover, we also aim to target the secondary prevention strategies of the potential mental health sequelae of ACEs, focusing specifically on depression in our community. In screening for both ACEs in children and depression in adults, we are hoping to identify these symptoms earlier and prevent the cyclic nature of ACEs and depression from progressing.
Finally, tertiary prevention strategies include treatment of the disease or illness. Asian Americans are the racial and ethnic minority least likely to seek treatment, driven by many barriers including language, stigma, and lack of culturally sensitive care (2015). Our tertiary prevention strategy aims to increase culturally sensitive and trauma-informed care to ensure that people feel safe enough to begin care and to maintain care.
Socioecological Model
First, educational campaigns on ACEs and intergenerational trauma will be implemented on an individual level. On a relationship level, initiatives include strengthening the relationships between the community and mental health care providers by ensuring providers give trauma-informed and culturally sensitive care. On a community level, program activities include working with local providers to ensure providers within the community are screening for ACEs and mental health sequelae. Targeted interventions were selected to be at these three levels to ensure a comprehensive yet tailored plan to address ACEs and mental illness in this population. As Asian Americans are a diverse group of people with various ethnicities and nationalities, ensuring that a multi-pronged approach that start on the individual level is integral to the success of this program. Furthermore, the combined impact of individual, relationship, and community initiatives will hopefully make a deeper impact on the societal level (CDC, 2022).
Trauma Informed Principles
Safety: This program will ensure that the environment and relationships promote psychological safety for community members. For instance, leveraging culturally sensitive and language appropriate resources can reduce fear and mistrust with healthcare systems (Govere, 2016).
Trustworthy and Transparency: This program will ensure trust with the community members by leveraging their feedback on program initiatives and modifying activities in response to community feedback. Moreover, having community members on project teams will ensure the community voice is heard.
Cultural, Historical, Gender: cultural and historical issues are at the heart of this program. By focusing and educating how historical traumas and events are impacting the wellness of our community today, we hope to bring our community healing in a way that resonates with cultural values and needs. Addressing historical trauma of our community will also ensure that this program is rooted in trauma-informed principles.
References
(2015, February). Racial/Ethnic Differences in Mental Health Service Use among Adults [Review of Racial/Ethnic Differences in Mental Health Service Use among Adults]. SAMHSA; SAMHSA. https://store.samhsa.gov/sites.../priv/sma15-4906.pdf
(2020). Cdc.gov. https://nccd.cdc.gov/BRFSSPrevalence
Asian Americans in North Carolina. (n.d.). Retrieved February 6, 2023, from https://ncaatogether.org/wp-co...final-03-10-0936.pdf
Blackburn, SS. (2019, March 21). What Is the Model Minority Myth? Learning for Justice; Southern Poverty Law Center. https://www.learningforjustice...-model-minority-myth
Budiman, A., & Ruiz, N. G. (2021, April 29). Key facts about Asian Americans, a diverse and growing population. Pew Research Center. https://www.pewresearch.org/fa...out-asian-americans/
Cai, J., & Lee, R. M. (2022). Intergenerational Communication about Historical Trauma in Asian American Families. Adversity and Resilience Science. https://doi.org/10.1007/s42844-022-00064-y
CDC. (2022, January 18). The Social-Ecological Model: A Framework for Prevention. Centers for Disease Control and Prevention; CDC. https://www.cdc.gov/violencepr...ecologicalmodel.html
Centers for Disease Control and Prevention. (2020, September 3). Preventing adverse childhood experiences. Www.cdc.gov. https://www.cdc.gov/violencepr...n/aces/fastfact.html
Data & Demography, Asian American Center. (n.d.). Aac.unc.edu. Retrieved February 13, 2023, from https://aac.unc.edu/data-demography/
Govere L, Govere EM. How effective is cultural competence training of healthcare providers on improving patient satisfaction of minority groups? A systematic review of literature. Worldviews on Evidence-Based Nursing. 2016;13(6):402-410.
Mental Health America (n.d.). Asian American / Pacific Islander Communities and Mental Health [Review of Asian American / Pacific Islander Communities and Mental Health]. Mental Health America. https://www.mhanational.org/is...es-and-mental-health
Philanthropy Network Greater Philadelphia, Thomas Scattergood Behavioral Health Foundation, and United Way of Greater Philadelphia and Southern New Jersey (2016). Trauma Informed Philanthropy: A Funder’s Resource Guide for Supporting Trauma-Informed Practice in the Delaware Valley.
Sieben, A., Lust, K., Crose, A., Renner, L. M., & Nguyen, R. H. N. (2021). Race and sex differences in adverse childhood experiences among Asian/Pacific Islander college students. Journal of American college health : J of ACH, 69(4), 353–360. https://doi.org/10.1080/07448481.2019.1677671
Stop AAPI Hate. (2021, August 12). Stop AAPI Hate National Report. Stop AAPI Hate. https://stopaapihate.org/stop-...e-national-report-2/
Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014
Tebes, J. K., Champine, R. B., Matlin, S. L., & Strambler, M. J. (2019). Population Health and Trauma‐Informed Practice: Implications for Programs, Systems, and Policies. American Journal of Community Psychology, 64(3-4), 494–508. https://doi.org/10.1002/ajcp.12382
Yang N.I. & Dinh Q (n.d.). Intergenerational Trauma and Southeast Asian American Youth in California. Retrieved February 6, 2023, from https://www.equalmeasure.org/w...Rise_YangDinh_R1.pdf
Comments (0)