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5 Ways Social Determinants of Health Are Affecting Community Members

In January 2023, Change InSight released its inaugural report, Changing Tides. CASL was proud to partner with various other organizations—Apna Ghar, the Alliance of Filipinos for Immigrant Rights and Empowerment Chicago, the Indo-American Center, the Hanul Family Alliance, and SAAPRI—to survey 2,000+ members of Chicago’s AANHPI community about their social determinants of health. The result was actionable insights that policymakers can use to truly improve the conditions where people live, work, and play in their communities. Read the report here.

In this blog post, we review the top five risks facing AANHPI populations in Chicago and offer specific recommendations for policymakers to act on, including both upstream and downstream interventions.

  • Upstream interventions focus on laws and regulations, including structures that impact health outcomes.
  • Downstream interventions focus on providing equitable access to care, including offering medical interventions, evaluations, clinical services, and treatment.

We plan to advocate for many of these topics, such as language equity and access, culturally competent healthcare services, and more at the upcoming Asian American Action Day (AAA Day) taking place in Springfield, IL on Tuesday, May 9. If you are interested in learning more about CASL’s affiliation with this event, please contact Felicitas_Yari@caslservice.org.

#1: Limited English Proficiency

When you can’t effectively communicate that you need help, or the kind of help you need, getting medical care can become a sincere challenge, as Changing Tides’ data suggests.

Limited proficiency in the English language (for the Chicago AANHPI population surveyed) was reported the #1 top risk factor for Chinese and Korean individuals and the #3 top risk factor for Asian Indian, Filipino and Pakistani individuals.

The upstream recommendation offered by the Change InSight team to address limited English proficiency is urging policymakers to strategically collaborate with partners for sustainable funding from local, national, public and private agencies that provide language services. With increased funding for free language class providers, more people will feel comfortable seeking health services and other types of community support.

The downstream recommendations offered by the Change InSight team are to urge policymakers to prioritize language accessibility and availability of translated materials for communities with English as a second language, and provide community education around these resources. This could include ensuring more culturally and linguistically accessible health systems in affected communities, recruiting linguistically competent service providers, ensuring translation of state documents into more AANHPI languages, more robust ESL programs, developing training and credentialing programs for bilingual staff, and more affordable daycare services for parents attending ESL classes.

#2: Unemployment

Being unable to obtain employment is associated with lower psychological well-being, as well as unhealthy behaviors that can contribute to higher mortality rates. Struggling to find work is a situation no one wants to be in, as being able to pay rent and maintain health with insurance is much more of a challenge for unemployed individuals.

The upstream recommendations offered by the Change InSight team are to address unemployment rates as a risk factor among AANHPI communities to capitalize on federal programs that increase access to grants, contracts, resources, and employment opportunities for AANHPI communities to promote business. This can include engaging in specific outreach programs to advance inclusivity and access to contracts, federal grants, resources, and employment programs for AANHPI communities, as well as other underserved communities. This will lead to more opportunities for these communities to participate in federal programs.

The downstream recommendation offered by the Change InSight team is to advocate for more education and workforce development training in AANHPI communities and schools. Educating local businesses on favorable market policies could also help reduce local unemployment rates.  More job fairs with representatives from local and community-serving businesses focused on recruiting AANHPI and underserved community members, as well as community education about unemployment benefits could help.

Ensuring local businesses are up-to-date in legal and fair hiring and employment practices is also key. If local businesses also offered internships specifically for AANHPI individuals and others, more people with diverse backgrounds, especially youth, will have more employment opportunities. Additionally, more education for workers around fair labor laws and practices could help prevent exploitation and discrimination against specific groups in the workplace.


#3: Low Social Integration

Focus on one’s state of mental health and social isolations’ effects on it has increased following the coronavirus pandemic. Changing Tides paid special attention to the socialization of survey respondents, including the number of close relationships in their life, frequency of social contact, and overall relationship quality. More than 20% of respondents were considered at risk due to low social integration.

The upstream recommendations offered by the Change InSight team to address low social integration is simple: offer, and/or increase access to improved mental and behavioral services for AANHPIs and other underserved community members. Through advocating for more integrated care options for these groups, cultural definitions of health can be more widely recognized and addressed.

The downstream recommendations offered by the Change InSight team to address low social integration is to develop an inclusive approach to socialization that incorporates technology use, education, and physical and mental activities that enhance social cohesion through support groups in the community.

Many community service centers have special engagement programs or councils that empower people of different age groups such as senior citizens to be more connected to their culture and community. Using technology to increase access for disabled community members and others with restricting schedules can also improve social integration. Encouraging participations in specialized groups and programs makes a significant impact on the social health of a community.


#4: Stress

Nearly three-fourths of Changing Tides respondents reported elevated stress levels in their everyday lives. Cardiovascular illness and pregnancy complications are just two examples of health conditions significantly influenced by stress levels.

The upstream recommendations offered by the Change InSight team are focused on leveraging increased education, technology use and funding to offer holistic, culturally and linguistically integrated behavioral health services that reduce stigma while offering personalized clinical services and support for stress. Additionally, increasing funding for agencies offering these services will improve access to evidence-based mental health screening, diagnosis, and treatment.

Agencies should pursue funding from organizations that place special focus on stress management and behavioral health support—National Institute for Health (NIH), Substance Abuse and Mental Health Services Administration (SAMHSA), and National Science Foundation, to name a few.

The downstream recommendations offered by the Change InSight team are focused on increasing awareness of cultural attitudes to help break barriers and address stigma as it relates to specific ethnicities, and increasing access to culturally competent services through telehealth, and even digital literacy training for families to ensure they are prepared to utilize telehealth services. Additionally, more bilingual counselors for mental health interventions would greatly reduce risk.


#5: Poverty

Over half of Changing Tides respondents were considered “living in poverty” according to federal poverty guidelines—based on self-reported income and number of people reported as living in one household. When an individual struggles to afford food, housing, healthcare and some public benefits connected to having an income, their personal health can quickly be affected. With the coronavirus pandemic significantly impacting employment in industries AANHPIs are highly represented, like food and retail, many people are still struggling as a result.

The upstream recommendations offered by the Change InSight team to address this are focused on engaging in federal and community-based programs that empower small business, foster workforce development, increase access to social services, and expand investment opportunities with local businesses and schools. Advocacy for local, state, and federal programs combating poverty are key, such as the City of Chicago’s Resilient Communities Pilot Program, which provides 5,000 struggling Chicago households with $500 monthly checks to help recover from the pandemic’s effects on the economy.

Other upstream recommendations include enhancing access to capital for AANHPI-owned small businesses to spur economic growth while reducing employment. This could include providing training and counseling for AANHPI entrepreneurs to help them secure grants and other types of small business funding.

The downstream recommendations offered by the Change InSight team include partnering with local business to invest in local communities and encouraging business development that benefits community members while preventing the consequences of gentrification. Increasing access to social services like SNAP and WIC would also benefit community members, as well as funding programs that increase access to healthy foods.


Asian American Action Day 2023

Advocacy is a surefire way to activate the changes we want to see socially and politically. Equipped with these valuable data insights, the Pan Asian Voter Empowerment (PAVE) coalition (a coalition of 13 Asian American advocacy and direct service organizations in the Chicagoland area) which CASL is a member of, will be headed to Springfield, IL on Tuesday, May 9 with at least 300 Asian Americans who plan to share personal stories and speak with elected officials about solutions to systemic challenges facing AANHPI and underserved communities.

Interested in joining us? Register here.

*All participants must attend an Advocacy Day 101 training prior to AAA Day. Trainings are available on the following days:

  • Thursday, May 4th 6:00pm-7:30pm (Korean, Mandarin, and Cantonese interpretation available)

  • Saturday, May 6th 11:00am-12:30pm (Arabic, Hindi/Urdu, Khmer interpretation available)

  • Tuesday, May 8th 11:00am-12:30pm (Tagalog and Vietnamese interpretation available)

Questions? Contact Dr. Felicitas Yari (Felicitas_Yari@caslservice.org) and Abbey Eusebio (Abbey_Eusebio@caslservice.org).


CASL is an all-inclusive non-profit agency with 45 years of experience connecting families and individuals with the vital support they need: providing an educational and cultural foundation for our children, ensuring our seniors live full and independent lives with dignity, enhancing education and training for tomorrow’s workforce, putting immigrants on the pathway to citizenship, securing our community’s housing and financial well-being, navigating healthcare systems and wellness resources,​ and fighting for equal access to justice. Since our founding, CASL has been rooted in the principles of equity and justice. That legacy continues to shape our efforts today as we strive to champion diversity, equity, inclusion, and accessibility at all levels of the organization.