Topline

Asian Immigrant Experiences with Racism,

Immigration-Related Fears, and the COVID-19

Pandemic

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 1

Methodology

This analysis is based on a KFF survey of Asian adult patients from four community health centers: Asian Health Services in Alameda Count, CA; North East Medical Services, in San Francisco, CA; HOPE Clinic in Houston, TX; and International Community Health Services (ICHS) in King County, WA. In 2019, these four health centers served a total of 154,604 patients, 117,617 of whom identified as non-Hispanic Asian as of 2019, or 79% of patients with known race/ethnicity. Health centers do not collect information on patient immigration status, but nearly seven in ten patients at these health centers are best served in a language other than English.1

The survey was designed by researchers at KFF in collaboration with staff at the Association of Asian Pacific Community Health Organizations and the community health centers who participated in the survey. Community health center staff translated the survey into Chinese (traditional), Vietnamese, Korean, and Burmese. Reflecting their patient demographics, Asian Health Services, North East Medical Services, and ICHS fielded the survey in English, Chinese, Vietnamese, and Korean, while HOPE Clinic fielded the survey in English, Chinese, Vietnamese, and Burmese. Respondents were patients from the four community health centers who were contacted by the health center staff between February 15th and April 12th, 2021. Over a third (34%) of respondents completed the survey in-person with clinic staff, 32% completed a paper version of the survey, 25% completed the survey online, and 7% completed the survey via phone.

There were a total of 1,467 survey respondents. This analysis is based on the convenience sample of 1,086 respondents who self-identified as Asian and indicated that they were a patient of one of the four health centers in their survey responses. Of those included in the analysis, 874 indicated that they were born outside the United States or Puerto Rico and 176 were born in the U.S. or Puerto Rico; 36 respondents did not answer the survey question on nativity.

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 2

Table 1: Demographic Characteristics of Respondents by Health Center Location

Category Percent of All Respondents

(n = 1,086)

Percent of CA Health Center Patients

(n = 615)

Percent of Other Health Center

Patients (TX and WA) (n = 471)

Gender Female 59% 59% 59% Male 37 37 38 Do not Identify as Male or Female (non-binary) 2 3 1 Skipped/Refused 1 1 1

Age

18-44 27 31 22 45-64 34 37 30 65+ 39 31 49 Skipped/Refused * * *

Ethnicity

Chinese 62 71 49 Vietnamese 18 13 24 Other Ethnicity 21 16 27

Nativity

Native-Born (U.S. or Puerto Rico) 16 18 14 Immigrant 80 77 85 Skipped/Refused 3 5 1

Parent/Guardian

Parent or Guardian of Child in Home 33 40 24 Not a Parent or Guardian of Child in Home 67 60 76

NOTE: CA = California, TX = Texas, WA = Washington. Percentages may not sum to 100 due to rounding. * Indicates a less than 0.5 percent.

Unless otherwise noted, all percentages are based on total responses to the survey (n = 1,086). Asterisks

(*) indicate a value of less than 0.5 percent.

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 3

Q1. How old are you? _____years of age.

[Shown in Appendix Table 1]

Q2. Are you the parent or guardian of any child under the age of 18 living in your household?

Yes 33 No 67

Q3. What type of impact has the coronavirus pandemic had on each of the following? [Select one

for each option]

Your ability to pay for basic needs, like housing, utilities, and food

Positive impact 23 Negative impact 48 No impact 27 Refused/Blank 3 Total (all respondents): n = 1,086

Your ability to do your job

Positive impact 31 Negative impact 40 No impact 25 Refused/Blank 5 Total (all respondents): n = 1,086

[FOR PARENTS] Your children’s education

Positive impact 30 Negative impact 52 No impact 16 Refused/Blank 3 Total (parents/guardians only): n = 361

[FOR PARENTS] Your ability to care for your children

Positive impact 30 Negative impact 41 No impact 26 Refused/Blank 4 Total (parents/guardians only): n = 361

Your mental health

Positive impact 29 Negative impact 43 No impact 25 Refused/Blank 3 Total (all respondents): n = 1,086

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 4

Q4. Has worry or stress related to the coronavirus outbreak caused you to experience the

following in the past 2 months, or not? [Select all that apply]

Trouble falling or staying asleep, or sleeping to much 48 Poor appetite or overeating 39 Frequent headaches or stomach aches 24 Increasing your alcohol or drug use 10 Difficulty controlling your temper 15 Worsening chronic conditions like diabetes or high blood pressure 9

Q5. Since February 2020, have you or another adult in your household lost a job, been placed on

furlough, or had your income or hours reduced because of the coronavirus outbreak, or not?

Yes 54 No 45 Refused/Blank 1

Q6. Have you ever been worried that you might have been exposed to coronavirus, or not?

Yes 58 No 41 Refused/Blank 1

Q7. Have you personally been tested for coronavirus, or not? (regardless of whether your result

was positive or negative)

Yes 46 No 53 Refused/Blank 1

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 5

Q8. Were any of the following reasons why you did not get tested? [Select all that apply]

Asked of respondents who answered “Yes” to question 6 and “No” to question 7, i.e. worried about

exposure but never tested (n = 246).

You didn’t know where to go to get tested 26 You were told by a health professional that you did not need to get tested 13 You were concerned about costs 13 You were afraid it might negatively affect your or a family member’s immigration status 10 You were afraid that it would affect whether you can work if you were positive 12 You thought you could just isolate at home 31 Other reason specified 14

Q9. When an FDA approved vaccine for COVID-19 is available to you for free, do you think you

will…?

Get the vaccine as soon as you can 64 Wait until it has been available for a while to see how it is working for other people 23 Only get the vaccine if you are required to do so for work, school, or other activities 9 Definitely not get the vaccine 2 Refused/Blank 2

Q10. Which is the main reason why you would not get a vaccine for coronavirus?

Asked of respondents who chose “Only get the vaccine if you are required to do so for work, school, or

other activities” or “Definitely not get the vaccine” in question 9 (n = 116).

You are afraid it might negatively affect your or a family member’s immigration status 7 You don’t think you’re at risk for getting seriously ill from coronavirus 25 You don’t trust vaccines in general 6 You think the development of the coronavirus vaccine was being rushed 26 You’re concerned the vaccine would make you sick or have side effects 31 Some other reason (please specify) 2 Refused/Blank 3

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 6

Q11. In the past 12 months, have you experienced any of the following because of your racial or

ethnic background? [Select one for each option]

Received poorer service than other people at a store or other public place

Yes 35 No 51 Not sure 12 Refused/Blank 3

Been denied housing you could afford

Yes 18 No 70 Not sure 7 Refused/Blank 5

Been denied a job you were qualified for

Yes 20 No 65 Not sure 10 Refused/Blank 5

Been criticized for speaking a language other than English in public

Yes 16 No 69 Not sure 11 Refused/Blank 4

Been told that you should go back to your home country

Yes 15 No 73 Not sure 9 Refused/Blank 4

Been verbally or physically attacked

Yes 14 No 71 Not sure 9 Refused/Blank 5

Been accused of “spreading or causing COVID-19"

Yes 15 No 71 Not sure 9 Refused/Blank 5

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 7

Q12. Have you personally felt more discrimination or less discrimination based on your racial or

ethnic background since the coronavirus pandemic began in the U.S., or has the discrimination

been about the same?

More discrimination 33 Less discrimination 9 About the same discrimination 28 I haven't felt any discrimination 28 Refused/Blank 2

Q13. Since the coronavirus pandemic began in the U.S., have you been criticized for [Select one

for each option]:

Wearing a mask Yes 42 No 46 Not Sure 9 Refused/Blank 3 Not wearing a mask Yes 13 No 66 Not Sure 11 Refused/Blank 11

Q14. Was there a time in the past 12 months when you put off getting or did NOT get health care,

or has this not happened?

Yes 30 No 68 Refused/Blank 2

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 8

Q15. Were any of the following a reason that you put off or did NOT get health care? [Select all

that apply]

Asked of respondents who chose “Yes” in question 14 (n = 328).

Because you couldn’t afford the cost 31 Because you couldn’t take time off work 45 Because of difficulty traveling to the doctor’s office or clinic 26 Because you were concerned about exposure to coronavirus 42 Because you were concerned it might affect your or a family member’s immigration status 6 Other reason specified 5

Q16. Was there a time in the past 12 months when you put off getting or did NOT get health care

for any of your children, or has this not happened?

Yes 37 No 62 Refused/Blank 2

Q17. In the past 12 months, have you or another family member living in your household received

any government assistance to help pay for things like housing, food, or health insurance, or not?

Yes 40 No 58 Refused/Blank 2

Q18. Was there a time in the past 12 months when you or a family member in your household

decided not to apply for or stopped participating in a government program to help pay for health

care, food, or housing, because you were afraid it might affect you or a family member’s

immigration status?

Yes 25 No 73 Refused/Blank 2

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 9

Q19. Did you decide not to apply or stop participating in a program that helps with any of the

following or some other program? [Select all that apply]

Asked of respondents who chose “Yes” to question 18 (n = 272).

Food 48 Housing 67 Health care 42 Other reason specified 3

Among all respondents (n = 1,086):

Food 12 Housing 17 Health care 10 Other reason specified 1 Not asked to complete this question 60

Q20. Regardless of your own immigration or citizenship status, how much, if at all, do you worry

that you or a family member could be detained or deported? Please remember that your answers

are confidential and will not be used to identify you or your family.

A lot 14 Some 29 Just a little 17 Not at all 36 Refused/Blank 4

Q21. Regardless of your own or your child’s immigration or citizenship status, have any of your

children had any worries or fears about you or a family member being detained or deported?

Asked of respondents to identified as parents/guardians of children in their home in question 2 (n = 361).

Yes 30 No 66 Refused/Blank 3

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 10

Q22. Do you feel you have enough information about recent changes to U.S. immigration policy,

such as public charge, to understand how they might impact you and your family, or do you not

have enough information?

Have enough information 43 Do not have enough information 54 Refused/Blank 4

Q23. In the past 12 months, how often have you used any of the following to get information about

U.S. immigration policy [Please select one for each option]

English language television and radio

Very Often 24 Somewhat Often 20 Not often 24 Do not use this source 21 Refused/Blank 11

English language newspapers

Very Often 17 Somewhat Often 22 Not often 22 Do not use this source 25 Refused/Blank 13

Television or radio in your native language

Very Often 25 Somewhat Often 34 Not often 23 Do not use this source 11 Refused/Blank 6

Newspapers in your native language

Very Often 18 Somewhat Often 33 Not often 25 Do not use this source 15 Refused/Blank 9

Social media, such as WeChat, Twitter, or Facebook

Very Often 20 Somewhat Often 36 Not often 22 Do not use this source 14 Refused/Blank 9

Close friends or family

Very Often 14 Somewhat Often 42 Not often 23 Do not use this source 10

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 11

Refused/Blank 10 A nonprofit organization that provides immigration assistance

Very Often 9 Somewhat Often 27 Not often 27 Do not use this source 24 Refused/Blank 13

A religious organization or church

Very Often 10 Somewhat Often 24 Not often 26 Do not use this source 28 Refused/Blank 13

Government sources, such as the USCIS website or immigration forms

Very Often 11 Somewhat Often 23 Not often 29 Do not use this source 23 Refused/Blank 13

An immigration attorney

Very Often 14 Somewhat Often 18 Not often 23 Do not use this source 31 Refused/Blank 14

Q24. Are you, yourself, now covered by any form of health insurance or health plan or do you not

have health insurance at this time? A health plan would include any private insurance plan

through your employer or a plan that you purchased yourself, as well as a government program

like Medicare or Medicaid [Medi-CAL]

Covered by health insurance 82 Not covered by health insurance 15 Refused/Blank 2

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 12

Q25. Which of the following is your MAIN source of health insurance coverage?

Asked of respondents who chose “Covered by health insurance” in question 24 (n = 895).

Plan through your or your spouse’s employer 16 Plan you purchased yourself 20 Medicare 32 Medicaid/[Medi-Cal] 28 Somewhere else (please specify) 3 Refused/Blank 2

Q26. Are all of your children now covered by any form of health insurance or health plan or do any

of your children not have health insurance at this time? A health plan would include any private

insurance plan through your employer or a plan that you purchased yourself, as well as a

government program like Medicare or Medicaid [Medi-CAL]

Asked of respondents to identified as parents/guardians of children in their home in question 2 (n = 361).

Covered by health insurance 84 Not covered by health insurance 14 Refused/Blank 2

Q27. Are you male or female?

Female 59 Male 37 Do not identify as male or female (non-binary) 2 Refused/Blank 1

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 13

Q28. What best describes your employment situation today?

Employed full-time 24 Employed part-time 19 Retired 26 A student 4 On disability and can’t work 2 Stay at home parent/caregiver 5 Unemployed and currently seeking employment 12 Unemployed and not seeking employment 7 Refused/Blank 1

Q29. What is the highest level of school you have completed or the highest degree you have

received?

Less than high school 20 High school graduate 38 Some college, no degree 22 College degree or higher 19 Refused/Blank 2

Q30 How many people currently live in your household INCLUDING YOURSELF?

1 8 2 35 3 or more (NET) 55

3 20 4 19 5 7 6 5 7 1 8+ 2

Refused/Blank 2

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 14

Q31. Do you currently live in a household with anyone who is age 65 or older or who has a serious

health condition such as high blood pressure, heart disease, lung disease, cancer or diabetes?

Yes 33 No 65 Refused/Blank 2

Q32. What is your residential zip code (where you live)? ________________

[Not Shown]

Q33. What racial/ethnic group do you identify with? [Select all that apply]

Values of less than 0.05 percent or containing fewer than 100 respondents have been suppressed (*).

Chinese 62 Vietnamese 18 Other Asian (NET) 21

Asian Indian * Burmese * Cambodian * Filipino * Hmong * Japanese * Korean * Laotian * Mongolian * Thai * Native Hawaiian * Chamorro/Guamanian * Samoan * Tongan * African American/ Black * American Indian/ Alaska Native * Hispanic/ Latinx * Non-Hispanic White * Other (please specify): _________________ *

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 15

Q34. Were you born in the United States, on the island of Puerto Rico, or in another country? This

information is private, we ask only for research purposes, and all your answers are recorded

confidentially.

U.S. 15 Puerto Rico 1 Another country (please specify) 80 Refused/Blank 3

Q35. What year did you come to live in the United States? This information is private, we ask only

for research purposes, and all your answers are recorded confidentially.

Asked of respondents who chose “Another country” in question 34.

[Not Shown]

Q36. In 2019, what was your total family income from all sources, before taxes?

Less than $20,000 21 $20,000 to less than $30,000 34 $30,000 to less than $40,000 17 $40,000 to less than $50,000 9 $50,000 to less than $75,000 6 $75,000 to less than $90,000 4 $90,000 to less than $100,000 1 $100,000 or more 4 Refused/Blank 4

Q37. Are you a patient of one of the following health centers?

Asian Health Services (AHS), Oakland, CA 24 HOPE Clinic, Houston, TX 11 International Community Health Services (ICHS), Seattle/King County, WA 32 North East Medical Services (NEMS), San Francisco, CA 32

Asian Immigrant Experiences with Racism, Immigration-Related Fears, and the COVID-19 Pandemic 16

Q38. In what format are you responding to this survey?

By phone 7 In-person with clinic staff 34 On paper 32 Online 25 Refused/Blank 1

1 KFF analysis of the 2019 Uniform Data System, Health Resources and Services Administration.

KFF

Headquarters and Conference Center185 Berry Street, Suite 2000

San Francisco, CA 94107650-854-9400

Washington Offices and Conference Center1330 G Street, NW

Washington, DC 20005202-347-5270

This publication is available at kff.org.

Filling the need for trusted information on national health issues, KFF (Kaiser Family Foundation) is a nonprofit organization

based in San Francisco, California.