Anti-Asian hate incidents rose dramatically during COVID, likely fueled by prominent statements about the “Chinese virus.”  VIewed through the wider lens of history, this was just the latest in a long experience of Anti-Asian hate, including the murder of Vincent Chin, the Chinese Exclusion Act, and the internment of Japanese Americans during WWII.  For those who think that anti-Asian hate has receded as the COVID has “ended,” just two days prior to recording this episode a Filipino woman was pushed to her death on BART in San Francisco. These incidents are broadcast widely, particularly in Asian News outlets.

Today we talk about the impact of anti-Asian hate on the health and well being of older adults with Russell Jeung, sociologist, Professor of Asian Studies at San Francisco State, and co-founder of Stop AAPI-Hate, Lingsheng Li, geriatrician/palliative care doc and T32 fellow at UCSF, and Jessica Eng, medical director of On Lok, a PACE, and Associate Professor in the UCSF Division of Geriatrics. 

We discuss:

• What is considered a hate incident, how is it tracked, what do we know about changes over time

• The wider impact of Anti-Asian hate on older Asians, who are afraid to go out, leading to anxiety, social isolation, loneliness, decreased exercise, missed appointments and medications. Lingsheng (and I) recently published studies on this in JAMA Internal Medicine, and JAGS.

• Ongoing reports from patients about anti-Asian hate experiences 

• Should clinicians screen for Anti-Asian hate? Why? Why not?

• Proposing the clinicians ask a simple follow up question to the usual “do you feel safe at home?” question used to screen for domestic violence.  Add to this, “do you feel safe outside the home?” This question, while providing an opportunity to talk about direct and indirect experiences, can be asked of all patients, and opens the door to conversations about anti-semitism, islamophobia, or anti-Black racism.

See also guides for how to confront and discuss anti-Asian hate in these articles in the NEJM and JGIM.

And to balance the somber subject, Lingsheng requested the BTS song Dynamite, which was the group’s first English language song, and was released at the height of the COVID pandemic.  I had fun trying to make a danceable version with electronic drums for the audio-only podcast.  Maybe we’ll get some BTS followers to subscribe to GeriPal?!?

 

-@AlexSmithMD