The gendered and public health consequences of anti-Asian racism in America


Six of the eight victims killed in the Atlanta massacre on Tuesday March 16, 2021 were women of Asian descent. This horrific incident is illuminating the United States’ long history of anti-Asian racism and violence, especially gender-based violence, and raising questions about what we know and don’t know about the intertwined effects of racism, violence, and health outcomes for Asian women.

Anti-Asian racism and violence is widely believed to be under-reported but cuts across age and ethnic strata, which means that the entire Asian American and Pacific Islander (AAPI) community is being terrorized. However, AAPI women bear a disproportionate burden compared to men.  Nearly 70% of the almost 4,000 hate incidents reported to the Stop AAPI Hate tracker between March 19, 2020 and February 28, 2021, were reported by women.

Xenophobic political rhetoric in the last year, including characterizing the coronavirus as the “Kung Flu” or “China virus”, has fueled an escalation in this racism and violence, and Asian women, in particular, continue to fare the worst.  Only after the Atlanta incident is the United States beginning to grasp how dehumanizing racism and violence have been for Asian women, particularly working-class and migrant women with professions that jeopardize their safety, health and wellbeing. An initial explanation offered by Atlanta Police Department – that the shootings were motivated by “sexual addiction” – is a tragic reminder of the entrenched socio-ecological environment of sexism, hyper-sexualization, and fetishization specific to Asian women.  This environment, which has been engendered by systems of patriarchy and supremacy, continues to reinforce stereotypes, discrimination and negative gender norms that intersect with other social factors and can be harmful to an individual’s health and wellbeing.

This socio-ecological environment may also contribute to sexual and gender-based violence (SGBV).  Nearly a quarter to a half of all Asian women in the United States experience intimate physical and/or sexual violence in their lifetime. The negative public health consequences to women experiencing SGBV range from mental health outcomes such as depression, substance abuse, self-harm and suicide to sexual and reproductive health outcomes like unwanted pregnancies, miscarriages, and sexually transmitted infections.  The added racialized nature of this violence endured by the AAPI women can trigger past and intergenerational traumas, particularly for Asian refugees and migrants who were victims of warfare, former victims of SGBV, and those with existing mental health illnesses, which can further exacerbate poor mental health disorders.

For years and much more acutely in the last year, racism and racial violence has also restricted the freedom of movement for many members of the AAPI community, especially women, due to their legitimate fear of being the target of verbal and physical assaults while doing basic everyday tasks, such as taking public transportation or buying groceries. This trauma and fear have led to isolation, which can have serious adverse physical and mental health outcomes.

What can public health officials and professionals do to ensure the health and wellbeing of Asian women?

Strengthen data systems.  Public health officials need to work closely with The Uniform Crime Reporting Program to improve the collection and analyses of data on racially motivated hate crimes and the links to SGBV and mental health.  This data will need to be disaggregated by age, gender, race and ethnicity, and occupations at both sub-national and national levels.  Currently, the Centers for Disease Control and Prevention report data on gun violence and SGBV separately without addressing whether it is racially motivated and how they manifest into other health outcomes. Without robust data, it is not possible to understand the breadth and depth of these issues or to effectively design public health and safety interventions.

Invest in violence prevention measures. State and city public health officials need to encourage affected AAPI communities to report hate crimes and other hate incidents, promote anti-hate campaigns and mental health services in public spaces, invest in anti-racist training for public health staff that tackles power and gender dynamics through the Asian American historical lens, offer free resources for bystander and de-escalation training for the public, and provide support for accompaniment services for Asian women and elders.

The rise of Anti-Asian violence disproportionately hurts Asian women and racialized gender-based violence has a massive impact on public health.  As we advocate to #StopAsianHate, let’s center the experience, health and well-being of Asian women in this moment of change, especially migrant and working-class Asian women who often fall at the margins of our society.

About the author: Thoai D. Ngo, Ph.D., is the global director of the Poverty, Gender, and Youth Program and the Founding Director of the GIRL Center at the Population Council. An epidemiologist based in New York City, his research focuses on the intersections between gender, health, and poverty globally.

Competing interests: None.

Handling Editor: Neha Faruqui

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