The Affordable Care Act and Asian Americans and Pacific Islanders. Endnotes

04/01/2012

1  “Health disparities: A case for closing the gap.” Office of Health Reform, Department of Health and Human Services, 2009.  (Accessed at http://www.healthreform.gov/reports/healthdisparities/).

2  Lesley M. Russell, “Reducing disparities in life expectancy: What factors matter?” The Institute of Medicine, 2011.  (Accessed at http://www.iom.edu/~/media/Files/Activity percent20Files/SelectPops/HealthDisparities/2011-FEB-24/Commissioned percent20Paper percent20by percent20Lesley percent20Russell.pdf).

3  “Overview of the Uninsured in the United States: A Summary of the 2011 Current Population Survey.” Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, 2011, p. 1.  (Accessed at http://aspe.hhs.gov/health/reports/2011/CPSHealthIns2011/ib.shtml).

4  Karen R. Humes, Nicholas A. Jones, and Roberto R. Ramirez, “Overview of Race and Hispanic Origin: 2010.” U.S. Census Bureau, Table 8 (p. 14) and Table 9 (p. 15).  (Accessed at http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf). Population estimate combines the total number of Asians alone and the total number of Native Hawaiian and Other Pacific Islanders alone.  Throughout the brief, we use the term “Asian Americans and Pacific Islanders” for estimates encompassing both groups, and “Asian Americans” and “Native Hawaiians and Other Pacific Islanders”, respectively, for estimates for each of those groups separately.  Some data sources refer to Asian Americans as “Asians,” and some data sources refer to Native Hawaiians and Other Pacific Islanders as “Pacific Islanders.” Some data sources that report data for Asian Americans do not report data for Native Hawaiians and Other Pacific Islanders due to small sample sizes and/or high standard errors for the latter population.

5  Karen R. Humes, Nicholas A. Jones, and Roberto R. Ramirez, “Overview of Race and Hispanic Origin:  2010.” U.S. Census Bureau, Table 1 (p. 4).  (Accessed at http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf). This growth rate estimate was taken by first combining the Asian alone and Native Hawaiian and Other Pacific Islanders alone categories for both 2000 and 2010, and then calculating the growth rate of these totals.

6  Population estimates for Native Hawaiians and Other Pacific Islanders are from Karen R. Humes, Nicholas A. Jones, and Roberto R. Ramirez, “Overview of Race and Hispanic Origin:  2010.” U.S. Census Bureau, Table 3 (p. 7).  (Accessed at http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf). All other Asian American and Pacific Islander subgroup population estimates are from Elizabeth M. Hoeffel, Sonya Rastogi, Myoung Ouk Kim, and Hasan Shahid, “The Asian Population: 2010.” U.S Census Bureau, Table 6 (p. 15). (Accessed at http://www.census.gov/prod/cen2010/briefs/c2010br-11.pdf).

7  Carmen DeNavas-Walt, Bernadette D. Proctor, and Jessica C. Smith, “Income, Poverty, and Health Insurance Coverage in the United States: 2010.” U.S. Census Bureau Current Population Reports Table 8 (p. 26).  (Accessed at http://www.census.gov/prod/2011pubs/p60-239.pdf).

8  Estimates are from the 2008-2010 American Community Survey (ACS) for subgroups of Asian alone using the U.S. Census Bureau’s American FactFinder tool.  The American FactFinder tool can be accessed at http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml.

9  Patient Protection and Affordable Care Act (Public Law 111-148) and Health Care and Education Reconciliation Act of 2010 (Public Law 111-152).

10  Section 1001.

11  Benjamin D. Sommers and Karyn Schwartz, “2.5 million young adults gain health insurance due to the Affordable Care Act.” Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, 2011, p. 1.  (Accessed at http://aspe.hhs.gov/health/reports/2011/YoungAdultsACA/ib.shtml). The estimate is based on data from the June 2011 National Health Interview Survey (NHIS).

12  “New Report Shows Affordable Care Act Has Expanded Insurance Coverage Among Young Adults of All Races and Ethnicities.” Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, 2011, p. 2.  (Accessed at http://aspe.hhs.gov/health/reports/2012/YoungAdultsbyGroup/ib.shtml).

13  Estimates provided to the Office of the Assistant Secretary for Planning and Evaluation under contract no. HHSP23320095649WC.  Information on the RAND COMPARE model is available at http://www.rand.org/health/projects/compare.html.

14  Section 2001.  Section 2002 provides for an income disregard of 5 percent of Federal Poverty Guidelines, raising the effective income limit to 138 percent ($31,809 for a family of four).

15  Section 1401.

17  Benjamin D. Sommers and Lee Wilson, “Fifty-four million additional Americans are receiving preventive services without cost-sharing.” Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, 2011, p. 3.  (Accessed at http://aspe.hhs.gov/health/reports/2012/PreventiveServices/ib.shtml).

18  The Medicare preventive services provisions are in Section 4104.  Medicare enrollment data computed from 2009 Medicare Current Beneficiary Survey.  The complete list of benefits covered with no cost-sharing is available in “The Affordable Care Act: Strengthening Medicare in 2011.” U.S. Department of Health and Human Services.  (Accessed at http://www.cms.gov/apps/files/MedicareReport2011.pdf).

19  “Health, United States, 2010.” Centers for Disease Control and Prevention (CDC), Table 85 (p. 293).  (Accessed at http://www.cdc.gov/nchs/data/hus/hus10.pdf#085). Native Hawaiians and Pacific Islanders are not included in this estimate and are not shown separately in the source due to high standard error.

20  “Cancer Screening – United States, 2010.” Morbidity and Mortality Weekly Report, 61(03), Centers for Disease Control and Prevention (CDC), 2012, pp. 41-45.  (Accessed at http://www.cdc.gov/mmwr/pdf/wk/mm6103.pdf). Asian American and Pacific Islander screening rates are 8.7 percentage points below that for Whites for mammograms, 8.0 percentage points below that for Whites for Pap smears, and 12.9 percentage points below that for Whites for colorectal cancer screening.  Estimated Asian American and Pacific Islander rates for mammograms and Pap smears are also below those for African Americans, American Indians and Alaska Natives, and Latinos.  Estimated Asian American and Pacific Islander rates for colorectal cancer screening are below those for African Americans and for American Indians and Alaska Natives, but slightly above those for Latinos.

21  “The Affordable Care Act Helps Asian Americans and Pacific Islanders.” The White House, 2012, p. 1.  (Accessed at http://www.whitehouse.gov/system/files/docs/the_aca_helps_aapis_fact_sheet.pdf).

22  “Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2010.” Centers for Disease Control and Prevention (CDC), Table 41 (p. 136).  (Accessed at http://www.cdc.gov/nchs/data/series/sr_10/sr10_252.pdf ).

23  “HIV Surveillance Report.” Centers for Disease Control and Prevention (CDC) Vol. 21, 2009, p. 6.  (Accessed at http://www.cdc.gov/hiv/surveillance/resources/reports/2009report/pdf/2009SurveillanceReport.pdf).

24  “Health, United States, 2010.” Centers for Disease Control and Prevention (CDC), Table 78 (p. 279).  (Accessed at http://www.cdc.gov/nchs/data/hus/hus10.pdf#085). Native Hawaiian and Other Pacific Islanders are not included and not shown separately in the source because of high standard error.

25  “Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2010.” Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, Table 35 (p. 118).  (Accessed at http://www.cdc.gov/nchs/data/series/sr_10/sr10_252.pdf).

26  Innovation Center, Health Care Innovation Challenge Funding Opportunity Number: CMS-1C1-12-001, CFDA: 93.610. (Accessed at http://www.innovations.cms.gov/Files/x/Health-Care-Innovation-Challenge-Funding-Opportunity-Announcement.pdf).

27  “Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2010.” Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, Table 7 (p. 34).  (Accessed at http://www.cdc.gov/nchs/data/series/sr_10/sr10_252.pdf).  Native Hawaiian and Other Pacific Islander adults are not included and are not shown separately in the source due to high standard error.

28  “Notice to Readers: National Hepatitis B Initiative for Asian Americans/Native Hawaiian and Other Pacific Islanders.” Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report 58(18), 2009, pp. 503-4.  (Accessed at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5818a6.htm).

29  “Trends in Tuberculosis — United States 2010.” Centers for Disease Control and Prevention (CDC), p. 1.  (Accessed at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6011a2.htm#fig1).

30  “The Affordable Care Act Helps Asian Americans and Pacific Islanders.” The White House, 2012, p. 3.  (Accessed at http://www.whitehouse.gov/system/files/docs/the_aca_helps_aapis_fact_sheet.pdf ).

31  For example, Section 5402 provides for loan repayments and educational assistance for health care professionals with disadvantaged backgrounds, and provision of training in cultural competency is a priority criterion for support and development of primary care training programs under Section 5301.

32  “Quality of Health Care for Asian Americans,” based on the 2001 Health Care Quality Survey. The Commonwealth Fund, March 2002, p. 2.  (Accessed at http://www.commonwealthfund.org/~/media/Files/Publications/Other/2002/Mar/Quality%20of%20Health%20Care%20for%20Asian%20Americans%20%20A%20Fact%20Sheet/Hughes_factsheetasam%20pdf.pdf).

33  Estimates are from the 2008-2010 American Community Survey (ACS) for Asian alone and White alone using the US Census Bureau’s American FactFinder tool.  The American FactFinder tool can be accessed at http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml.

34  Sections 4302, 6301, 10334.  Final Data Collection Standards for Race, Ethnicity, Primary Language, Sex, and Disability Status Required by Section 4302 of the Affordable Care Act available at http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208.

35  More information on the HHS Disparities Action Plan can be accessed at http://minorityhealth.hhs.gov/npa/templates/content.aspx?lvl=1&lvlid=33&ID=285.

36  Section 10334.

37  More information on the Community Transformation Grant program can be accessed at http://www.cdc.gov/communitytransformation/.

38  More information on HHS ethnicity standards is available at:  http://aspe.hhs.gov/datacncl/standards/ACA/4302/index.shtml. http://www.minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208.

39  “Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2010.” Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, Table 2 (p. 19).  (Accessed at http://www.cdc.gov/nchs/data/series/sr_10/sr10_252.pdf). The Native Hawaiian and Other Pacific Islander rate of all circulatory diseases is higher than the rates shown for Whites, Blacks or African Americans, American Indians or Alaska Natives, Asians, or Hispanics or Latinos.

40  “Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2010.” Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, Table 19 (p. 70).  (Accessed at http://www.cdc.gov/nchs/data/series/sr_10/sr10_252.pdf). The Native Hawaiian and Other Pacific Islander rate of difficulty in physical functioning is higher than the rates shown for Whites, Blacks or African Americans, American Indians or Alaska Natives, Asians, or Hispanics or Latinos. Physical difficulties include inability to walk a quarter of a mile, climb up ten stairs without resting, or stand for two hours.

41  “Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2010.” Centers for Disease Control and Prevention (CDC) - National Center for Health Statistics, Table 31 (p. 106).  (Accessed at http://www.cdc.gov/nchs/data/series/sr_10/sr10_252.pdf). The Native Hawaiian and Other Pacific Islander obesity rate is higher than the rates shown for Whites, Blacks or African Americans, American Indians or Alaska Natives, Asians, or Hispanics or Latinos.

42  “Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2010.” Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, Table 35 (p. 118).  (Accessed at http://www.cdc.gov/nchs/data/series/sr_10/sr10_252.pdf).

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