oversight

Asian Americans: A Status Report

Published by the Government Accountability Office on 1990-03-08.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

                                               i
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                             United   States       General   Accounting     Office   *
                                  Fact Sheet for the Chairman, Select
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                                  Committee on Hunger, House of
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     ‘.                      ASIAN AMERICANS
                             A Status Report




                    RESTRICTED--       Not to be released outside         the
                    General Accounting   Office unless specifically
                    approved by the Offke of Congressional
                    Relations.
GAO                  United States
                     General Accounting  Office
                     Washington, D.C. 20548

                     Human Resources    Division

                     B-237669

                     March 8, 1990

                     The Honorable Tony Hall
                     Chairman, Select Committee on Hunger
                     House of Representatives

                     Dear Mr. Chairman:

                     As requested April 7, 1989, by the late Chairman of the Select Commit-
                     tee on Hunger, Representative Mickey Leland, and as subsequently
                     agreed with your office, this fact sheet provides information about the
                     status of Asians in the United States-hereafter    referred to as Asian
                     Americans. Specifically, we were asked to provide information on Asian
                     American

                   . income, employment, education, health, and nutrition status and
                   . enrollment in nine federal welfare programs: Aid to Families With
                     Dependent Children; Supplemental Security Income; Medicaid; Low-
                     Income Housing; Food Stamp; the Special Supplemental Food Program
                     for Women, Infants, and Children; School Lunch; School Breakfast; and
                     Summer Food.

                     In addition, we were asked to identify (1) possible barriers to Asian
                     American participation in the above programs and (2) existing pro-
                     grams, in selected communities, to assist new Asian immigrants and ref-
                     ugees in achieving economic self-sufficiency.


                     We reviewed available studies; spoke with federal, state, and local offi-
Review Scope and     cials, as well as nonprofit Asian American organizations and other com-
Methodology          munity organizations; and analyzed available data from the U.S. Bureau
                     of the Census. We also obtained information about the laws and regula-
                     tions, eligibility criteria, and funding for federal programs that assist
                     immigrants and refugees. We used the Census Bureau’s definition of
                     Asian Americans, which includes all people who categorized themselves
                     as from 1 of 28 Asian countries of origin or ethnic groups or from 1 of
                     25 identified Pacific Island cultures (see table 1.1 and footnotes). In
                     1980, the Chinese, Filipino, Japanese, Indian, Korean, and Vietnamese
                     groups accounted for about 89 percent of the Asian American popula-
                     tion. (See pp. 12-19.)




                     Page 1                                        GAO/HRD!W36FS   Asian Americans
                   B-237669




                   Available information indicates that Asian Americans overall are com-
Results in Brief   parable with the U.S. population overall for per capita income, employ-
                   ment, educational attainment, general health and nutrition status, and
                   participation in U.S. public assistance programs. However, data on
                   Asian Americans are limited, primarily because (1) Asian Americans
                   make up a small portion of the total U.S. population and (2) available
                   studies, for the most part, do not contain sufficient data about Asian
                   Americans to make statistically valid projections nationwide.

                   Data on Asian Americans by country of origin or ethnic group generally
                   are not available except for the 1980 census, which reveals wide varia-
                   tions among people from different groups. For example, recent arrivals
                   from Southeast Asia (Cambodia, Laos, and Vietnam) have lower incomes
                   and educational levels, as well as higher poverty, unemployment, and
                   welfare-program participation rates than other Asian American groups.

                   Barriers to welfare programs exist, but do not prevent Asian American
                   enrollment.

                   Various federal, state, and local programs have been established to help
                   new arrivals adjust to life in the United States, enroll in public assis-
                   tance programs, and achieve self-sufficiency.


                   Although the average household income for Asian Americans was 28
Income and         percent higher than the U.S. average in 1985, the average size of the
Employment         Asian American household was larger. Thus, on a per capita basis, Asian
                   American income was about the same as the national average. Incomes
                   varied widely among Asian American groups, however. For example,
                   data from the 1980 census showed that, in 1979, the average annual per
                   capita incomes for Indian and Pakistani Americans were over $8,000,
                   compared with the national average annual per capita income of $7,400.
                   On the other extreme, Southeast Asian groups had average annual per
                   capita incomes ranging from $1,600 for Laotian Americans to $3,200 for
                   Vietnamese Americans.

                   The same patterns emerged for employment. In 1980, Asian American
                   adults aged 16 and over had slightly lower unemployment rates and
                   were somewhat more concentrated in white-collar occupations overall
                   than U.S. adults. However, among some Asian American groups, such as
                   the Laotians and Cambodians, the unemployment rate was much higher
                   and the percentage employed in white collar occupations was much
                   lower. (See pp. 20-25.)


                   Page 2                                        GAO/HRD-90-36s   Asian Americans
                        B-237669




                        In 198.5, Asian American adults over the age of 25 had an average of
Educational Levels of    12.27 years of education. This compared favorably with the total I1.S.
Adults                  adult population over the age of 25, which had an average of 12.39
                        years of education. However, a greater proportion of Asian American
                        adults (48.4 percent) had attended college than the total U.S. adults
                        (38.4 percent). Again, wide variation exists among Asian American
                        groups. A 1982 Department, of Health and Human Services (1~s) study
                        showed that over 75 percent of Southeast Asian adults emigrating from
                        Vietnam between 1978 and 1982 had less than a high school education.
                        HHS officials told us that Southeast Asians who came later had even less
                        education. (See pp. 26-28.)


                        Although national statistics on Asian American disease and death rates
Health and Nutrition    generally are lacking, data suggest that their health and nutrition
Status                  appear at least as good as the U.S. population’s in general. Available
                        data show that Asian Americans have longer life expectancy, lower
                        death rates from all causes, and lower infant mortality rates. Data on
                        the nutritional status of Asian American children show it to be compar-
                        able with U.S. standards. However, Southeast Asian refugees suffer
                        higher rates of tuberculosis and hepatitis B than the U.S. population as a
                        whole and experience more nutritional and mental health problems. (See
                        pp. 29-37.)


                        Asian Americans made up from 1.4 to 3.4 percent of all participants in
Welfare Program         the welfare programs we reviewed. In 1985, about the same percentage
Participation           of Asian Americans as the total U.S. population participated in these
                        programs. However, a large proportion-58      percent to 73 percent-of
                        recently arrived Southeast Asian refugees participate in special assis-
                        tance programs established specifically to help refugees. (See pp. 38-42.)


                        Asian American community groups we spoke with said that some Asian
Barriers to Program     Americans experience difficulties and delays enrolling in welfare pro-
Participation           grams, primarily because of a limited knowledge of English. In addition
                        different attitudes toward welfare and government make some Asian
                        Americans reluctant to enroll. However, such obstacles generally do not
                        prevent eventual participation; the groups with the most language diffi-
                        culties have among the highest participation rates in welfare programs.
                        (See pp. 43-46.)




                        Page 3                                        GAO/HRD90-36FS   Asian Americans
                     ES-237669




                     In fiscal year 1988, federal agencies provided almost $150 million to vol-
Programs to Assist   untary agencies and, through the states, to nonprofit, community orga-
New Arrivals         nizations for services to help new arrivals overcome obstacles to self-
                     sufficiency. Such services include resettlement, English language
                     instruction, job training, and job placement. Other federal grant moneys
                     are also available to enable school districts, local government agencies,
                     and community organizations to provide employment training for low-
                     income or limited English-speaking people. In addition to using federal
                     funds, community organizations use funds from a variety of other
                     sources-states, cities, and counties, private donors, and grants from
                     corporations and charitable organizations-to      help new arrivals in their
                     communities. (See pp. 47-53.)


                     As agreed with your office, unless you publicly announce its contents
                     earlier, we plan no further distribution of this fact sheet until 30 days
                     after its issue date. At that time, we will send copies to interested par-
                     ties and make copies available to others on request. If you have any
                     questions about this fact sheet, please call me on (202) 275-1793. Other
                     major contributors are listed in appendix VIII.

                     Sincerely yours,




                     Franklin Frazier
                     Director, Income Security Issues
                       (Disability and Welfare)




                     Page 4                                         GAO/HRD-9036FS   Asian Americans
Page 5   GAO/HRD-90-36s   Asian Americans
                                                                                              ~-
Contents


Letter                                                                                               1
Map of Asia and the                                                                                 10
Pacific Islands
Section 1                                                                                           12
Introduction             The Asian American Population                                              12
                         Objectives, Scope, and Methodology                                         16

Section 2                                                                                           20
Overall Income and       Income and Poverty Rates                                                   20
                         Unemployment and Occupation                                                23
Employment Status
Comparable With U.S.
Population, but Varies
Widely Among Asian
American Groups
Section 3                                                                                           at;
Overall Adult
Educational Levels
Same or Higher Than
Total U.S. Adults, but
Vary Widely Among
Asian American
Groups
Section 4                                                                                           29
Health and Nutrition     Health Status of Asian Americans Reported to Be Good                       29
                         Nutrition Status of Asian American Children Reported to                    33
Appear to Compare             Be Generally Comparable With U.S. Standards
Well With U.S.           Health and Nutrition Problems Cited for Southeast Asians                   34

Population Overall,
Except for Southeast
Asian Refugees


                         Page 6                                      GAO/HRD-SO-36FS   Asian Americans
                         Contents




Section 5
Welfare Participation
Approximates
Representation in U.S.
Population
Section 6                                                                                           43
Barriers Exist, but Do   Limited Knowledge of English Causes Most Difficulties                      43
                         Certain Attitudes Make Some Asian Americans Reluctant                      4.5
Not Prevent Welfare           to Accept Welfare
Participation
Section 7                                                                                           47
Programs Help New        Federal Agencies Fund Special Programs for Refugees                        47
                         Examples of Programs Assisting Asian Americans in Five                     50
Arrivals Attain              Localities
Economic Self-
Sufficiency
Appendixes               Appendix I: Chronology of Selected U.S. Laws and                           54
                             Presidential Actions Affecting Asian Immigration to
                             the United States
                         Appendix II: Data Limitations                                              56
                         Appendix III: SIPP Methodology                                             57
                         Appendix IV: Asian American and Other Local                                61
                             Community Organizations GAO Contacted
                         Appendix V: Detailed Statistics on Asian American                          62
                             Education
                         Appendix VI: Cancer Deaths per 100,000 Population                          63
                             (1978-81)
                         Appendix VII: Cultural and Religious Barriers Facing                       64
                             Southeast Asian Refugees Seeking Medical Treatment
                         Appendix VIII: Major Contributors to This Fact Sheet                       65

Bibliography                                                                                        66

Tables                   Table 1.1: Asian Americans by Yational or Ethnic Origin                     13
                             (1980)


                         Page 7                                      GAO/HRD-SO-36FS   Asian Americans
Contents




Table 1.2: ,4sian Immigration by Country of Origin                       16
     (198188)
Table 1.3: Areas of Greatest Concentration by Large                      19
     Immigrant Asian Groups (1980)
Table 2.1: Average Annual Household and Per Capita                       22
     Income of Asian Americans, by National Origin or
     Ethnic Group (1979)
Table 2.2: Percentage of Asian American Families With                    23
     Incomes Below the Poverty Level, by National Origin
     or Ethnic Group (1979)
Table 2.3: Occupations of Asian Americans (1980)                         24
Table 3.1: Educational Levels of Asian Americans Aged                    26
     25 or Over, by National Origin or Ethnic Group
    (1980)
Table 3.2: Educational Levels of Southeast Asian                         27
     Refugees, Aged 17 or Over, Upon Entry to the United
    States (1978-82)
Table 3.3: Department of Education Programs for Refugee                  28
     and Immigrant Children
Table 4.1: Nutrition-Related Abnormalities Among                        33
    American Children, Through 9 Years of Age, in
    Selected States, by General Ethnic Group (1979-83)
Table 4.2: Disease Rates Among Southeast Asian Refugees                 35
    Compared With Whites, Blacks, and the Total U.S.
    Population (per 100,000 Population)
Table 5.1: Asian American Participation in U.S. Public                  39
    Assistance Programs
Table 6.1: Asian Americans’ Ability to Speak English, by                44
    National Origin or Ethnic Group (1980)
Table 7.1: Major Federal Grant Programs That Help                       48
    Refugees Attain Self-Sufficiency
Table 7.2: Funding of Major Federal Refugee Grant                       49
    Programs
Table 7.3: Examples of Federally Funded Job Training                     50
    Programs for People With Low Income or Limited
    English Proficiency
Table III. 1: SIPP Data Used in Analysis                                58
Table 111.2:Sampling Errors for SIPP Data                               59
Table V. 1: SIPP Data on Educational Levels of Asian                    62
    Americans Compared With the Total U.S. Population,
    Aged 25 or Over (1985)




Page 8                                     GAO/HRDM-36FS   Asian Americans
          Contents




          Table V.2: Annual Housing Survey Data on Educational                        62
              Levels of Asian Americans Compared With the Total
              1J.S.Population, Aged 25 or Over (1987)

Figures   Figure 1.1: Immigration to the United States
               (Fiscal Years 1981-88)
          Figure 2.1: Comparison of Average Monthly Household
               and Per Capita Incomes for Asian Americans and
               Total U.S. Population (1985)
          Figure 2.2: Comparison of Household Sizes for Asian                         21
               Americans and Total U.S. Population (1985)
          Figure 4.1: Life Expectancy of Asian Americans                              30
               Compared With White Americans in California
               (1960) and Hawaii (1980)
          Figure 4.2: Mortality Rates for White, Black, and Asian                     31
               Americans (1979-8 1)
          Figure 4.3: Infant Mortality Rates for White, Black, and                    32
               Asian Americans (1986)
          Figure 4.4: Mean Height-for-Age of Asian Americans                          34
               Compared With U.S. Standard (1981-89)
          Figure 4.5: Study of Southeast Asian Refugee Mental                         37
               Health h’eeds in California (1986-87)
          Figure 5.1: Asian Americans Receiving Benefits From                         40
               Selected U.S. Public Assistance Programs (1985)
          Figure 5.2: Participation of Southeast Asian and Other                      42
               Refugee Groups in Selected U.S. Public Assistance
               Programs (1987)

          Abbreviations

          AFDC       Aid to Families With Dependent Children
          CDC        Centers for Disease Control
          GAO        General Accounting Office
          HHS        Department of Health and Human Services
          JTPA       Job Training Partnership Act
          ORR        Office of Refugee Resettlement
          PHS        Public Health Service
          SIPP       Survey of Income and Program Participation
          SSA        Social Security Administration
          SSI        Supplemental Security Income
          WC         Special Supplemental Food Program for Women, Infants, and
                         Children


          Page 9                                       GAO/HRD-So-36FS   Asian Americans
Map of Asia and the Pacific Islands




                                                                   Y, I

                                    lndla



                                                                                    Phlllpplnes
      A r (I h i a tz
          Sea


                                .                     Sri Lanka
                     Maldives   5




         I       n          d           i         a           n

             0         c            e         a           n




                                    Page 10                       GAO/HRD-SO-36FS     Asian Amrricans
              P            a            c             i                 f             i               c

                         0              c             e                 a             n


                                                                                                                                                    Hawaii
                                                                                                                                                                  &-OS
        -I.                                                                                                                                                                0
              .                                                0
                                                                   Wake
                  *= Mariana Islands
                     b
                                                Trust Territory
                    \ Guam                           of the
                                                Pacific Islands                                                                  -0
                                 44
                                                                                              k, Marshall
    Yap                                     i                                                    ,Islands
     .                 l - v_*                    C                                                                                    0
 B                    ***                                 /-                                       4
                     Caroline Islands                                                                .
Palau                                                                   0                                                                  /
                                                                            r)
                                                                                          e                                                    L
                                                                                                  s
   New Guinea                                                                                             i
                                                                                                              a                                     3

                                                                                                                                                        CD

                                                  \a  b \
                                                               .h
                                                                    Solomon
                                                                     Islands
                                                                                                                  Tokelau
                                                                                                                             0                               d,

                                                  /                 b                                             Western                                         /’
                                                                                                                  Samoa o
                                                                                                                                 Q
                                                                                                                                     American                          9
                                                                                                                                      Samoa
                                                                            s                                                                                                        Tahiti a
                                                                                 /’                                         8. Tow
                                                                                          ’      Fiji *




                                                                    Page 11                                                                        GAO/HRD90-36FS              Asian Americans
Section 1

Introduction


                     Asian Americans, including Pacific Islander Americans, numbered 3.7
The Asian American   million or 1.6 percent of the LJ.S.population, according to the most
Population           recent census in 1980. Subsequent survey data from the U.S. Bureau of
                     the Census indicate that by 1985, the Asian population in the IJnited
                     States had increased to about 5.9 million or 2.5 percent of the U.S. popu-
                     lation. As shown in table 1.1, the Census Bureau records data for people
                     who classify themselves as from 1 of 28 Asian countries of origin or
                     ethnic groups or from 1 of 25 identified Pacific Island cultures (see map
                     on pp. 10 and 11). The Chinese, Filipino, Japanese, Indian, Korean, and
                     Vietnamese groups accounted for about 89 percent of Asian Americans
                     in 1980. A large portion of the Asian American population is foreign
                     born, in part because of legislation restricting Asian immigration before
                      1965 (see app. I).




                     Page 12                                        GAO/HRD90-36FS   Asian Americans
                                           Section 1
                                           Introduction




Table 1.1: Asian Americans   by National
or Ethnic Origin (1980)                                                                                                          Percent
                                           National       or ethnic origin’                          Population        Total Asians      Foreign born
                                           Chinese                                                         812.178                22                          63
                                           Flliplno                                                        781,894                21                          65
                                           Japanese                                                        716,331                19                          28
                                                ~..---~
                                           lndlanb                                                         387,223                10                          70
                                           Korean                                                          357,393                16                          82
                                                              --.~~                                                                                      -.     -
                                           Vietnamese                                                      245,025                 7                          90
                                           Hawaiian                                                        172,346                  5                          2
                                           Laotian                                                          47,683                  1                         94
                                           Thai                                                             45,279                  1                         82
                                           Samoan                                                           39,520                  1                         36
                                                                                                                                                         -~
                                           Guamanlan                                                        30,695                  1                         10
                                                                                  --     --. --~.-
                                           Cambodian                                                        16,044                      c                     94
                                                                                                     __-
                                           PakIstani                                                        15,792                      c                     85
                                           lndoneslan                                                        9,618                      c                     83
                                                                                                                                               -_____-
                                           Tonqan                                                            6,226                                            75
                                           Hmong”                                                            5,204                      c                     91
                                           Other Mtcroneslane                                                4,813                      c                     44
                                           Melanesian’                                                       3,311                      c                     81
                                           Other Polynestang                                                 2,186                      c                       5
                                           All other Asian Americans”                                       27,679                  1
                                           Total Asian Americans                                       3,726,440                 100
                                           “Based on respondents’       classlflcatlon    of themselves.
                                           “Includes only those who tdentlfied themselves as AsIan Indian

                                           ‘Less than 1 percent
                                           “The Hmong are a hllltop tribe who migrated to northeast Laos from Chlna and Vietnam in the first part
                                           of the 19th century Thetr culture IS dlstlnct from that of other Laohans.

                                           elncludes Carolmlan, Salpanese. TInIan Islander, Marshallese, Blkinl Islander, Entwetok Islander,
                                           Kwajaleln Islander Mlcronesian, Palauan, Ponapean, Tarawa Islander, Trukese, and Yapese. These
                                           groups are not reported separately by the Census Bureau. (Guamanlan, also a Mlcroneslan group, IS
                                           reported separately )

                                           ‘Includes FIJIan, Melanesian. Papua New Gulnean. Solomon Islander, and New Hebrides Islander These
                                           groups are not reported separately by the Census Bureau.

                                           glncludes Polynesian, TahItIan. Tokelauan These groups are not reported separately by the Census
                                           Bureau (HawaIIan, Tongan. and Samoan-which      are also Polynesian groups-are    reported separately )

                                           ‘Includes Bangladeshi, Ehutanese, Bornean, Burmese, Celebesban. Cernan, Indochmese. Iwo Jiman,
                                           Javanese, Malayan, Maldivlan, Nepall. Oklnawan, Slkklm, Singaporean, Sri Lankan, and other Asian
                                           Americans Although the Census Bureau collects data on each of these lndivldual groups, It does not
                                           publish the data on them separately
                                            Data not avallable.
                                           ‘May not add due to rounding.
                                           Source Census Bureau, Aslan and Paclflc Islander Population tn the United States, 1980 (1988).




                                            Page 13                                                                  GAO/HRD-90-36F’S       Asian Americans
Section 1
Introduction




In 1965, new legislation reopened the door to Asian immigrants, with
preference to those with relatives in the United States and highly skilled
professionals. Data from the Immigration and Naturalization Service
indicate that of the recent growth in the Asian population in the United
States, about three-quarters is from immigration. Since the 1980 census,
more refugees and other immigrants have come to this country from
Asia and the Pacific Islands than from any other region of the world,’ A
as shown in figure 1.1. Nearly half of the immigration from Asia and the
Pacific Islands is due to the large influx of Southeast Asians from Viet-
nam, Cambodia, and Laos, following the Vietnam War. (See table 1.2.)




‘A “refugee” is defined as a person who is outside his or her native country and is unable or unwell-
ing to return for fear of persecution on the basis of race, religion, nationality, membership in a partrc-
ular social group, or political opinion. (In certain circumstances, people within their native countries
may also qualify as refugees.) 8 U.S.C. llOl(aX42). Refugees are admitted to the United States every
year in accordance with an overall ceiling established by the President in consultation with the Con-
gress. 8 USC. 1157(a)(2).

‘An “immigrant” is defined as any alien (including refugees) except those that belong to certain specr-
fied classes, such as foreign government officials, tourists, or students. 8 USC. 1lOl(aX15). Except
for several classes of immigrants, since 1980 the number of immigrants admitted to the United States
annually has been limited to 270,000. Of this number, there are quotas, based on family relatronshrps
or job skills, for various preference groups. Although there is an annual limit of 20,000 from any one
country, there are no more discriminatory quotas based on country of origin. 8 U.S.C. 1151(a L
 1152(a).



Page 14                                                           GAO/HRD-SO-36FS       Asian Americans
                                        Section 1
                                        Introduction




Figure 1.1: Immigration to the United
States (Frscal Years 1981-88)
                                        2500     immigrants in Thousands




                                                 1       Other immigrants
                                                         Refugees
                                        dThe Census Bureau defrnrtron of Asra/Pacrfrc Islands was used

                                        hlncludes the countries of Afghanistan, Bahrarn, Cyprus, Iran, Iraq, Israel, Jordan, Kuwart Lebanon,
                                        Oman, Palestme, Qatar, Saud1 Arabra, Syria, Turkey, United Arab Emirates, Yemen (Aden) and Yemen
                                        (Sanaa)

                                        %cludes rmmrgrants from countrres outsrde these regrons, such as Australia and New Zealand, lmmr-
                                        grants from unknown countrres of ongin, and stateless rmmrgrants.
                                        Source U S Department of Justrce. Statrstrcal Yearbooks of the lmmtgratron and Naturaltzatron Servrce
                                        (1981-88)




                                        Page 15                                                          GAO/HRD-90-36Fs    Asian Americans
                                                Section 1
                                                Introduction




Table 1.2: Asian Immigration   by Country
of Origin (1981-88)                                                                                                                   Percent of total
                                                                                                                                                 Asian
                                                Country of origin                                                 Immigrantsa             immigrantsb
                                                Southeast Asia:
                                                Vtetnam                                                                 549 462                       23
                                                Cambodia                                                                222,642                        9
                                                Laos (tncludtng        Hmong)                                           207.713                        9
                                                  Subtotal                                                             979,817=                      42c
                                                Other Asian countries           and Pacific Islands:
                                                Phtltpptnes                                                             374,523                       16
                                                Chtna”                                                                  343,607                       15
                                                Korea                                                                   272,355                       12
                                                lndra                                                                   200,038                        9
                                                Thatland                                                                 48,188                        2
                                                Paktstan                                                                 43,714                        2
                                                Japan                                                                    32,669                          1
                                                lndonesta                                                                 9,319
                                                Tonga                                                                     4 343
                                                Samoa                                                                     2.147
                                                Guam                                                                              5
                                                Other                                                                    41,458                          2
                                                  Subtotal                                                           1,372,366                        58
                                                Total Asian immigration                                              2,352,183                       100
                                                %cludes     refugees
                                                bMay not add due to roundrng.

                                                ‘in addrtton, about 166,700 Southeast Asrans arrived durrng 1980, and most were not counted In the
                                                1980 census, accordtng to R W. Gardner G Rogey. and P C Smith Asian Amencans Growth.
                                                Change, and Drversrty,‘~ Populatron Bullettn (1985)

                                                dlncludes emtgratton from Tarwan, Hong Kong, and Macau

                                                ‘Less than 1 percent
                                                Source U S Department of Justrce, lmmigratron and Naturalrzatton Service, Stattstrcal Yearbooks of the
                                                lmmrgratton and Naturalization Servrce (1981-88)



                                                The objective of our review, requested by the late Chairman, House
Objectives, Scope, and                          Select Committee on Hunger, was to assess the status of Asian Ameri-
Methodology                                     cans. Specifically, we were asked to provide information on Asian
                                                American

                                            l   income, employment, education, health, and nutrition status and




                                                Page 16                                                         GAO HRD-YO-3BFS Asian Americans
    Section 1
    Introduction




l   enrollment in nine federal welfare programs: Aid to Families With
    Dependent Children (AFDC); Supplemental Security Income (SSI); Nedi-
    caid; Low-Income Housing; Food Stamp; Special Supplemental Food Pro-
    gram for Women, Infants, and Children (wrc); School Lunch; School
    Breakfast; and Summer Food.

    In addition, we were asked to identify (1) possible barriers to Asian
    American participation in the above programs and (2) existing programs
    in selected communities to assist new Asian immigrants and refugees in
    achieving economic self-sufficiency,

    As agreed with the Select Committee, we relied primarily on readily
    available and published information. (For a bibliography, see pp. 66-69. )
    Data on Asian Americans in general are limited, primarily because Asian
    Americans make up a small portion of the total U.S. population. (For
    further details on data limitations, see app. 11.)

    To determine Asian American income status and educational attain-
    ment, we examined data from the 1980 census, the U.S. Department of
    Education, and the Office of Refugee Resettlement (ORR) within the I-3.
    Department of Health and Human Services (HHS). We analyzed the Cen-
    sus Bureau 1985 Survey of Income and Program Participation (SIPI')
    data. (See app. III for details on our methodology.) In addition, we dis-
    cussed issues relating to Asian American income and education with
    social service agencies and community organizations serving Asian
    Americans in various cities throughout the United States (see app. IV
    for a list of the community organizations contacted).

    We relied primarily on published reports and interviews with officials
    from the U.S. Public Health Service (PHS) and other offices within uns
    for information on the health and nutrition status of Asian Americans.
    We also conducted interviews with Asian American community health
    organizations in San Francisco and Oakland, California.

    To determine Asian American enrollment in the nine public assistance
    programs, we requested reports from each of the federal agencies
    responsible for administering the programs: HHS for the AFDC, SSI,and
    Medicaid programs; the U.S. Department of Agriculture for the Food
    Stamp, WIC, School Lunch, School Breakfast, and Summer Food pro-
    grams; and the U.S. Department of Housing and Urban Development for
    the Low-Income Housing program. We were able to obtain data on Asian
    American participation in eight of the nine programs. Asian American
    enrollment in the School Breakfast program was too small to be


    Page 17                                       GAO/HRD90-36FS   Asian Americans
Section 1
Introduction




reflected accurately on the basis of the sampling techniques used; there-
fore, its enrollment was not included in the Agriculture reports. We did
not verify the accuracy of the data provided by the various agencies. To
obtain another perspective, we independently analyzed the Census
Bureau 1985 SIPP data to determine what portion of the Asian American
population participates in these programs compared with the total U.S.
population.

To identify the nature and extent of barriers to participation in public
assistance programs, we surveyed 23 local community organizations
serving Asian Americans (see app. IV). We also spoke with five state
social service agencies in California, Kew York, Pennsylvania, Texas,
and Washington; as well as two county social service agencies in Los
Angeles, California.

We obtained descriptions of government programs that help new immi-
grants and refugees achieve economic self-sufficiency at the federal,
state, and local levels. We obtained information from the federal agen-
cies with the largest roles in providing assistance to new refugees and
immigrants: ORR and the Department of State Bureau for Refugee Pro-
grams To determine which states and communities to speak with for
more detailed descriptions of these programs at the local level, we
reviewed 1980 census data for where the largest immigrant Asian
groups were likely to have settled (see table 1.3).”




,‘Although the 1980 census data are old, they are the most current nationwide data available. In
 addition, in its 1988 report to the Congress, ORR said the geographic distribution of newly resettled
 refugees follows the residential pattern of refugees already established since most new arrivals are
joining relatives. Thus, we hypothesized that those areas with large populations of particular groups
 in 1980 (1) would still, in 1989, have among the largest populations in the United States and (2)
 would most likely have more programs established over time to help those groups. Whether or not
 this is true cannot be verified until data from the next census, in 1990, are analyzed.



Page 18                                                         GAO/HRD9@36FS Asian Americans
                                             Section 1
                                             Introduction




Table 1.3: Areas of Greatest
Concentration   by Large Immigrant   Asian                                      Metropolitan areas of greatest                 concentration    of Asian
Groups (1980)                                Asian groupa                        groups (in rank order)
                                             Chinese                            San Francisco/Oakland,            CalIf
                                                                                New York City. N.Y
                                                                                Los Angeles/Long         Beach,     Calif
                                             Flllplno                           Los Angeles/Long         Beach,     Callf
                                                                                San Francisco/Oakland,            Callf.
                                                                                Honolulu,    Hawaii
                                             Korean                             Los AnclelesiLona        Beach,     Callf.
                                                                                New York City, N.Y
                                                                                Chicaao.    Ill
                                             Indian                             New York Citv, N Y
                                                                                Chicago,    Ill
                                                                                Los Angeles/Long         Beach,     Calif.
                                             Southeast      AslanD               Los Angeles/Long        Beach,     Calif.
                                                                                Anaheim/Santa         Ana/Garden           Grove (Orange   County),   Callf -
                                                                                Houston,    Tex.

                                             “The large Aslan lmmlgrant groups speclfted here are those ldentlfled In table 1 2 p 16
                                             %outheast Astans Include Vietnamese. Cambodians. and Laotians (Including Hmong, a Laotian sub-
                                             group).
                                             Source Census Bureau. Aslan and Paclftc Islander Population in the United States. 1980 (1988)


                                             On the basis of these data, we spoke with Asian American and other
                                             community groups for information on resettlement services provided in
                                             four metropolitan areas: Los Angeles, San Francisco, New York City,
                                             and Houston.

                                             We did our review between May and August 1989, in accordance with
                                             generally accepted government auditing standards.




                                             Page 19                                                               GAO/HRD-90-36Fs         Asian Americans
Overall Income and Employment Status
Comparable With U.S. Population, but Varies
Widely Among Asian American Groups
                                        Asian Americans have comparable per capita incomes and poverty
                                        rates lower unemployment, and higher concentrations of white-collar
                                        professionals than the U.S. population overall, according to 1980 census
                                        and 1985 SIPP data. However, wide variations exist among Asian Ameri-
                                        can groups. Some Asian Americans are doing well compared with U.S.
                                        averages; others, poorly.


                                        Asian American average household income exceeded the U.S. average in
Income and Poverty                      1985 by about 28 percent, with an average monthly household income
Rates                                   of $2,973, compared with the U.S. average of $2,325. But when per cap-
                                        ita income is examined, the difference disappears.’ (See fig. 2.1.)


Figure 2.1: Comparison of Average
Monthly Household and Per Capita        Dollars
incomes for Asian Americans and Total   3,,c,,
U.S. Population (1985)                               1

                                        2!ioo




                                        HOUSEHOLD INCOME                        PER CAPITA INCOME

                                        Source Census Bureau, SIPP (1985)



                                        ’ Due to the small number of Asian Americans m the sample and the resulting large margin of sam-
                                        pling error, the apparent difference between the average monthly per capita income for Asian .4meri-
                                        cans. 6827 ( 2 570). and the total LT.S.population, 5888 ( i- $1 l), is not statistically significant. (See
                                        app. III. p. 59.)



                                        Page 20                                                           GAO/HRD-90-36FS       Asian Americans
                                             Section 2
                                             Overall Income and Employment    Status
                                             Comparable With U.S. Population,  but Varies
                                             Widely Among Asian American Groups




                                             Average per capita income was similar to the L1.S.average because most
                                             Asian American households were larger than U.S. households. On the
                                             average, U.S. households had 2.6 members: Asian American households,
                                             3.5 members. Almost two-thirds of Asian American households had 3 01
                                             more members, and about one-fourth had 5 or more (see fig. 2.2).



Figure 2.2: Comparison   of Household   Sizes for Asian Americans    and Total U.S. Population      (1985)
       2                                     5 or More Members                                                            5 of More Members




                                             l-2 Members


                                                                                                                          l-2 Members




                                                                                  I                                       3-4 Members
               A                             3-4 Members

ASIAN AMERICANS                                                       TOTAL U.S. POPULATION
                                             Source Census Bureau, SIPP (1985).


                                             Although Asian Americans overall have per capita income comparable
                                             with that of the total U.S. population, incomes vary considerably among
                                             Asian American groups. For example, census data from 19i9 show that
                                             Vietnamese, Cambodian, and Laotian Americans had much lower aver-
                                             age annual household incomes than those of Indian, Pakistani, and .Japa-
                                             nese Americans.’ Southeast Asian groups also had the largest
                                             households and, thus, even lower per capita incomes. (See table 2.1.)




                                              ‘The most recent data on mcome by national or ethnic group come from t hc l!)HOCIYISI~~.
                                                                                                                                    whwh
                                              gathered income data from 1979.



                                              Page 21                                                        GAO/HRD-90-36FS   Asian Americans
                                          Section 2
                                          OveraIl Income and Employment    Status
                                          Comparable With U.S. Population, but Varies
                                          Widely Among Asian American Groups




Table 2.1: Average Annual Household
and Per Capita Income of Asian            National origin or ethnic            Annual household                Persons per           Annual per
Americans, by National Origin or Ethnic   group                                         incomea                 household       capita incomea
Group (1979)                              Total U.S. population                                $20,300                  2.7                $7,400
                                          All Asian Americans                                   23,700                  3.4                 6,900
                                          Filipino     ____-                                    25600                   38                      6 700
                                          lndlan       _____~.        -~            ~~~         25,000                  29                      8.800
                                          Pakistan1                         _____         -.    23,800                  2.9                     8300
                                          Chinese                                               23,700                  31                      7500
                                          Japanese                                              22,900                  29                      7800
                                          Korean                 -~                             22,500                  43                      5200
                                          lndoneslan                                            21,000                  28                      7400
                                          That                                                  20,500    ~~      ~~    41                      5000
                                          Guamanian                                             19,700                  36                      5.500
                                          HawaIIan                                               19,500                 35                      5600
                                          Melanesian                                            19,200                  41                      4 700
                                          Tongan                                                18,400                  46                      4000
                                          Samoan                                                16,500                  49                      3400
                                          Vietnamese                                            15300                   48                      3200
                                          Cambodian                                             12.500                  45                      2800
                                          Hmong                                                  9,100                  59                      1600
                                          Laotian                                                8,300                  54                      1 600

                                          %ounded to the nearest 100
                                          Source Census Bureau, Aslan and Paclflc Islander Population In the Untted States    1980 (publlshed
                                          1988)


                                          Similarly, although about the same percentage of Asian American
                                          households and total U.S. households had incomes below the poverty
                                          level in 1979,:’ the incomes of much higher percentages of Southeast
                                          Asian groups (Vietnamese, Cambodian, Hmong, and Laotian) were below
                                          the poverty levekf (See table 2.2.)




                                          “In addition based on our analysis of SIPP data, 13 percent of both Asian Amencan and total 1. S.
                                          households had income below poverty in 1985.

                                          ‘The poverty level varies by household size and composition. In 1979, the poverty level for a f;url~l>
                                          of four was an annual household income of $7,412.



                                          Page 22                                                          GAO/HRD-SO-36PS     Asian Amwicaus
                                          Section 2
                                          Overall Income and Employment    Status
                                          Comparable With U.S. Population, but Varies
                                          Widely Among Asian American Groups




Table 2.2: Percentage of Asian American
Families With Incomes Below the                                                                                    Percent below poverty
Poverty Level, by National Origin or      National origin or ethnic group                                                           level
Ethnic Group (1979)                       Total U.S. population                                                                       9.6
                                          All Asian Americans                                                                        10.7
                                          JaDanese                                                                                       42
                                          Fllclno                                                                                        62
                                          In&an                                                                                          74
                                          Paklstant                                                                                     105
                                          Chinese                                                                                       105
                                          Melaneslan                                                                                    11 5
                                          Guamanlan                                                                                     11 6
                                          Korean                                                                                        13 1
                                          Thai                                                                                          134
                                          HawaIIan                                                                                      143
                                          lndoneslan                                                                                     152
                                          Tonaan                                                                                         180
                                          Samoan                                                                                        27 5
                                          Vietnamese                                                                                    35 1
                                          Cambodian                                                                                     46 9
                                          Hmona                                                                                         65 5
                                          Laotian                                                                                       67 2

                                          Source Census Bureau, We, the Aslan and Paclflc Islander Americans (1980 census data publlshed in
                                          1988)


                                          In 1980, Asian American adults had lower unemployment rates and
Unemployment and                          were more highly concentrated in white-collar occupations than U.S.
Occupation                                adults overall. Of Asian American adults, 5 percent were unemployed,
                                          compared with 7 percent of U.S. adults overall. In addition, 57 percent
                                          of Asian Americans in the labor force were employed in white-collar
                                          occupations classified as managerial, professional, technical, sales, or
                                          administrative, compared with 49 percent of the U.S. population. How-
                                          ever, occupation and employment status differed among the various
                                          Asian Americans groups. For example, whereas 72 percent of Indian
                                          Americans worked in white-collar jobs in 1980 and 6 percent were
                                          unemployed, only 18 percent of Hmong Americans were white-collar
                                          workers and 20 percent were unemployed. (See table 2.3.)




                                          Page 23                                                      GAO/HRD-90-36FS      Asian Americans
                                                     Section 2
                                                     Overall Income and Employment    Status
                                                     Comparable With U.S. Population,  but Varies
                                                     Widely Among Asian American Groups




Table 2.3: Occupations      of Asian Americans       (1980)
Numbers      In percent
                                                                                                               ~          -.-~~~~~
                                                                                    Civilian     labor forcea
                                                                                                             Precision
                                                         Technical,                         Farming,       production,
National origin or ethnic         Managerial,                  sales,                         fishing,          crafts,        Laborer,
grow                             professional        administrative           Service        forestry            repair        operator       Unemployedb        TotaP
Total U.S. population                           21                 28    --         12               3               12               17                    7      100
All Asian Americans                         28                     29               15               2                    8           14                    5      100
Indian                                          46                  26                  7                d                5               9                 6      100
Pakistan1                                       43                  25              10               1                    5           10                    6      100
Chrnese                                         31                  29              18                   d                5           12                    4      100
Japanese                                        28                  33              12               4                10              10                   3
                                                                                                                                                     ..___._~~     100
Filrpino                                        24                  32              16               3                    a           13                   5       100
Korean                                          24                  26              16                   d                9           19                    6      100
lndonesran                                      23        -28                       18                   d            10              15                    6      100
Thai                                            22                  22              23                   d                9           ia                    6      100
Hawaiian                                        16                  26              20               3                11              17                    7      100
Guam                                            13                  32              17               1                13              17                    7      100
Vretnamese                                      12                  25              14                   d           13               27                    8      100
Samoan                                          11                  24              ia               2               11               24                 10        100
Tonoan                                          10                  17              24               6               11               23                    8      100
Cambodian                                       10                  19              16               2               13               30                 11        100
Hmong                                            a                  10              ia               2               12               31                20         100
Laotian                                          7                  10              19               3               12               35                 15        100
                                                     aPeople aged 16 and older Occupatron and employment status is based on respondents’
                                                     classrfrcatrons

                                                     bThose In the labor force who do not have lobs, are lookrng for work, and are available to accept jobs

                                                     ‘May not add to 100 due to rounding

                                                     ‘Less than 1 percent
                                                     Source, Census Bureau, Asran and Pacrfrc Islander Populatron In the Unrted States: 1980 and 1980
                                                     Census of Populatron General Socral and Economrc Charactenstrcs.


                                                     The income and employment disparity among Asian American groups is
                                                     a reflection of their diversity. Factors influencing the ability of different
                                                     groups to support themselves include when they or their ancestors came
                                                     to the United States, their job skills, and their familiarity with Western
                                                     culture and the English language. First-generation or second-generation
                                                     Asian Americans, for example, are generally integrated into the U.S.
                                                     work force and able to support themselves. Among more recent immi-
                                                     grants, some groups come primarily from urban centers that are highly




                                                     Page 24                                                                  GAO/HRLNO-36F?3      Asian Americans
Section 2
Overall Income and Employment    Status
Comparable With U.S. Population,  but Varies
Widely Among Asian American Groups




Westernized and thus they are better prepared for American life. Specif-
ically, many of the more recent arrivals from Korea, Hong Kong, and
India are highly educated and skilled.

In contrast, many recent arrivals from Southeast Asia come from rural
areas! with values and behaviors very different from the predominant
U.S. culture. Adjusting to U.S. life for such groups is generally difficult.
For example, rural Hmong and Vietnamese accustomed to farming and
fishing trades are likely to have little or no education, be unfamiliar
with Western technology, and have few transferable job skills. As a
result, Asian American community organization officials said, the pov-
erty and unemployment rates among Southeast Asian groups remain
high.




Page 25                                          GAO/HRD90-36FS   Asian Americans
Section 3

Overall Adult Educational Levels Same or
Higher Than Total U.S. Adults, but Vary Widely
Among Asian American Groups
                                         Our analysis of SIPP data for 1985 indicates that Asian American adults
                                         over the age of 25 had an average of 12.27 years of education. This com-
                                         pared favorably with the total U.S. adult population over the age of 25,
                                         which had an average of 12.39 years of education. However. 1985 SIPP
                                         and 1987 Annual Housing Survey data also indicate that a greater pro-
                                         portion of Asian American adults had attended college than total c’.S.
                                         adults. (For more details, see app. V.) Moreover, 1980 census data indi-
                                         cate that educational levels vary widely among Asian Americans of dif-
                                         ferent national origin or ethnic groups. Several Asian American groups
                                         had higher percentages of high school graduates and college-educated
                                         adults than the U.S. overall. For other groups, such as the Cambodian,
                                         Laotian, and Hmong, the percentages were much lower. (See table 3.1.)

Table 3.1: Educational Levels of Asian
Americans Aged 25 or Over, by National   Numbers      In percent
Origin or Ethnic Group (1980)                                                        Graduating   from high         Attending at least 4
                                         National origin or ethnic group                             school             years of college
                                         Total U.S. population                                          66.5                          16.2
                                         All Asian Americans                                            74.8                          32.9
                                         lndoneslan                                                      89.8                         33 3
                                         PakIstanI                                                       87.0                         58 4
                                         Japanese                                                        81.6                         26 4
                                         lndlan                                                          80.1                         51 9
                                         Korean                                                          78.1                         33 7
                                         FillDlno                                                        74.2                         37 0
                                         Thai                                                            72.4                         32 3
                                         Chinese                                                         71.3                         36 6
                                         Hawatlan                                                        68.4                          96
                                         Guamanlan                                                       67 9                          82
                                         Tonqan                                                          66 1                          129
                                         Vietnamese                                                      62 2                          129
                                         Samoan                                                          61 2                           73
                                         Melaneslan                                                      47 4                          108
                                         Cambodian                                                       42.6                           77
                                         Laotian                                                         31 4                           56
                                         Hmong                                                           22.3                           29
                                         Source Census Bureau, We, the Aslan and Paclflc Islander Amencans (1980 census data publlshed In
                                         1988)


                                         Those groups with low educational attainment include large numbers of
                                         new immigrants who arrived in the United States with relatively little
                                         education. For example, of the Southeast Asian refugees aged 17 or over




                                         Page 26                                                     GAO/HRD-SO-36FS     Asian Americans
                                        Section    3
                                        Overall    Adult Educational  Levels Same or
                                        Higher    Than Total U.S. Adults, but Vary
                                        Widely    Among Asian American Groups




                                        who entered the United States between 1978 and 1982, about 75 pct‘cdent
                                        arrived with less than a high school education. (See table 3.2.)

Table 3.2: Educational Levels of
Southeast Asian Refugees, Aged 17 or    Numbers      In percent
Over, Upon Entry to the United States   Level of educationa          --                   Vietnamese            Chineseb      Laotians          TotaF
(1978-82)
                                        No formal education                                             1.6d           6 53         21 0            8.3
                                        Elementary                                                    34   5          50.3          566           44.2
                                        Secondary                                                     27.4            240            12.2         22.2
                                        High school     graduates                                     22.6            155             49          15.9
                                        Some college                                                  13.8             3 76           5.1           9.2
                                        TotaP                                                        100.0          100.0          100.0         100.0
                                        “Source did not Indicate what grades were Included In elementary,         secondary, or high school levels of
                                        education

                                        “From Vletnam

                                        ‘Percentages    based on totals for the three groups combined

                                        “This percentage    IS based on fewer than 50 observattons

                                        ‘Way not add due to roundrng
                                        Source HHS ORR, Southeast Aslan Refugee Self-Sufflclency             Study (1985)


                                        Reports from ORR indicate that Southeast Asians arriving since 1982
                                        have entered the United States with even less education than previous
                                        arrivals. More recent Cambodian and Vietnamese arrivals, particularly
                                        those from rural areas, were sometimes illiterate in their own languages.
                                        Others had their education interrupted during the Vietnam War. Some
                                        recent arrivals, such as Hmong, came from societies in which written
                                        forms of communication are rare.

                                        Community organization officials told us that adults arriving with little
                                        education have the greatest difficulties adjusting to life in the llnited
                                        States, including learning English, participating in job training, and
                                        obtaining jobs with sufficient wages to support their often large fami-
                                        lies. The officials added that Asian Americans arriving in the United
                                        States as young children tend to adapt well to school and to be highly
                                        motivated; those arriving at high school age tend to have greater diffi-
                                        culties in school, particularly if they arrive without age-appropriate
                                        education and knowledge of English.

                                        The Department of Education administers two programs that provide
                                        supplemental grants to school districts to help refugee and immigrant




                                        Page 27                                                                GAO/HRDML36FS        Asian Americans
                                                       Section    3
                                                       Overall    Adult Educational  Levels Same or
                                                       Higher    ‘man Total U.S. Adults, but Vary
                                                       Widely     Among Asian American Groups




                                                          children achieve and maintain a satisfactory level of academic perform-
                                                          ance: the Transition Program for Refugee Children and the Emergency
                                                          Immigrant Education Program (see table 3.3).


Table 3.3: Department        of Education   Programs        for Refugee    and Immigrant      Children
Dollars   In mullions                                                                                                                                          ___-
                                                                                                       Funding
                                                                                                       in fiscal
Program                                Eligible   recipients                                         year 1988        Services      authorized           ..~_____            -
TransItron   Program    for Refugee    School drstrlcts     with at least 20 refugee                       $15.2a      Bilingual educatron       and other special
Chrldren                               studentsb                                                                       English Instructron      and materials

                                                                                                                       In-service   trarnrng for teachers

                                                                                                                       Counseling      and gutdance        services

                                                                                                                       Other support       servrcesc
Emergency      lmmlgrant   Educatron   School districts where newly arrived Immigrant                       30.0d      Supplementary        educatronal      services
Program                                students number at least 500 or make up
                                       at least 3 percent of total enrollment                                          Basic instructron       for lmmlgrant      children

                                                                                                                       In-servtce   trafnrng    for teachers

                                                          ‘These funds served an estimated 80 215 refugee children, for an average expenditure           of about $190
                                                          per child
                                                          “Refugee children are ellglble if they have been In the Unlted States for no more than 2 years at the
                                                          elementary school level or no more than 3 years at the secondary school level.

                                                          ‘Such as tralnmg for parents and services deslgned to meet the special educational           needs of refugee
                                                          children
                                                          ‘These funds served an estimated 428,688 immigrant students. with an average expenditure of about
                                                          $70 per child
                                                          Sources Code of Federal Regulations, title 34, part 538, “TransItIon Program for Refugee Children, and
                                                          part 581, ‘Emergency lmmlgrant Educatton Program, ” and House CommIttee on Appropnatlons. Sub-
                                                          commlttee on the Departments of Labor, Health and Human Services, Education. and Related Agen-
                                                          cues, Appropriations for 1989, Hearings (Washington, D C U S Government Prlntmg Office. 1988). part
                                                          6. pp 462,481, and 485




                                                          Page 28                                                            GAO/HRD90-36s              Asian Americans
Health and Nutrition Appear to Compare Well
With U.S. Population Overall, Except for
Southeast Asian Refugees
                              With the exception of Southeast Asian refugees, the limited available
                              information suggests that the health and nutrition of Asian Americans
                              appear to be at least as good as that of the lJ.S. population generally.’


                              In a 1988 report,’ the U.S. Public Health Service (PHS) concluded that the
Health Status of Asian        health status of Asian Americans as a group was good. It reported that
LktllWiCZlllS   Reported to   although national morbidity and mortality figures for Asian Americans
Be Good                       were generally lacking, available data indicate that Asian Americans
                              enjoyed a longer life expectancy than whites and lower death rates from
                              all causes, including heart disease and cancer (see figs. 4.1 and 4.2). i
                              However, the data were generally limited to only a few Asian American
                              groups and were 7 to 10 years old.-’ Infant mortality rates also were
                              found to be lower for Asian Americans. (See fig. 4.3.) The PHS report
                              acknowledged that more detailed research was needed to further define
                              the health status and needs of Asian Americans.




                              ‘Comprehensive data on the health and nutrition status of Asian Americans are not readily available.
                              This is a category not covered by the decennial census. Other surveys (such as the U.S. Department of
                              Agriculture’s tidtionwide Food Consumption Survey and the National Health Interview Survey as
                              well as the Health and Nutrition Examination Survey conducted by the PHS National Center for
                              Health Statistics) do not publish data on Asian Americans because the Asian portion of the samples is
                              too small, according to agency personnel.
                              ‘Disease Prevention/Health Promotion: The Facts. Office of Disease Prevention and Health Prom*
                              tion, PHS, HHS (1988). Data cited in the report are primarily from the National Center for Health
                              Statistics (1978-1981); the Census Bureau (1980); and the Report of the Secretary’s Task Force on
                              Black and Minority Health. HHS (1986).

                              “The data also indicated, however, that the death rates from different cancers varied widely among
                              Asian American groups (see app. VI).

                              ‘PHS officials told us that more recent disease prevalence rates are difficult to develop because accu-
                              rate population projections are unavailable between censuses.



                              Page 29                                                         GAO/HRD-9036FS Asian Americans
                                            Section 4
                                            Health and Nutrition   Appear to Compare
                                            Well With U.S. Population Overall, Except for
                                            Southeast Asian Refugees




Figure 4.1: Life Expectancy of Asian
Americans Compared With White
Americans in California (1960) and Hawaii        Years of Life Expectancy
                                            85
(1980)

                                            60



                                            75



                                            70



                                            65



                                            60

                                                  1960 Study             1999 study
                                                  Conducted in           Cond~~cled In
                                                  California (a)         Hawaii (a)




                                                            Chinese Americans
                                                            Filipino Americans(b)

                                            “Information   was gathered only on the Aslan Amencan groups shown and Includes combtned data for
                                            both sexes
                                            %llplno Americans were not Included In the 1960 Caltfornla study
                                            Source: R W Gardner, R. Robey, and P C Smith, “Aslan Amencans Growth. Change, and Diversity
                                            Population Bulletin (1985), as presented In the PHS report, The Facts (1988), p 191




                                            Page 30                                                        GAO/HRD90-36FS      Asian Americans
                                                           Section 4
                                                           Health and Nutrition   Appear to Compare
                                                           Well With U.S. Population Overall, Except              for
                                                           Southeast Asian Refugees




Figure 4.2: Mortality               Rates for White, Black, and Asian Americans        (1979-81)


14w YALEDEATHPER100,ooo
                     PoPuLATloN
                             (a)                                                      1400        FEMALE DEATHS PER 100,ooO POWLATKN,,)


lzw                                                                                   1200


Iwo                                                                                   rwo


 so0                                                                                   SW


 600                                                                                   wa


 wa                                                                                    400


 200                                                                                   zoo


      0                                                                                     cl

          All cam            kit-
          CAUSESOF   DEATH




                                                           aAverage annual age-adjusted          death rates

                                                           bThese data are based on only three groups of Asran/Pacrfrc Amerrcans                Chrnese, Frlrprnos, and
                                                           Japanese
                                                           ‘The PHS report, The Facts (1988). notes that “Death rates for Asran/Pacrfrc Amerrcans are probably
                                                           underestrmated due to less frequent reportrng of these rates on death certrfrcates as compared wrth the
                                                           Census ”

                                                           ‘Under the age of 45
                                                           Sources HHS. PHS, Natronal Center for Health Statrstrcs; Census Bureau, and the HHS Report of the
                                                           Secretary’s Task Force on Black and Mrnority Health, Vol I (1985), partrally presented rn the PHS report,
                                                           The Facts, pp 191-3




                                                           Page 31                                                                        GAO/HRD!ML36FS     Asian Americans
                                    Section 4
                                    Health and Nutrition   Appear to Compare
                                    Well With U.S. Population Overall, Except      for
                                    Southeast Asian Refugees




White, Black, and Asian Americans
                                    20   Deaths per 1,000 Live Births (a) (b)
(1986)




                                    aThe NatIonal Center for Health Statistics notes that infant mortality rates for Asian Amencans   should
                                    be Interpreted with caution because of InconsistencIes In reporting race on birth and death
                                    certificates
                                    “Infant mortality rates from 1982, presented in the PHS report, The Facts (1988). showed similar dlrfer
                                    ences among groups
                                    -Includes deaths among Hawallans and part-Hawaiians
                                    Source HHS. PHS, National Center for Health Statlstlcs    VItaI Statistics of the Unlted States. Vol 11
                                    (1986)




Nutrition Status of                 ered by the PHS Centers for Disease Control (CDC). CDC only gathers data
Asian American                      from participants in publicly funded programs (primarily WC) in about
Children Reported to                29 states; therefore, CDC cautions that the data are not representative of
                                    Asian American children in the general population. Data in its last pub-
Be Generally                        lished annual report (issued in August 1985) indicate,’ however, that the
Comparable With U.S.                nutrition status of Asian American children was generally comparable
                                    with U.S. standards, as measured by the weight-for-height and blood
Standards                           content indexes for the period 1979 to 1983 (see table 4.1).



                                    ‘Publication of annual reports was discontinued after 19%. according to CDC officials.



                                    Page 32                                                           GAO/HRD-90-36FS       Asian Americans
                                       Section 4
                                       Health and Nutrition   Appear to Compare
                                       Well With U.S. Population Overall, Except for
                                       Southeast Asian Refugees




Table 4.1: Nutrition-Related
Abnormalities    Among American                                                       Percentage with an abnormal           indicatoP
Children, Through 9 Years of Age, in   Indicator   of abnormality”                White        Black Hispanic               Native         Asian
Selected States, by General Ethnic     Low weight-for-height                         29           37        36                   31            49
Group (1979-83)
                                       High weight-for-height                        67             77            79           100             48
                                       Low height-for-age                            85             75            93             al           24 1

                                       Blood content    I’
                                         Low hemoglobm                               55       -~    91            4.4            31            55
                                         Low hematocrlt                              6.4            75           10.0            62            64

                                       ‘Abnormality IS defined as being In the (1) lower or upper 5th percentlle of the National Center for Health
                                       Statlstlcs reference population for weight-for-height or (2) lower 5th percentlle for height-for age and
                                       blood content lndlcators

                                       “Hemoglobin IS the Iron-contalnlng protein In red blood cells, hematocnt IS the ratlo of the volume of
                                       packed red blood cells to the volume of whole blood Low hemoglobm and hematocnt are lndlcators of
                                       anemia
                                       Source HHS PHS. Centers for Disease Control Nutntlon Surveillance. Annual Summary 1983 @sued
                                       Aug 1985). pp 17 and 24


                                       The height-for-age index indicated a potential problem area for Asian
                                       American children. According to more recent data we obtained from CM’.
                                       however, short stature has become less prevalent among Asian Ameri-
                                       cans over time. The 1989 data indicate that Asian American children are
                                       approaching the U.S. height-for-age standard. (See fig. 4.4.)




                                       Page 33                                                            GAO/HRB90-36FS        Asian Americans
                                           Section 4
                                           Health and Nutrition   Appear to Compare
                                           Well With U.S. Population   Overall, Except      for
                                           Southeast Asian Refugees




Figure 4.4: Mean Height-for-Age of Asian
Americans Compared With U.S. Standard
                                           60    Mean Percentiles
(1981-89)

                                           50


                                           40                                                                                    *****--1*****
                                                                                                           ***********-
                                                                                        **.**----
                                                                    *****I----
                                                           ***---
                                           30 *******


                                           20


                                           10


                                            0

                                            1991         1992       1993         1994               1995       1995       1997            1999      1999
                                            YEARS

                                                 -        U.S. Standard
                                                 -1-1    AsianAmericans
                                           Source, Data from the Pedlatrlc Nutntlon Surveillance System, provided to GAO by HHS, PHS. CDC
                                           (July 1989)



                                           Due to tracking by the PHS Office of Refugee Health and CDCand clinical
Health and Nutrition                       studies conducted in selected regions, more detailed information is avail-
Problems Cited for                         able about the health and nutrition status of Southeast Asian refugees.
Southeast Asians                           These studies indicate that Southeast Asian refugees are carriers of-or
                                           suffer from- tuberculosis, hepatitis B, and malaria at much higher
                                           rates than the U.S. population generally. (See table 4.2) Studies also
                                           indicate that (1) up to 80 percent of Southeast Asian refugees have
                                           intestinal parasites and (2) Southeast Asians experience some nutrition
                                           and mental health problems.




                                           Page 34                                                                GAOjHRD-90-36F3       Asian Americans
                                          Section 4
                                          Health and Nutrition   Appear to Compare
                                          Well With U.S. Population Overall, Except for
                                          Southeast Asian Refugees




Table 4.2: Disease Rates Among
Southeast Asian Refugees Compared                                                Southeast
With Whites, Blacks, and the Total U.S.                                               Asian                                             Total U.S.
Population (per 100,000 Population)       Disease                                 refugees             Whites           Blacks         population
                                          TubercuIosIs”                                   250                   4             28       -__~           9

                                          Heoatltls     W
                                             Chrome       InfectIon                    10,000               190              850                300
                                             Overall    infectlon                     70,000             3 %I0            13,700              4,800
                                             Malaria’                                     150    -                  3              1                  4

                                          ‘Rates for Southeast Aslan refugees are based on disease stallstIcs from 1987 for refugees arrlvlng in
                                          1986 Accordmg to CDC, the nsk of Infection IS greatest during the year after lmmtgration

                                          “Rate for Southeast Aslan refugees IS from early 1980s Rates for whites blacks and total U S popula
                                          tlon are from the 1976-80 National Health and Nutrltlon Examlnatlon Survey

                                            Rates based on Southeast Asian refugees arrlvlng between 1980 and 1988 Rates for total U S popula-
                                          tion based on 1985 population estimates and Infections reported between 1983 and 1988 Vlalarla lnfec-
                                          tlons are only acquired abroad, according to CDC
                                          ‘A breakdown for whites versus blacks was not available
                                          Source CDC (July and Aug 1989)


                                          A study examining Southeast Asian refugees who had relocated in Con-
                                          necticut indicated that nutritional abnormalities may be more prevalent
                                          among refugee children.” The study examined 36 refugee children, aged
                                          1 to 12, between September 1979 and November 1980. The study found
                                          that 17 (47 percent) were below the height-for-age index, and 8 (22 per-
                                          cent) were below the weight-for-height index. These percentages are
                                          substantially higher than the rates found during a comparable time
                                          period for Asian Americans overall. (See table 4.1, p. 33.)

                                          Other regional studies have revealed differences among various South-
                                          east Asian groups. For example, a San Diego study showed that the
                                          Vietnamese are at greater risk than the Laotians for tuberculosis and
                                          have different risks for different types of intestinal parasites.

                                          To ensure that arriving refugees do not pose a public health threat and
                                          to ensure their good health, PHS operates several programs coordinated
                                          by the Office of Refugee Health. These include CDC medical screening of
                                          U.S.-bound refugees in camps in Thailand, screening at U.S. ports-of-
                                          entry, and notification of appropriate state and local health depart-
                                          ments of health problems of resettled refugees.



                                          “Michele Barry. M.D., and others, “Chnical Findings In Southeast Asian Refugees.” .Journal of the
                                          American Medical Association (June 17, 1983).




                                          Page 35                                                          GAO/HRD90-36FS          Asian Americans
Section 4
Health and Nutrition   Appear to Compare
Well With U.S. Population Overall, Except   for
Southeast Asian Refugees




According to CDC,tuberculosis and hepatitis B among Southeast Asian
Americans pose significant public health challenges. Nonetheless, CDC
hopes to eliminate tuberculosis in this country by the year 2010 by
(1) developing new technologies for treatment, diagnosis, and preven-
tion and (2) integrating these technologies into clinical use. The major
goal concerning hepatitus B is to increase immunizations and thereby
help prevent (1) transmission at birth, (2) childhood infection, and
(3) primary liver cancer. CDCdoes not currently consider malaria and
other parasitic diseases-which    rarely result in fatal illness-and nutri-
tional abnormalities among refugee children to be major public health
problems.;

Various studies estimate that mental health disorders afflict as many as
50 percent of newly arriving refugees. Traumatic experiences in their
countries of origin, conditions in resettlement camps, and difficulties in
acculturation have been cited as reasons for refugees’ mental problems.
Recognizing the significant presence of diagnosable mental health condi-
tions among the refugee population, in September 1985, the HHS ORR
entered into an interagency agreement with the National Institute of
Mental Health to encourage the development and implementation of cul-
turally relevant diagnostic and treatment procedures.

A 1986-87 study conducted in California under this program found that
over 40 percent of the 2,773 refugees interviewed had a moderate or
severe need for mental health treatment. (See fig. 4.5.) The study
reported that most Southeast Asian refugees interviewed were forced to
spend years in camps awaiting resettlement, and more than half expe-
rienced separations from, or deaths of, family members. Cambodian and
Laotian refugees spent an average of nearly 3 years in the refugee
camps, and nearly two-thirds of the Cambodians had lost close relatives.
The study found that over 16 percent of the Cambodians interviewed
met the criteria for post-traumatic stress disorder. According to PHS, this
study, as well as those done for other states under the program, showed
a high level of need for mental health assistance among Southeast Asian
and other refugees in the United States.




‘CDC also recently discontinued surveillance of “sudden unexplained death syndrome” (SUDS)
among Southeast Asian refugees because the number of annual cases has been decreasing. A total of
 117 cases of SCDS had been reported as of April 1988, primarily among young adult male Laotian
refugees who had lived in the United States less than 2 years.



Page 36                                                      GAO/HRD!M-36FS      Asian Americans
                                                        Section 4
                                                        Health and Nutrition   Appear to Compare
                                                        Well With U.S. Population Overall, Except   for
                                                        Southeast Asian Refugees




Figure 4.5: Study of Southeast          Asian Refugee     Mental Health Needs in California      (1986-87)
loo   Percent With Need tor Treatment




      All Refupes            Vfetnsmese             Cambodians             Leothe               Hmongs               Chinws
      Studied (a)



      I      1 No Need for Treatment
      m        MildNeedforTreamt
               Moderate Need for Treatment
               Severe Need for Treatment


                                                        aWeighted averages
                                                        Source The Callfornla Southeast Aslan Mental Health Needs Assessment, Asian Community blental
                                                        Health Serwces. Oakland, Caltfornta (1988)


                                                        Language is frequently cited as a barrier to the obtaining of required
                                                        medical treatment by Southeast Asian refugees. In addition, Southeast
                                                        Asian refugees experience various cultural and religious barriers to
                                                        seeking treatment in this country. There are markedly different con-
                                                        cepts of health and disease in Eastern and Western cultures, and reli-
                                                        gious beliefs influence refugees’ health beliefs and practices (see app.
                                                        VII).




                                                        Page 37                                                      GAO/HRD-90-36FS    Asian Americans
Welfare Participation Approximates
Representation in U.S. Population

               The proportion of Asian American participants among the U.S. public
               assistance programs we looked at roughly approximates the proportion
               of Asian Americans in the U.S. population. In 1985, Asian Americans
               accounted for 2.5 percent of the U.S. population and 1.8 percent of 1I.S.
               households. Agency studies conducted during various years throughout
               the 1980s report that Asian Americans have between 1.4 and 3.4 per-
               cent of participants in the AFDC, SSI,Medicaid, Low-Income Housing,
               Food Stamp, WIG, School Lunch, and Summer Food programs.] (See table
               5.1.)




               ‘Data were not available from the U.S. Department of Agriculture showing the number of Asian
               American participants in the School Breakfast program (see p. 17).



               Page 38                                                     GAO/HRD-SO-36FS     Asian Americans
                                          Section 5
                                          Welfare Participation    Approximates
                                          Representation    in U.S. Population




Table 5.1: Asian American Participation
in U.S. Public Assistance Programs                                                Estimated Asian American                           Percent of total
                                          Program                                   participants                                         participants
                                          AFDP                                    84,675 famllles                                                    23
                                                                                  222,023 children                  -_______           ~~~~          31
                                          SSlb                                    42,100 mdlvlduals       (aged 65 or
                                                                                     over)c                                        __~.__-          ..~18
                                          Medlcaldd                               447,713   Individuals                                               20
                                          Low-Income      Houslnge                78,923 households                                                  20
                                          Food Stamp’                             130,000 households                                                 18
                                          WIG                                     10,243 women                                                       14
                                                                                  26.319 Infants                                                     33
                                                                                  33,827 children     (aqed   1 to 4)                                21
                                          School   Lunch”
                                            Free                                  205,023 children                                                   21
                                            Reduced-once                          61,744 children                                                    34
                                          Summer      Food’                       30,000 children                                                    20
                                          Note Years for above data vary, as indicated In the footnotes.
                                          aHHS, Family Support Admlnlstratlon. Charactenstlcs and Financial Circumstances          of AFDC Rectplents
                                          (1986)
                                          “HHS, Social Security AdmInistratIon, “Number and Percent of Persons Aged 65 and Older Recelvlng
                                          Social Security or Supplemental Security Income by Race and Spanish Orlgln” (1980).

                                          %cludes participation In other welfare programs, but, according to SSA officials, responses for people
                                          65 years of age or older reflect SSI for the most part.
                                          “HHS. Health Care Flnancmg AdmInIstration         “MedIcaId Recipients and Expenditures,    by Race and
                                          State, Fiscal Year 1986
                                          eDepartment of Housing and Urban Development,            Annual Housmg Survey (1987)

                                          ‘Department    of Agnculture, Food and Nutrition Service, Charactenstlcs      of Food Stamp Households
                                          (1986)
                                          gDepartment of Agnculture, Food and Nutntlon Service, Study of WIC Participant and Program Charac-
                                          teristics (1986). Data are from 1984.

                                          ‘Department of Agnculture, Food and Nutrition Service, Characteristics of the National School Lunch
                                          and School Breakfast Program Participants (1988) Data are from 1984

                                          Department of Agnculture, Food and Nutrition Service, An Evaluatron of the Summer Food Service Pro-
                                          gram (1988) Data are from 1986.


                                          The percentage of the Asian American population receiving benefits
                                          from public assistance programs provides another perspective on partic-
                                          ipation. (See fig. 5.1.) SIPP data show that for most programs, about the
                                          same percentage of Asian Americans received benefits as the total U.S.
                                          population in 1985. Differences between the percentages of Asian Amer-
                                          icans receiving benefits and the total U.S. population were not statisti-
                                          cally significant for the Medicaid, Food Stamp, AFDC, Low-Income
                                          Housing, SSI, and WIG programs. (See app. III.) Only in the School Lunch


                                          Page 39                                                                GAO/HRD-90-36FS      Asian Americans
                                        Section 5
                                        Welfare Participation    Approximates
                                        Representation    in U.S. Population




                                        and Breakfast programs was Asian American participation significantly
                                        greater: 10.6 percent of Asian American households received benefits
                                        from these programs, compared with 6.5 percent of U.S. households.2


Figure 5.1: Asian Americans Receiving
Benefits From Selected U.S. Public
                                        25   Percent Receiving Benefits
Assistance Programs (1985)


                                        20



                                        15




                                        ‘School Lunch and Breakfast reclplents were measured by households IIJ which one or more children,
                                        aged 5 to 18, received free or reduced-pnce lunches or breakfasts. All other reclplents were measured
                                        by the lndivldual

                                        “Includes benefits from public houslng and government      rental assistance.

                                        ‘-AsIan American sample size (24) was too small for the analysis to be statlsttcally   stgnlflcant
                                        “Asfan Amencan sample size (14) was too small for the analysis to be statlstlcally     slgnlficant
                                        Source Census Bureau, SIPP (1985)


                                        In contrast with the 1985 SIPP data, 1980 census data analyzed by the
                                        Social Security Administration (SSA) showed that Asian Americans aged




                                        ‘Participation in the Summer Food Program was not analyzed because the SIPP database did not
                                        include data on this program.



                                        Page 40                                                             GAO/HRD90-36FS          Asian Americans
Section 5
Welfare Participation     Approximates
Representation     in U.S. Population




65 or over participated in SSIto a greater extent than their I!.S. counter-
parts. Almost 19 percent of Asian Americans aged 65 or over received
SSIbenefits, compared with 9 percent of the U.S. elderly. i

Proportionately, newly arrived Southeast Asian refugees are much more
likely to receive assistance than Asian Americans overall, in part
because of special programs established to help refugees. Refugee Cash
Assistance and Refugee Medical Assistance are available to low-income
refugees who have lived in the United States less than 1 year but are
ineligible for AFDC, SSI, and Medicaid because of family composition or
other reasons not related to income. The federal government reimburses
states for 100 percent of such refugees’ welfare costs. In 1987, the most
recent year for which published data were available, Southeast Asian
refugees had higher rates of participation in these aid programs than
most other refugee groups for whom data were available. (See fig. .5.2.)




 ‘Despite different SSI participation rates, an equal percentage of Asian American and 1. S. adlilts
 aged 65 or over lived in poverty in 1980 (15 percent), according to SSA reports. The SSA diremx.
 Division of Statistical Analysis, Office of Research and Statistics, hypothesized that many eldcrl)
 Asian Americans rely on SSI because they are immigrants without work histories in the I .mtt>d States
 and, thus, are ineligible for Social Security benefits.




 Page 41                                                        GAO/HRD-90-36FS      Asian Americans
                                         Section 5
                                         Welfare Participation    Approximates
                                         Representation    in U.S. Population




Figure 5.2: Participation of Southeast
Asian and Other defugee Groups in
                                         100   Percent Paftkipaling
Selected U.S. Public Assistance
Programs (1987)

                                          so



                                          60



                                          40



                                          20



                                           0




                                                  SOUTHEAST ASIAN REFUGEES               OTHER REFUGEE GROUPS
                                         Note Reported data covered the Refugee Cash Assistance. Refugee MedIcal Assistance. AFDC, SSI
                                         MedIcaId, and General Assistance programs and only for refugees In the groups shown who were in the
                                         Unlted States for 31 months or less

                                         aExcludlng Poles.
                                         Source HHS, ORR, Report to the Congress. Refugee Resettlement    Program (1988)




                                         Page 42                                                       GAO/HRD-96-36FS     Asian Americans
Section 6

Barriers Exist, but Do Not Prevent
Welfare Participation

                       Community organizations told us that Asian Americans face difficulties
                       when enrolling in welfare programs, but the problems do not prevent
                       their eventual participation. The barriers most frequently cited were
                       (1) limited knowledge of English and (2) different attitudes toward gov-
                       ernment and welfare. The Asian American groups with the most lan-
                       guage difficulties had among the highest participation rates in welfare
                       programs (as shown on p. 42).


                       People with limited English fluency have difficulties with all aspects of
Limited Knowledge of   the enrollment process, according to Asian American community organi-
English Causes Most    zations. Those unable to read program materials have difficulty under-
Difficulties           standing what programs exist, who is eligible, and what documents to
                       supply. Those with limited knowledge of English have difficulties com-
                       pleting English language program applications and communicating with
                       social service agency intake workers who do not speak Asian languages.
                       In addition, some recent arrivals, particularly the Hmong, are unaccus-
                       tomed to systems requiring documentation and often do not retain nec-
                       essary documents.

                       Limited English lanaguage fluency also poses other problems. For exam-
                       ple, the Southeast Asia Center officials in Chicago, Illinois, told us that
                       from where most Southeast Asians live in Chicago, traveling by train to
                       the welfare office takes at least an hour and requires a transfer. The
                       trip is particularly difficult for recent arrivals with limited English
                       knowledge who cannot read the street signs or maps or ask for and
                       understand directions.

                       The number of non-English or limited-English speakers appears high
                       among those Asian Americans requiring public assistance. For example,
                       in 1980,38 to 69 percent of the various Southeast Asian groups reported
                       that they did not speak English well or at all. (See table 6.1.) The Associ-
                       ation of Asian/Pacific Community Health Organizations also found that
                       about 95 percent of its primarily low-income patients nationwide had
                       limited or no ability to speak English.’




                       ‘The association 1sa national network of community health centers serving Asian and Pacific
                       Islander populations. headquartered in Oakland, California.



                       Page 43                                                      GAO/HRD-90-36FS     Asian Americans
                                         Section 6
                                         Barriers Exist, but Do Not Prevent
                                         Welfare Participation




Table 6.1: Asian Americans’ Ability to
Speak English, by National Origin or     Numbers      in percent
Ethnic Group (1980)                                                                               English-speaking     abilitya
                                         National origin or ethnic
                                            group                                     Wellb     Not well    Not at all UnknownC           Total*
                                         All Asian Americans                             82            12              3          2          100
                                         Hawaiian                                        98              0             0          2         100
                                         Ftllplno                                        91              5             1          j         100
                                         Japanese                                        90              8             1          1         100
                                         Samoan                                          88              8             1          3~        100
                                         lndlan                                          87              4             1          7         100
                                         Guamanlan                                       87              2             0         11         100
                                         Thai                                            86             11             1          2         100
                                         PakIstanI                                       84              8             2          6         100
                                         Chinese                                          76            16             7          1         100
                                         Korean                                           75            20             4          1         100
                                         lndoneslan                                       69             5             1         25         100
                                         Tongan                                           65            14             2         18         100
                                         Vietnamese                                       60            29             9          2         100
                                         Cambodian                                        37            44            15          4         100
                                         Hmong                                            34            32            31          3         100
                                         Laotian                                          27            43            26          4         100
                                         ‘Self-reported   ablllty to speak English for people aged 5 and over In households
                                         blncludes those speakmg Aslan or Pacific Islander languages at home who reported speaking English
                                         very well or well and those who speak only English at home

                                         CThe Census Bureau did not report on the English-speaking ablltty of those who reported speaking a
                                         language other than English or an Aslan or Pacific Islander language at home

                                         dMay not add to 100 due to rounding
                                         Source Census Bureau, Astan and Pacific islander Population In the Unlted States. 1980 (1988)




Help in Overcoming                       Federal, state, local, and community agencies offer bilingual services to
                                         help Asian Americans overcome problems with English. California, New
Language Problems                        York, and Texas state and local community officials told us that many
                                         social service agencies, including federal agencies in areas with large
                                         concentrations of Asian Americans, now employ bilingual staff. The
                                         Social Security Administration, for example, once a week sends a bilin-
                                         gual Cantonese worker to the Oakland Chinese Community Council, in
                                         Oakland, California, to enroll the elderly in SSI,Council staff told us. In
                                         addition, WIGprogram reports state that in 1984, about 20 percent of WIG
                                         clinics nationwide had staff who spoke Vietnamese, Cambodian, or Lao-
                                         tian; 10 percent had staff who spoke Thai; and 6 percent had staff who
                                         spoke Chinese.



                                         Page 44                                                             GAO/‘HRD-90-36FS   Asian Americans
                      Section 6
                      Barriers Exist, but Do Not Prevent
                      Welfare Participation




                      Some Asian American community organizations attempt to hire people
                      with the ability to speak various Asian languages to accompany limited
                      English-speaking clients to social service agencies. serve as translators
                      give help filling out program applications, and make referrals to welfare
                      offices. For example, the director of Northeast Medical Services in San
                      Francisco, California, told us that to help provide social and medical ser-
                      vices to non-English speaking clients, her program employs staff speak-
                      ing Mandarin, Cantonese, Korean, Vietnamese, and Burmese. Asian
                      American community organizations told us, however, that the multiplic-
                      ity of languages and dialects makes it difficult for community organiza-
                      tions and government agencies to provide bilingual services for all Asian
                      American groups.


                      Asian American community organizations told us that some Asian
Certain Attitudes     Americans are reluctant to participate in welfare programs for reasons
Make Some Asian       that include their general distrust of government and the stigma
Americans Reluctant   attached to welfare. They also told us that Chinese and .Japanese Ameri-
                      cans, in particular, have a distrust of American government that stems
to Accept Welfare     from certain exclusionary and discriminatory legislation, such as the
                      1882 Chinese Exclusion Act, which denied Chinese individuals the right
                      to U.S. citizenship; the Immigration Act of 1924, effectively stopping
                      Japanese and other Asian immigration to the United States; the World
                      War II evacuation and internment of U.S. citizens of *Japanese origin
                      under Executive Order 9066; and state laws prohibiting ownership and
                      leasing of land by noncitizens.

                      Other Asian American groups had developed a general distrust of gov-
                      ernment in their native countries. For example, Cambodians who fled
                      the war there have had to learn to overcome a fear of government
                      engendered by the violent Khmer Rouge.

                      In addition, some Asian American immigrants fear that accepting public
                      aid will jeopardize their U.S. sponsors or their own ability to sponsor the
                      immigration of additional family members.

                      Moreover, in most traditional Asian societies, the elderly expect their
                      children and grandchildren to care for them and the young accept this
                      obligation. Chinese, Filipinos, and Koreans have particularly strong tra-
                      ditions of relying on family, friends, and social organizations of their
                      own ethnic groups, rather than on the state, for aid. Many consider the
                      receipt of welfare to be disgraceful. Asian American community organi-
                      zations told us! however, that this traditional support is collapsing in


                      Page 45                                       GAO/HRD-90.36FS   Asian Americans
Section 6
Barriers Exist, but Do Not Prevent
Welfare Participation




some Asian American immigrant communities, in part because extended
families lack sufficient resources and in part because family ties are
weakening in the United States. The breakdown of family support
among some Asian Americans may create an additional need for ser-
vices and benefits, particularly for the elderly-the  age group least
likely to seek aid.




Page 46                                     GAO/HRD9@36FS   Asian Americans
Section 7

Programs Help New Arrivals Attain
Economic Self-Sufficiency                                                                                     \

                        New arrivals often face significant problems in finding employment and
                        attaining self-sufficiency because of such factors as language compe-
                        tence, education, skills, and job opportunities. Refugees and immigrants
                        can receive assistance in these areas through various means. Local gov-
                        ernment agencies, community and other nonprofit organizations, and
                        schools use federal and other funds to provide English instruction;
                        employment services, such as training, placement, and subsidized
                        employment; and assistance with acculturation and resettlement. Some
                        programs are directed towards refugees; others are available to any
                        American with low income or difficulty with English.


                        The Refugee Act of 1980 and subsequent legislation established pro-
Federal Agencies Fund   grams, administered by the HHS ORR and the Department of State, to help
Special Programs for    refugees become self-sufficient.’ Funds for a variety of services are (1)
Refugees                channeled through the states to local government agencies, nonprofit
                        organizations, and mutual assistance associations or through 12 national
                        voluntary organizations to their local affiliates or (2) provided directly
                        to voluntary agencies. (See table 7.1.)




                        ‘In a statement of program goals, priorities, and standards for its refugee program, HHS defines
                        “economic self-sufficiency” as employment in a nonsubsidized job for at least 90 days, at a wage fully
                        adequate for the basic economic needs of the person and his or her family.



                        Page 47                                                        GAO/HRLHlO-36FS      Asian Americans
                                                          Section 7
                                                          Programs Help New Arrivals          Attain
                                                          Economic Self-Sufficiency




Table 7.1: Major Federal Grant Programs That Help Refugees                         Attain Self-Sufficiency
Agency and program               Refugees eligible                                      Types of assistance            funded        Flow of funds
Department      of Health        and Human
Services:”
Employment       services                    Vary by state (those recelvlng            English      InstructIon                      Through states to local
                                             cash or medical assistance     are                                                      government      agencies. nonproflt
                                             required to participate)                  Vocational       tralntng                     organizations,     and mutual
                                                                                                                                     assistance     assoclatlons
                                                                                       Job referral      and placement

                                                                                       On-the-job       training

                                                                                       Skills recertlflcatlon
-.~---
Targeted     assistance                      Those llvlng in localltles with large     Vocational      English     InstructIon       Through states to local
                                             concentrations   of refugees on                                                         government    agencies and
                                             welfare                                   On-the-lob       tralnlng                     nonprofit organlzatlons

                                                                                       Job development
Voluntary    agency       matching   grant   Those in the United     States   4        English      InstructIon                      To voluntary   agencies
                                             months or less
                                                                                       Orientation       to U S culture

                                                                                       Job development

                                                                                       Job placement

Department      of State,‘:
Refugee reception          and               Those In the United     States   90       Referral     to employment        services    Through 12 national voluntary
placemenF                                    days or less                                                                            organizations to local affiliates
                                                                                       Resettlement     aid, Including help          (grants based on number of
                                                                                       obtaining employment,        houslng,         refugees served)
                                                                                       food, clothing, health care. and
                                                                                       Enalish Instructton

                                                          V addltlon     In some years, 01% funds specsal projects In specific localities to ald In resettlement

                                                          bThe Department of State also admInIsters an Onentatlon and Tralnlng Program, conducted In Refugee
                                                          Processing Centers overseas, Including ThaIland and the Phlllpplnes The program provides English
                                                          InstructIon and onentatlon to American Ilfe, work, and schools to refugees departing for the UnIted
                                                          States
                                                           “GAO has audlted funds expended under the State Department s Refugee Reception and Placement
                                                           Program on three separate occasions, covenng different aspects of the resettlement process (For
                                                           details. see GAO/NSIAD-85-132, GAO/NSIAD-86-69. and GAO/NSIAD-88-91.)
                                                           Sources HHS. Family Support Admlnlstration. Justlflcatlons of Appropriation Estimates for Committee
                                                           on Appropnatlons, Fiscal Year 1990, and ORR, Report to the Congress (1987)


                                                           In fiscal year 1988, HHS and the State Department spent $148 million on
                                                           the four programs shown in table 7.1. The HHS budget request for fiscal
                                                           year 1990 proposed reduced funding for its refugee programs because of
                                                           funding carryovers and an expected reduction in the number of refugees
                                                           eligible for the programs. The Department of State budget request, on




                                                           Page 48                                                                  GAO/HRD-SO-36FS      Asian Americans
                                      Section 7
                                      Programs Help New Arrivals             Attain
                                      Economic SelfSufficiency




                                      the other hand, proposed additional funding to increase grants paid to
                                      voluntary agencies, (See table 7.2.)

Table 7.2: Funding of Major Federal
Refugee Grant Programs                In mlllions
                                                                                                         Fiscal year funding
                                      Agency        and program                       1988 obligated      1989 appropriated     1990 proposed
                                      Department       of Health        and Human
                                        Serwces
                                      Employment        serwces                                 $65.7                  $64.9              $30 0
                                      Targeted      ass/stance                                    34.5                   34.1                     0
                                      Gtary         agency       matching                          7.7                   15.8                77

                                      Department       of State:
                                      Refugee reception           and
                                        Dlacement
                                      Total                                                    $148.0                 $157.8              $84.7

                                      Sources HHS, Family Support Admlnlstratlon, Justlflcatlons of Approprlatlon Estimates for CommIttee
                                      on Appropnatlons, Fiscal Year 1990, p. 78, US Department of State, Mlgratlon and Refugee Asststance,
                                      Emergency Refugee and Mlgratlon Assistance (Fiscal Year 1990).




Other Agencies Assist                 Community organizations and local school districts use funds received
                                      from numerous other federal programs to provide employment-related
Refugees and Immigrants               services to immigrants (including refugees) with low income or limited
                                      proficiency in English. Examples of such programs include job training
                                      and summer youth employment, both funded through the Job Training
                                      Partnership Act (JTPA), and vocational education. (See table 7.3.)




                                      Page 49                                                                GAO/HRD-90-36FS    Asian Americans
                                                          Section 7
                                                          Programs Help New Arrivals    Attain
                                                          Economic Self-Sufficiency




Table 7.3: Examples       of Federally   Funded Job Training         Programs    for People With Low Income or Limited English Proficiency
Agency __-
        and program                      Eligible participants                    Types of assistance funded      Flow of funds
Department     of Education
Vocatronal   education                   Adults and secondary      students      Vocatronal      skills trarnrng                 Through states to state and local
                                         who are educationally                                                                   education agencies, public.
                                         disadvantaged,   deficient in           Work-related       language       tnstructton   pnvate, and nonprofit
                                         English. in need of tralnlng, or                                                        organrzations: and postsecondary
                                         handicapped                              Basic skrlls Improvement                       instrtutitions

                                                                                 Career    InternshIps

                                                                                  Counseling      and guidance

Department     of Labor
JTPA block grant training                Economically  disadvantaged              Job skill training                             Through states to local
                                         adults and youth                                                                        government   and private    sector
                                                                                  Unsubsldrzed       employment                  partnerships
                                         Adults and youth facing serious
                                         barriers to employment,     including
                                         welfare recipients.  dislocated
                                         workers, those with lrmrted
                                         Englrsh proficiency,   and the
                                         handrcapped
JTPA summer      youth employment        :E;nhosmrcally    drsadvantaged          Subsidized      summer       jobs              Through states to local
and training                                                                                                                     governments   and private    sector
                                                                                                                                 partnershrps

                                                          Sources House Committee on Approprlatlons, SubcommIttee on the Departments of Labor, Health and
                                                          Human Serwces Education and Related Agencies. Approprlattons for 1989 Hearings (WashIngton,
                                                          D C U S Government Printing Offlce, 1988), part 1, pp 262-5. and part 6, pp 405-8


                                                           In addition to these federal programs, city, county, and state govern-
                                                           ment agencies, as well as corporations, charitable organizations, and
                                                          others, provide grants to community and other nonprofit organizations
                                                           to assist new refugees and immigrants. These funds often support such
                                                          job-related social services as child care, tutoring, summer youth recrea-
                                                           tion programs, transportation, and counseling.


                                                          Community organizations tailor services to the specific needs of the
Examples of Programs                                      local community and to the regional job market. Most programs include
Assisting Asian                                           English instruction and cultural orientation to the United States as
Americans in Five                                         essentials to successful employment. Program administrators furnished
                                                          us with the following descriptions of the services their programs
Localities                                                provide.




                                                          Page 50                                                                GAO;HRD90-36FS     Asian Americans
                         Section 7
                         Programs Help New Arrivals   Attain
                         Economic SelfSufficiency




Chinatown Manpower       The Chinatown Manpower Project offers newly arrived refugees and
                         immigrants vocational training in six areas: office clerical skills. data
Project, New York City   entry, automated bookkeeping, typing and word processing, vocational
                         English, and counseling on seeking employment. The majority of partici-
                         pants are ethnic Chinese. Since its founding in 1972, the project has
                         placed in jobs, on the average, 90 to 95 percent of its several hundred
                         students per year. Graduates regularly find employment with such com-
                         panies as Citibank, Blue Cross/Blue Shield? and Pinpoint Marketing, Inc.

                         In 1987, the project received federal funding from three     sources: the
                         Department of Education Vocational Training Program,        the Department
                         of Labor JTPA Program, and the ORR Targeted Assistance       Grants. In addi-
                         tion, the project receives contributions from the private   sector and the
                         community.


Texan Training and       The Texan Training and Employment Center offers employment-related
                          services for refugees, immigrants, and low-income people. Its services
Employment Center,        include vocational training, on-the-job training, outreach to employers,
Houston and Dallas       job placement, a summer youth employment program, job counseling,
                         and English instruction. In addition, the center runs a state-sponsored
                         Model Outreach for Refugee Employment project that encourages Asian
                          refugee women to work to supplement household income. The center
                          also helps identify support services, such as child care and transporta-
                         tion. About 60 percent of those served are Asian.

                         Some job placements draw upon participants’ skills. For example, the
                         center matched carpenters from Southeast Asia with a wooden toy man-
                         ufacturer, and placed those with cooking skills in a company providing
                         airline meals. In other instances, the center teaches new skills. People
                         participating in the center JTP.4 on-the-job training program learn cook-
                         ing, sewing, and assembly jobs, among others. The vocational education
                         program teaches industrial tailoring for the Dallas garment industry.
                         The center finds employment for about 1,000 people each year through
                         its various services.

                         The center receives virtually all of its funds from the federal govern-
                         ment, including Department of Labor JTPA Block Grants and ORR grants.




                         Page 5 1                                      GAO/HRD9036FS     Asian Americans
                             Section 7
                             Programs Help New Arrivals   Attain
                             Economic !Mf-Sufficiency




Korean Youth Center, Los      The Korean Youth Center offers numerous programs and activities to
                              serve Korean youths and their families who are recent immigrants or
Angeles                       economically disadvantaged or both. Services include employment assis-
                              tance and placement, family and youth counseling, education and tuto-
                              rial programs, youth recreation leagues, and other community services.
                              The center (1) operates a job bank and a Summer Youth Employment
                              and Training Program funded by the City of Los Angeles and (2) spon-
                              sors seminars with guest speakers from various companies to explain
                             job opportunities and application procedures. Almost all of the 3,000 to
                              5,000 people served each year are Korean Americans.

                             Korean immigrants often face language and acculturation difficulties
                             that present obstacles to employment. In addition, the faster accultura-
                             tion of youths causes tension within families as traditional Asian and
                             current American values clash. By providing activities and training
                             opportunities, the center attempts to reduce conflicts between youths
                             and their families and communities.

                             The center receives funding from numerous sources, including the fed-
                             eral government (from a federal demonstration block grant through the
                             California Department for Mental Health), the Los Angeles County Com-
                             munity and Senior Citizens Services, the Los Angeles City Department of
                             Senior Citizens, the United Way, and various corporate and private
                             donors.


Filipino-American Service    Job counseling and placement are among the services the Filipino-Amer-
                             ican Service Group offers to immigrants in Los Angeles. Many of the
Group, Los Angeles           Service Group’s clients for employment counseling are retired elderly
                             Filipino Americans who came to the United States to join children. Many
                             are seeking part-time employment since they are ineligible for Social
                             Security or other public assistance programs. Often, they are unfamiliar
                             with the U.S. employment system and require help writing resumes and
                             identifying available jobs.

                             Much of the Service Group’s funding comes from Los Angeles county
                             agencies. It also receives private donations and United Way moneys.


Center for Southeast Asian   The Center for Southeast Asian Refugee Resettlement provides a variety
                             of services to aid newly arrived refugees and immigrants in the San
Refugee Resettlement, San    Francisco Bay Area. As a resettlement agency, the center carries out the
Francisco                    functions of the State Department reception and placement program,


                             Page 52                                       GAO/HRDSO-36FS   Asian Americans
Section 7
Fkograms Help New Arrivals   Attain
Economic SelfSufficiency




 including providing initial assistance in housing and employment. As a
 social service agency, the center provides such employment services as
job orientation, counseling, placement, English instruction, and bilingual
 vocational education. The vocational education program at the center
 has three emphases: hotel housekeeping, building maintenance, and
 American restaurant cooking. The center also operates a small business
 loan and technical assistance program to assist refugees in opening and
 expanding their own businesses. Furthermore, the center provides
 translation and interpretation services to government agencies, schools,
 private businesses, and others.

The center’s funding sources include the Department of State (through a
national voluntary agency), ORR Targeted Assistance Grants, Depart-
ment of Housing and Urban Development Community Block Grants,
Department of Labor JTPA Block Grants, California State Office of Eco-
nomic Opportunity, local government agencies, foundations, and fees for
services.




Page 53                                        GAO/HRD-SO-36FS   Asian Americans
Chronology of SelectedU.S. Laws and
Presidential Actions Affecting Asian
Immigration to the United States
               Chinese Exclusion Act (1882): Excluded Chinese laborers for 10 years.
               This was the first time the United States closed its doors to people from
               any country

               Alien Contract Labor Law of 1885: Made it unlawful to import aliens
               under contract for labor services.

               Scott Act (1888): Prohibited Chinese workers leaving the United States
               from returning, unless they had certain relatives living legally in the
               United States, owned property worth at least $1,000, or were owed
               $1,000.

               Chinese Exclusion Act Extension (1892): Renewed exclusion for 10
               years (until 1902).

               Chinese Exclusion Act Extension (1902): Renewed and extended exclu-
               sion to cover Chinese in territories under U.S. jurisdiction.

               Chinese Exclusion Act Extension (1904): Extended exclusion without
               limitation.

               Immigration Act of 1907: Authorized the President to enter into interna-
               tional agreements to regulate immigration. Subsequently, President The-
               odore Roosevelt concluded a “gentleman’s agreement” with Japan that
               limited the number of Japanese admissions.

               Executive Order 589 (March 14, 1907): Prohibited Japanese and Korean
               laborers receiving passports to enter Mexico, Canada, or Hawaii from
               entering the United States because they were considered detrimental to
               U.S. labor conditions.

               Immigration Act of 1917: Codified previous exclusions and expanded
               exclusions to include natives of India, Southeast Asia, Indonesian
               islands, and New Guinea. Required a literacy test.

               Quota Act of 1921: Established first immigration quotas. Permitted
               entry of approximately 350,000 immigrants, primarily from Western
               and Northern Europe.

               Act of 1921: Denied all foreign-born women the right to their husbands’
               U.S. citizenship.




               Page 54                                        GAO/HRD90-36FS   Asian Americans
Appendix I
Chronology   of Selected U.S. Laws and
Presidential  Actions Affecting  Asian
Immigration   to the United States




Immigration Act of 1924: Provided for the establishment of permanent
quotas on the basis of national origin and not place of birth. Decreed
that aliens ineligible for citizenship could not be admitted to the United
States as immigrants. (Affected primarily Japanese.)

Public Law 78-199 (1943): Repealed the Chinese Exclusion Acts.

Public Law 79-27 1 (1945): War Brides Act-allowed    immigration of
alien spouses and alien children of U.S. servicemen who married foreign
nationals during World War II.

Public Law 79-483 (1946): Allowed immigrants from India, the Philip-
pines, and Pakistan.

McCarran-Walter or Immigration and Nationality Act (1952): Revised
existing legislation. Eliminated race as a bar to immigration and
naturalization

Presidential Directive of 1962: Authorized about 15,000 Chinese refu-
gees from Hong Kong to immigrate.

Public Law 89-236 (1965): Amended the Immigration and Nationality
Act to phase out quotas based on national origin. Set annual numerical
ceiling of 170,000 immigrants to be admitted under various family rela-
tionship or job preference categories. Gave preference to immigrants
with relatives in the United States (74 percent), scientists and artists
(10 percent), skilled and unskilled labor (10 percent), refugees (6 per-
cent). Also authorized immigration of an additional 120,000 “special
immigrants” from the Western Hemisphere. No limit was placed upon
those classified as immediate relatives.

Presidential Directive of 1979: Allowed thousands of Vietnamese boat
people to enter the United States.

Refugee Act of 1980: Provided a systematic and permanent procedure
for the annual admission of refugees and authorized federal assistance
to resettle refugees and promote their self-sufficiency.


Sources include Linda Perrin, Coming to America: Immigrants from the
Far East (1980); H. Brett Melendy, Asians in America: Filipinos, Kore-
ans. and East Indians (1977); and the U.S. Statutes at Large.



 Page 55                                        GAO/HRLMO-36FS   Asian Americana
Appendix II

Data Limitations


                   Data on Asian Americans in general are limited, primarily because ( 1)
                   Asian Americans make up a small portion of the total U.S. population
                   and (2) available studies, for the most part, do not contain sufficient
                   data about Asian Americans to make statistically valid projections
                   nationwide. The decennial census is the only detailed national data
                   source on Asian Americans, and the Asian American population grew
                   almost 60 percent between 1980 and 1985 and underwent significant
                   compositional changes. The Census Bureau Current Population Survey,
                   which is conducted more frequently, only gathers data on whites,
                   blacks, and “other.” The other national surveys large enough to include
                   data on Asian Americans, such as the Census Bureau SIPP data and the
                   Department of Education Degrees and Other Formal Awards Conferred
                   Survey, for the most part, are not large enough to include data on Asian
                   Americans by national or ethnic group.

                   Asian American and other community organizations told us that much
                   data on Asian Americans may not be accurate. Asian Americans with
                   poor English skills may not be counted and multiple Asian American
                   households that share a dwelling may be counted as one household.
                   Although Census Bureau interviewers attempt to address such problems
                   by using interpreters and correctly identifying all occupants, other
                   surveys may not.

                   Organization officials also told us that the “national origin” classifica-
                   tions in the 1980 census may not be precise. Asian Americans can clas-
                   sify themselves (or be classified) according to their (1) ancestry, (2)
                   country of birth, or (3) country of emigration. For example, Asian Amer-
                   icans of Chinese ancestry may have been born in Laos and have emi-
                   grated from Vietnam. Their national origin could be identified as any of
                   the three countries and classified differently for different purposes. In
                   addition, the classifications do not allow for those of mixed ancestry.




                   Page 56                                       GAO/HRDSO-36FS   Asian Americans
Appendix III

SIPP Methodology


               The Census Bureau Survey of Income and Program Participation (SIPP)
               provides information on economic and demographic characteristics of
               individuals, families, and households in the United States. The SIPP data-
               base covers such areas as income, wealth, education, employment, pov-
               erty, and participation in government programs. The objective of our
               SIPP analysis was to obtain information on Asian Americans’ income,
               education, and welfare participation compared with the U.S. population
               as a whole. In addition, we reviewed other demographic data in SIPP,
               such as household size, age, sex, and employment, for a better under-
               standing of Asian Americans relative to the total U.S. population.

               SIPP is based on a statistical sample of U.S. residents, enabling projection
               to the population nationwide using Census Bureau weighting and esti-
               mating procedures. The Census Bureau determines sampling units on
               the basis of geographic areas and socioeconomic characteristics; within
               the sampling units, the Bureau systematically selects members of house-
               holds and group quarters (such as college dormitories and rooming
               houses) for participation in the survey.’ All participants selected in a
               given year are referred to as a “panel.” The Census Bureau divides
               panels into four groups and interviews each group in successive months
               over a 4-month period, which is referred to as a “wave.” Each group is
               interviewed eight times over a period of 2-l/2 years.

               For our analysis, we used a file compiled by the Census Bureau consist-
               ing of one wave each of the 1984 Panel and the 1985 Panel. We analyzed
               monthly data using August 1985 because it was the only month within
               the reference periods for all eight groups in the file. (See table III. 1.)




               ‘Those living in institutions. such as homes for the elderly, and people living abroad and in military
               barracks are excluded.



               Page 57                                                          GAO/HFUMO-36FS        Asian Americans
                                           Appendix III
                                           SIPP Methodology




Table 111.1:SIPP Data Used in Analvsis
                                                               Total          Asian         Interview
Panel                          Wave      Group        interviewed        Americans          month              Reference     period
1984                                7            1            10,794             269        Ott    1985        June   July   Aug       Sept   (i9651
                                             2                10.881              277       Nov    1985        July   Aug    Sept      Ott    I 1985
                                             3                10.818              246       Dee    1985        Aug    Sept    Ott      No::   : 1985,
                                             4                10.912              224       Sept   1985        May, June. July      Aug       (19851
1985                                3            1             9.082              225       Sept   1985        May, June, July Aug            (1985)
                                                 2             9,395              193       Ott    1985        June, July, Aug         Sept   (19851
                                                 3             9 439              254       Nov    1985        July, Aug     Sept      Ckt    (1985:
                                             4                 9,377              223       Dec. 1985          Aug    Sept    Ott      NOV f 1985
Total                                                         80,698           -1,911


                                           To analyze income status, we determined the average household
                                           monthly income, the average per capita monthly income, and household
                                           income relative to poverty thresholds. Household income includes earn-
                                           ings and property income for all household members aged 15 and over.-
                                           Average per capita monthly income was calculated by dividing total
                                           monthly income by the total number of people. To determine hous~~hold
                                           income relative to poverty, we divided household income by the applica-
                                           ble poverty threshold, which is based on household size and the mm~be1
                                           of related children under the age of 18. To analyze education status. RX?
                                           determined the highest educational level achieved by adults aged 25 or
                                           older, Age 25 was used as a minimum to ensure people were old enough
                                           for the highest educational levels the SIPP data include.

                                            Finally, we analyzed participation in eight of the nine public assistanctl
                                            programs we were requested to review.” SIPP does not contain informa-
                                            tion on the Summer Food program; hence, we could not include it in out
                                            analysis. For the purpose of our analysis, we defined the Low-Income
                                            Housing program to include both public housing and government rental
                                            assistance. Program participation was analyzed by a count of people fol
                                            all programs except the School Lunch and School Breakfast programs,
                                            which were analyzed by a count of households because of the WI) data
                                            structure.




                                            ?XPP does not gather data on mcome for children under the age of 15.

                                                                                                                                    1.1111c.h
                                            ‘These programs were AFDC. SSI. Medicaid. Low-Income Housing. Food Stamps. \VI(‘. S~~ho~lI
                                            School Breakfast. and Summer Food. (See p. 17.)



                                            Page 58                                                       GAO/HRD-90-i36FS     Asian     Amrricans
                                              Append.ix III
                                              SIPP Methodology




                                              We calculated sampling errors at the 95-percent level of confidence for
                                              all SIPP data cited in the report, as shown in table 111.2.

Table 111.2:Sampling   Errors for SIPP Data
                                                                                                                  Estimatesa
                                                                                                                           Sampling errors at
                                              Characteristics                                                Amounts         95% confidence
                                              Demographics
                                              Percentage      In the U S
                                                   Asran Amerrcan           rndrvrduals                          -2.50%                     t 0 25%
                                                   Asian American           households                             1 80                     2 020
                                              Average      household       size (persons)
                                                   Asian American           households                             3 51                     2 022
                                                   Total U S households
                                              Income
                                              Average      household       monthly      Income
                                                   Asran American           households                       $2.972.58                r $253 76
                                                   Total U S households                                       2,324.84                  z       26 84
                                              Average      per capita      monthly     Income           ~-
                                                   Asian Americans                                              826.90                  I       70 44
                                                   Total U S populatron                                         887.71                  t       1051
                                              Education
                                              Average hrghest education                level achreved
                                              (grade)
                                                    Asian Americans                                               12.38                     IO64
                                                   Total U S. population                                          1227     --               + 007
                                              Percentage      of indrvrduals         in education   ranges
                                                No educatron       or kindergarten          only
                                                   Asian Americans                                                 5 23%                    t 3 04%
                                                   Total U S. populatron                                           1 13                     2 022
                                                Elementary       to erghth grade
                                                   Asian Amerrcans                                                13.35                     -c 464
                                                   Total U S. oooulatron
                                                                       I
                                                                                                                  11 84                     + 066
                                                Hugh school      (9th to 12th.grade)
                                                   Asian Americans                                               32.99                      2 641
                                                   Total U S population                                          48.67                      2 1 02
                                                College     (undergraduate           or graduate    level)
                                                   Asran Americans                                               48 43                      2 682
                                                   Total U S population                                          38 37                      i    1 00
                                                                                                                                     (continued)




                                              Page 59                                                        GAO/HRD9036FS      Asian Americans
Appendix III
SLPP Methodology




                                                                       Estimate@
                                                                               Sampling errors at
Characteristics                                                   Amounts        95% confidence
Welfare participation
Percent    participatrng   in
  AFDC
     Asian Americans                                                    5.87                     k 215
     Total U S population                                               3.79                     2 028
  SSI
     Asran Amencans                                                     1.39                     2 1 07
     Total U S population                                               1 54                     i    018
  Medicaid
     Asran Americans                                                    9 63                      i   270
     Total US      population                                           7 18                      i- 037
  Low-Income        Housrng
     Asian Americans                                                    4 86                      t   1 97
     Total U.S. population                                              3 56                      + 027

- Food Stamps
    Asian Americans                                                     7 91                      t   247
     Total U.S. population                                              7.00                      It 037
  WIG
     Asian Americans                                                    0.79                      k 0.81
     Total U.S. population                                               1 20                     k 016
  School     Lunch and BreakfastO
     Asran American        households                                  1056                       i   3.48
     Total U.S. households                                              6 47                      z 038

aEstlmates were calculated using lndlvldual or household weights, as appropriate
bHouseholds with children aged 5 to 18 years receiving benefits from at least one of the free or reduced
price School Lunch and School Breakfast programs were counted as partlclpating households




Page 60                                                          GAO/HRD-SO-36PS       Asian Americans
Appendix I\

Asian American and Other Local Community
Organizations GAO Contacted

California

Northern California   Asian American Health Forum, San Francisco
                      Asians for Job Opportunities in Berkeley, Inc.
                      Association of Asian/Pacific Community Health Organizations, Oakland
                      Catholic Charities, San Francisco County
                      Center for Southeast Asian Refugee Resettlement, San Francisco
                      International Rescue Committee, San Francisco
                      North East Medical Services, San Francisco
                      Oakland Chinese Community Council, Inc.


Southern California   Korean Community Service Center, Los Angeles
                      Korean Youth Center, Los Angeles
                      Lao Family Community, Inc., Santa Ana
                      Filipino-American Service Group, Inc., Los Angeles
                      United Cambodian Community, Long Beach
                      United Way, Inc., Los Angeles


                      Southeast Asia Center, Chicago
Illinois

                      American Refugee Committee, Minneapolis
Minnesota

                      Chinatown Manpower Project, Inc., New York City
New York              Chinese-American Planning Council, Inc., New York City
                      Chinese Consolidated Benevolent Association, New York City
                      Immigrant Social Services, New York City


                      Catholic Charities of the Diocese of Houston/Galveston
Texas                 Texan Training & Employment Center, Houston and Dallas


                      National Pacific/Asian Resource Center on Aging, Seattle
Washington


                      Page 61                                     GAO/HRD9@36Fs   Asian Americans
ADDendix V

Detailed Statistics on Asian American Education


                                          According to our analysis of 1985 SIPP data and 1987 data from the
                                          Annual Housing Survey,’ a higher percentage of Asian American adults
                                          have attended college than U.S. adults overall, although a comparatively
                                          higher percentage of Asian American adults have little or no education.
                                          (See tables V. 1 and V.2.) Both analyses examined the highest education
                                          level attained by Asian Americans and the total U.S. population aged 2,5
                                          and older.

Table V.l: SIPP Data on Educational
Levels of Asian Americans Compared        Numbers    In percent
With the Total U.S. Population, Aged 25   Highest education         level
or Over (1985)                            attained                                    Asian Americans                Total U.S. population
                                          No educationa                                        52(t       30)                        11 (I   02)
                                          Some elementaryb                                    13 4 ( t 4 6)---          ~~~-~    11 8(r      07)
                                          Some high school                                    33 0 ( + 6 4)                      487(1       10)
                                          Some college                                        484(t68)           -               384(l+      10)
                                          Total                                             100.0                               100.0
                                          %cludes   kindergarten.

                                          blst through 8th grade
                                          Source Census Bureau, SIPP (1985)


Table V.2: Annual Housing Survey Data
on Educational Levek of Asian             Numbers    In percent
Americans Compared With the Total U.S.    Highest education         level
Population, Aged 25 or Over (1987)        attained                                    Asian Americans                Total U.S. population
                                          No educatIona                                        2.5 (+     1 5)                       0.6(*   0 1)
                                          Some elementaryO                                     8.0 (k     2 6,                   10.5(?      06)
                                          Some high school                                    33.0 (2     5 6)                   502(?       25j
                                          Some college                                        56.5 (k     7 9)                   38 7 ( 5 1 9)
                                          Total                                             100.0                               100.0
                                          %cludes   kindergarten

                                          bl st through 8th grade.
                                          Source U S Department of Houslng and Urban Development.     Annual Houslng Survey (1987)




                                          ‘The Annual Housing Survey, conducted by the Census Bureau. collects demographic data on educa-
                                          tion, income, and age, as well as different types of housing.



                                          Page 62                                                        GAO/HRD-SO-36FS Asian Americans
Appendix   VI

Cancer Deaths per 100,000 Population
(1978-81)

                                                   White and
                                                     Hispanic                         Asian Americans
                Cancer type                        Americans          Chinese         Filipino Hawaiian         Japanese
                All cancer types                         163.6             131.5          69.7         200.5        104.2
                Bladder                                       39               17          15             16           18
                Breast     (female)                          26 6             130          80           33 0           99
                Cervix     uteri                              32               2.9         16             4.2          2.7
                Corpus      uteri                             39               43          20             3.0          39
                Colon and rectum                             21 6             193          8.1           150          172
                Esophagus                                     26               33          19             65           19
                Larynx                                         13              07          04             14           0.2
                Lung (male)                                  69 3             48 2        20 0          88 0          32 7
                Lung (female)                                2o:ii            21 2         68           31 5           8.6
                Multlple     myeloma                          24               12          12             28           12
                Ovary                                         8.1              42          2.8            70           43
                Pancreas                                      8.4              74          3.3           109           70
                Prostate                                     21 0              75          8.2           11 6          88
                Stomach                                       53     -78                   3.3          25 3          175

                Note These are average annual age-adjusted      death rates

                Sources (1) HHS PHS. CDC, Natronal Center for Health Statrstics and (2) HHS, PHS, Natronal Institutes
                of Health, Natronal Cancer lnstrtute Cancer Among Blacks and Other Mrnorrtres Statistrcal Profrles
                (1986), as presented In Drsease Preventron/Health Promotron The Facts, Office of Disease Preventron
                and Health Promotron. PHS. HHS (1988). p 193




                Page 63                                                              GAO/HRD-SO-36FS     Asian Americans
Appendix VII

Cultural and Religious Barriers Facing
Southeast Asian RefugeesSeeking
Medid Treatment
                         In Buddhism, the main religion of Southeast Asia, suffering may be per-
Religion             l


                         ceived as an integral part of one’s life and seeking medical help for a
                         physical pain may be delayed or considered inappropriate.
                     l   Surgery and other invasive procedures are perceived as mutilating and
                         may disrupt the soul.


                         The germ theory and principles of anatomy and physiology are foreign
Unfamiliarity With   l


                         to those Southeast Asians with little or no education.
Western Medicine     l   Southeast Asians rarely seek preventive treatment.
                     l   There is no surgical tradition in Southeast Asia.
                     l   Southeast Asians tend not to seek formal mental health care.
                     l   Use of dual systems of health care (both traditional and Western) are
                         common,


                       Few Southeast Asian refugees are familiar with the process of making
Differing Cultural   l


                       an appointment to see a doctor.
Norms                . Decisions to seek medical care and what kind of medical care are often
                       made by the eldest member of the family.
                     9 Southeast Asian patients may appear unassuming and nod understand-
                       ing rather than acknowledge the fact that they are confused or do not
                       understand a question.
                     . Instant diagnosis and treatment from the first provider encountered is
                       expected.


                       Southeast Asian patients often use their own systems of health care
Folk Practices       l


                       before resorting to Western medicine.
                     . Folk medicine is almost universally practiced throughout Southeast
                       Asia, with such practices as cao gio, rubbing the skin vigorously with
                       either a coin or a spoon; bat gio, pinching the skin between the thumb
                       and index finger; and giac, applying a hot cup to the forehead or other
                       exposed area for a prolonged time.
                     l Among the hill tribe people of Laos, shamans may be the preferred
                       providers of medical care; they use such practices as tying a cord
                       around the patient’s wrist to enable communication with dead ancestors
                       or to prevent the loss of a sick person’s soul.




                         Page 64                                      GAO/HRD-90-36FS   Asian Americans
-Appendix VIII

Major Contributors to This Fact Sheet


                        Daniel 34. Brier, Assistant Director (Welfare Issues), (202) 27543616
Human Resources         Charles J. Gareis, Assignment Manager
Division, Washington,
D.C.

San Francisco           Susan Rothblatt, Site Senior
Regional Office         RoJeanne Liu, Technical Advisor
                        Richard S. Thomason, Evaluator




                        Page 65                                       GAO/HRD-SO-36l?S   Asian Americans
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(105469)       Page 69                                     GAO/HRD-90-36FS   Asian Americans