'Young Asians don't drink': Biases stop young Asians from seeking health care, study shows

Kiwi Filipino researcher Lovely Dizon co-authored the report Factors predicting forgone healthcare among Asian adolescents in New Zealand: unmasking variations in aggregate data. Photo / Alex Burton

Lovely Dizon often speaks up for her parents at doctor's appointments when people assume the Filipino couple don't speak English. Her dentist mum and electrician dad have been in New Zealand for 23 years.

Another time, a doctor did not believe Dizon's answer to a question about sexual health.

Tiny interactions like these have made the 26-year-old PhD student hesitant to get help when she suffered from anxiety and disordered eating in high school and university.

"The systems we have in New Zealand are very European-centric and those ways of thinking aren't necessarily helpful for non-Pakeha," she said.

"So it's hard to feel like the service is going to help you in the first place, if they're not going to understand your worldview."

Dizon is one of the co-authors of a new research report that shows one in five Asian secondary school students did not access health care when they needed it, putting them at higher risk of physical and mental health problems.

East Asian students are especially likely to forgo health care when they come from poor communities, are bullied in school, and do not spend enough time with family.

Lead researcher Associate Professor Roshini Peiris-John is a senior lecturer in epidemiology at the University of Auckland. Photo / Supplied

For South Asian students, those who do not always feel safe in their neighbourhood and do not have someone in the family to talk about worries were more likely to forgo health care.

Asian youth need to be able to talk about health issues with their families "because it can be complicated, expensive, discriminatory and scary to negotiate alone," said lead researcher and University of Auckland Associate Professor Roshini Peiris-John.

But young Asians find it difficult to talk to their parents when there are money or other problems at home, she said, and their families are often not equipped to react when it comes to mental health issues.

Migrant families settling into a new country tend to subscribe to the ethos of "put your head down, work hard, don't ruffle feathers", Peiris-John said.

Asians are projected to be the second-largest ethnic grouping in New Zealand by 2030, and today make up 20 per cent of residents aged 15-29.

As in other Western countries, young Asians here report favourable health outcomes, but this "healthy migrant" effect dissipates over time as length of residence increases.

The report, published in the New Zealand Medical Journal, is based on a survey of nearly 2000 Asian high schoolers in 2019, using data from a larger national survey of young New Zealanders called Youth19.

"Asian youth experience pressure to uphold the 'model minority' myth and the perception that Asian youth are successful and resilient to external stressors," the report wrote.

Further, their mental health needs are often hidden by stereotypes that prevent access to care, it said.

For example, the blanket assumption is that young Asians don't drink, so there is no need to ask about alcohol, says Youth19 principal investigator Associate Professor Terry Fleming, citing other micro-behaviours like pronouncing names incorrectly, not taking as much time with assessments, and being overly positive when responding to young Asians' health concerns.

"The research shows that little things like that build up to some really significant health disparities," she said.

The study recommends support for families to understand the New Zealand health care systems and their access, and cultural competency training for health providers.

"I don't think anybody comes to work with the intention of discriminating. But we do have our racial biases," said Peiris-John, and it's important to work with young people to address these biases in health care.

Dizon is no longer the young girl who did not feel heard at the doctor's office, and her experiences have driven her into research.

"[It's] definitely the reason I do what I do. It's important that Asian young people feel like they belong here and get the help they need."