>>I AM ELISEO PEREZ-STABLE, DIRECTOR OF THE NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES AND I WOULD LIKE TO WELCOME YOU TO THE NIMHD DIRECTORS'SEMINAR SERIES, WHICH TODAY HIGHLIGHTS DR. CHAU TRINH-SHEVRIN FROM NEW YORK UNIVERSITY. OUR SERIES HIGHLIGHTS PROMINENT RESEARCHERS WHO ARE WORKING IN THE SCIENCE OF MINORITY HEALTH AND HEALTH DISPARITIES AND AFTER AN INITIAL PAUSE LAST YEAR WHEN THE PANDEMIC SHUT US ALL TO WORK AT HOME, WE HAVE REASSUMED OUR PACE WITH VIRTUAL PRESENTATIONS. SO, TODAY WE ARE REALLY HONORED TO HAVE DR. TRINH-SHEVRIN. CHAU IS NATIVE OF VIETNAM WHO CAME TO THE U.S. AS A REFUGEE FROM THE VIETNAM WAR OR AS THE VIETNAMESE CALLED IT, THE AMERICAN WAR. SHE WENT TO STATE UNIVERSITY IN NEW YORK. WHERE SHE GOT HER BA IN ENGLISH AND MASTERS IN HEALTH POLICY BEFORE GOING TO COLUMBIA UNIVERSITY FOR HER DOCTORATE DEGREE IN PUBLIC HEALTH. SHORTLY THEREAFTER SHE JOINED NEW YORK UNIVERSITY AS AN ASSISTANT PROFESSOR IN 2005. AND WAS PROMOTED TO FULL PROFESSOR IN 2020. I FIRST MET CHAU BECAUSE SHE WAS ON THE COMMITTEE, THE SEARCH COMMITTEE THAT FOUND ME TO BE THE DIRECTOR OF NIMHD. AND SUBSEQUENTLY, I GOT TO KNOW HER WORK AND ALSO AS A PRINCIPLE INVESTIGATOR FOR MANY YEARS OF NIMHD-FUNDED CENTER OF EXCELLENCE. OVER THESE PAST 20-PLUS YEARS, HER RESEARCH HAS BEEN CENTERED ON RIGOROUS DEVELOPMENT AND EVALUATION OF MULTILEVEL STRATEGIES TO REDUCE HEALTH DISPARITIES AND ADVANCE HEALTH EQUITY WITH A SPECIAL FOCUS ON ASIAN AMERICANS. SHE IS A PI ON A NUMBER OF GRANTS FOR NIH. I WILL MAKE NOTE OF THE NIMHD CENTER OF EXCELLENCE FOR STUDY OF ASIAN AMERICAN HEALTH. WHICH WAS RENEWED IN THE CALL THAT WE MADE AFTER I ARRIVED AS DIRECTOR, EVEN THOUGH WE REDUCED THE NUMBER SIGNIFICANTLY. SHE ALSO HAS NATIONAL INSTITUTE ON AGING K70 AND R24 ON LONGEVITY AND RESEARCH COLLABORATIVE, JUST ABOUT EVERYONE DOING DIVERSITY WORK OR HEALTH EQUITY WORK IN THE AREA THAT CAN GET HER AS A CO-INVESTIGATOR, HAS. SHE MENTIONED EARLIER IN A CONVERSATION WITH HER ABOUT THE ROLE IN THE SEAL PROJECT, THAT WE JUST APPROVED IN THE NEW YORK AREA. OF WHICH SHE IS ALSO INVOLVED. CHAU HAS USED EXPERTISE IN COMMUNITY ENGAGED RESEARCH USING LONG STANDING RELATIONSHIPS WITH LOCAL, REGIONAL AND NATIONAL PARTNERS. SHE CO-DIRECTS THE COMMUNITY ENGAGEMENT AND POPULATION HEALTH RESEARCH CORPS FOR NEW YORK UNIVERSITY HEALTH + HOSPITALS AND THEIR CTSI. AND SHE HAS ALSO BEEN ACTIVE IN THE COMMUNITY, BEING BOARD OF DIRECTORS CHINA TOWN YMCA OF NEW YORK CITY AND NEW YORK STATE'S DEPARTMENT OF HEALTH MEDICAID REDESIGN TEAM WORKING ON THE WORK GROUP AND DELIVERY SYSTEM. SHE AUTHORED OR CO-AUTHORED MORE THAN 100 PEER-REVIEWED PAPER, COED TOR OF TWO TEXTBOOKS AND REMARKLY A NICE PERSON. TODAY HER TALK IS ENTITLED ACHIEVING HEALTH EQUITY FOR ASIAN AMERICANS: RESEARCH, POLICY, AND ACTION. A VERY TIMELY TOPIC IN THE CONTEXT OF WHAT NIH IS GOING THROUGH IN THE UNITE PROCESS. CHAU, WE LOOK FORWARD TO YOUR TALK. >> THANK YOU SO MUCH, ELISEO, I REALLY APPRECIATE THIS WONDERFUL INTRODUCTION. GOOD AFTERNOON, EVERYONE. I'M REALLY DELIGHTED TO BE HERE TODAY. MY PRESENTATION IS FOCUSED ON ACHIEVING HEALTH EQUITY FOR ASIAN AMERICAN COMMUNITIES, RESEARCH, POLICY AND ACTION. I HAVE FOUR OBJECTIVES TO UNDERSTAND DRIVERS OF HEALTH AND HEALTH DISPARITIES FOR THE ASIAN AMERICAN POPULATIONS TO DESCRIBE MULTILEVEL STRATEGIES TO REDUCE HEALTH DISPARITIES, TO DESCRIBE THE IMPACT OF COVID-19 PANDEMIC ON THE HEALTH OF ASIAN AMERICANS AND DISCUSS RECOMMENDATIONS TO ADVANCE HEALTH FOR ASIAN AMERICAN COMMUNITIES. I'M GOING TO BEGIN WITH CONTEXT ABOUT THE ASIAN AMERICAN POPULATION. NEXT. ASIAN AMERICANS ARE THE FASTEST GROWING POPULATION. WE ARE EXPECTED TO GROW TO ABOUT 39 MILLION BY 2060, REPRESENTING NEARLY 10% OF THE U.S. POPULATION. AND IN NEW YORK CITY, WE ALREADY REPRESENT NEARLY 15% OF THE CITY'S POPULATION AND WE ARE GROWING IN SIZE. THIS IS IN PART FUELED BY IMMIGRATION TRENDS. NEXT, PLEASE. TO GIVE YOU A SENSE, THERE HAS BEEN A 34% POPULATION GROWTH AMONG ASIAN AMERICANS COMPARED TO 22% FOR NATIVE, HAWAIIAN AND PACIFIC ISLANDERS AND 6% FOR OTHER ASIAN COMMUNITIES. WE FALL UNDER THREE BROAD SUBGROUPS. EAST, SOUTHEAST AND SOUTH ASIANS. AS YOU CAN SEE, THERE EASE TREMENDOUS DIVERSITY WITHIN THESE SUBGROUPS WITH RESPECT TO COUNTRY OF ORIGIN, CULTURES AND LANGUAGE. WE ALSO DIFFER IN POPULATION SIZE AND DIVERSITY. WE ARE GEOGRAPHICALLY DISPERSED. MORE THAN HALF OF ASIAN AMERICANS LIVE IN FIVE STATES, CALIFORNIA, NEW YORK, TEXAS, NEW JERSEY AND WASHINGTON. NEW YORK CITY HAS THE LARGEST CONCENTRATION OF ASIAN AMERICANS. WE HAVE MORE THAN 1.3 MILLION ASIAN AMERICANS IN ONE CITY. WE ARE REPRESENTATIVE OF THE DIVERSITY OF THE ASIAN AMERICAN POPULATION, INCLUDING MANY SOUTH, SOUTHEAST AND EAST ASIAN COMMUNITIES. AND WE ALSO HAVE A VERY LARGE FIRST AND SECOND GENERATION IMMIGRANT POPULATION. MY PRESENTATION TODAY IS GOING TO FOCUS ON THE ASIAN AMERICAN POPULATION, GIVEN THE BREADTH AND DEPTH OF MY WORK IN THIS AREA, FOCUSED IN NEW YORK CITY. ALSO OUT OF DEAF REASONS AND SOLIDARITY TO MY NATIVE HAWAIIAN AND PACIFIC ISLANDER AND COMMUNITY PARTNERS. I WILL TRY TO SEPARATE THE WORK WE DO IN THE ASIAN AMERICAN POPULATION FROM THESE OTHER COMMUNITIES. ASIAN AMERICANS HAVE THE HIGHEST PROPORTION OF FOREIGN BORN. MORE THAN HALF ARE FIRST GENERATION COMPARED TO THE U.S. POPULATION. IF YOU LOOK AT THE DATA BROKEN DOWN BY SUBGROUPS, NATIVITY VARIES BY ETHNICITY, JAPANESE LOW OF 27% AND HIGH FOR 85% FOR THE BHUTANESE COMMUNITY. THIS SHOWS RISKS FOR DISPARITIES. IF YOU AGGREGATE ASIAN AMERICANS, YOU SEE A HIGHER EDUCATIONAL ATTAINMENT LEVEL COMPARED TO THE REST OF THE UNITED STATES, BASED ON THE MEASURE OF SHARE WITH BACHELOR'S DEGREE OF AGES 25 AND OLDER. IF YOU LOOK AT THE DATA IN THE AGGREGATE, YOU SEE 30% VS. 20%. WHEN YOU LOOK AT THE DATA DISAGGREGATED, YOU SEE PROFOUND DIFFERENCES ACROSS ASIAN ETHNIC GROUPS. YOU ALSO SEE THAT THERE ARE MANY SUBGROUPS WHO HAVE MUCH LOWER RATES OF EDUCATIONAL ATTAINMENT, COMPARED TO ALL AMERICANS. NEXT, PLEASE. INCOME ALSO TELLS A SIMILAR STORY. ASIANS IN THE AGGREGATE DO MUCH BETTER THAN ALL OTHER U.S. COMMUNITIES. NEXT. BUT THERE ARE STARK DIFFERENCES WHEN YOU DISAGGREGATE BY ASIAN SUBGROUPS, MANY IN MUCH LOWER THAN THE AVERAGE AMERICAN INCOME. NEXT. IN NEW YORK CITY, FOR EXAMPLE, ASIAN AMERICANS ACTUALLY HAVE AMONG THE HIGHEST POVERTY LEVELS COMPARED TO OTHER RACIAL AND ETHNIC GROUPS. OFTENTIMES THIS DATA IS NOT PRESENTED OR DISMISSED OR EXCLUDED IN TERMS OF THINKING ABOUT SOCIAL AND ECONOMIC DISADVANTAGE FOR ASIAN AMERICAN COMMUNITIES. NEXT. LANGUAGE BARRIERS ALSO PERSIST. ENGLISH PROFICIENCY RATES ARE LOWER FOR ALL ASIAN SUBGROUPS COMPARED TO ALL OTHER RACIAL AND ETHNIC GROUPS. YOU CAN SEE BY THE SLIDE THESE RATES DIFFER ACROSS RACIAL SUBGROUPS. NEXT. I'M GOING TO SWITCH GEARS FOR A MOMENT AND HIGHLIGHT A FEW OF THE MAJOR HEALTH DISPARITIES, DIABETES, HYPERTENSION AND CANCER. REALLY MAINLY TO UNDERSCORE THE SALIENCE OF DIG AGENCY REGAITED DATA COLLECTION AND ANALYSIS. HERE DATA FROM THE NEW YORK CITY HEALTH DEPARTMENT ILLUSTRATE DIABETES DISPARITIES PERSIST FOR ALL RACIAL AND ETHNIC MINORITY COMMUNITIES AND PRONOUNCED FOR ASIAN SUBGROUPS, PARTICULARLY SOUTH AND SOUTHEAST ASIANS. NEXT. AND WHEN WE LOOK AT THE DATA WITH RESPECT TO DIABETES PREVALENCE BY ASIAN AMERICAN SUBGROUPS ACROSS DIFFERENT DATA SETS, ACROSS DIFFERENT REGIONS AND FOR DIFFERENT ASIAN SUBGROUPS, WE STILL SEE STRIKING DIABETES DISPARITIES THAT EXIST. NEXT. ASIANS HAVE A HIGHER DIABETES RISK AT LOWER BMI LEVELS COMPARED TO OTHER RACIAL AND ETHNIC GROUPS. THE WORLD HEALTH ORGANIZATION AND UNITED STATES DIABETES ORGANIZATION HAVE CALLED FOR LOWER CUTOFFS FOR ASIAN AMERICAN COMMUNITIES AND CENTERING AND UNDERSTANDING RISK BASED ON THAT COMMUNITY AS OPPOSED TO A DIFFERENT STANDARD. NEXT, PLEASE. IN NEW YORK CITY, HYPERTENSION DISPARITIES ARE ALSO EVIDENT FOR ALL RACIAL AND ETHNIC MINORITY COMMUNITIES. THEY ALSO DIFFER WITH ASIAN SUBGROUPS. SOUTH AND SOUTHEAST ASIANS HAVING HIGHER RATES COMPARED TO OTHER ASIAN SUBGROUPS. IF YOU LOOK AT THE SOUTH ASIAN RATE, FOR EXAMPLE, YOU SEE IT IS AT 43%, WHICH CLOSELY APPROACHES THAT OF BLACK AND AFRICAN-AMERICANS AT 43.5%. HIGH HYPERTENSION DISPARITIES AMONG THIS POPULATION. NEXT. THERE'S ALSO A SUBSTANTIAL CANCER BURDEN FOR ASIAN AMERICAN COMMUNITIES. THE LEADING CANCERS DIFFER ACROSS ASIAN SUBGROUPS FROM COUNTRY OF ORIGIN, CULTURE, LANGUAGE ACCESS, RELIGIOUS AFFILIATION, ALL OF THESE FACTORS IMPACT CANCER RATES AND ALSO CANCER RISK FACTORS, WHICH HAS IMPLICATIONS IN THINKING ABOUT TARGETED PREVENTION AND INTERVENTION STRATEGIES. UNFORTUNATELY, THERE IS VERY LITTLE DATA AROUND HOW BEST TO TAILOR. MORE DATA HAS BEEN PROBABLY AVAILABLE FOR ADDRESSING CANCERS FOR ASIAN AMERICANS, BUT EVEN THAT, THINKING IT THROUGH, TAILORED STRATEGIES TO REDUCE THE CANCER BURDEN AND CANCER DISPARITIES ARE IN SOME WAYS VERY LIMITED. NEXT, PLEASE. WE ALSO KNOW THAT CANCER SCREENING RATES ARE GENERALLY LOWER FOR ASIAN AMERICAN GROUPS COMPARED TO OTHERS. WE ALSO REALIZE THAT THE UPTAKE OF EVIDENCE-BASED PREVENTION STRATEGIES FOR INFECTION-RELATED CANCERS, WHICH HAVE A HIGH -- WHICH REPRESENTS A HIGH BURDEN FOR MANY ASIAN AMERICAN COMMUNITIES, IS VERY LIMITED IN TERMS OF REACH AND NOT FULLY OPTIMIZED. SO, FOR EXAMPLE, HEPATITIS B SCREENING IS SOMETHING THAT CAN BE DONE TO REDUCE LIVER CANCER THE DISPARITIES THAT ARE PARTICULARLY PRONOUNCED FOR EAST ASIAN SUBGROUPS. AND WE ALSO KNOW THAT MANY PREVENTIBLE CANCERS, LUNG, STOMACH, COL RORKS ECTAL TOP ASIAN AMERICAN SUBGROUPS. NEXT, PLEASE. SO OVERALL, CANCER, HEART DISEASE AND DIABETES AS WELL AS STROKE, REMAIN LEADING CAUSES IN MORTALITY, YET THEY DIFFER IF YOU LOOK AT THE DIFFERENT SUBGROUPS. WITH RESPECT TO THOSE LEADING CAUSES. WE ARE ALSO SEEING AN EMERGING RISK THAT IS RAPIDLY INCREASING FOR ALL AMERICANS AS WELL AS ASIAN SUBGROUPS, THAT IS ALZHEIMER'S DISEASE. THAT IS A MAJOR CONCERN GIVEN THE NEED TO UNDERSTAND HOW BEST TO TAILOR PREVENTION INTERVENTION STRATEGIES FOR DIFFERENT COMMUNITIES. AND THAT IS AN AREA WE HOPE TO BE ABLE TO GROW OUR FOCUS ON IN THE NEXT FEW YEARS. NEXT. SO I'M GOING TO BRIEFLY TOUCH ON ISSUES OF DRIVERS OF DISPARITIES. NEXT, PLEASE. I WANT TO TALK ABOUT STRUCTURAL RACISM. THE STEREOTYPES OF THE MODERN MINORITY, FOREIGNER CARRIERS OF DISEASE, SWELSZ THE INTERSECTIONALITY THAT OCCURS WHEN YOU OCCUPY BOTH A RACIAL MINORITY GROUP AND ALSO OUR IMMIGRANT OR SECOND-GENERATION IMMIGRANT AND WHAT THAT MIGHT IMPLY WITH RESPECT TO STEREOTYPES, RACISM AND DISCRIMINATION. I WANT TO TOUCH ON DATA INEQUITIES, SPECIFICALLY THE LACK OF DATA DISAGGREGATED BY SUBGROUP AVAILABLE AND THE NEED FOR MORE FUNDING TO NOT ONLY INTERVENTION STUDIES ON DIFFERENT HEALTH ISSUES, HEALTH DISPARITY ISSUES THAT OCCUR AMONG ASIAN AMERICANS, BUT THE NEED FOR MORE COHORT OBSERVATIONAL LONGITUDINAL STUDIES ON THIS POPULATION AND DISAGGREGATED BY THE VARIOUS ASIAN AMERICAN SUBGROUPS. I WANT TO TOUCH ON THE LIMITED ACCESS TO SOCIAL AND HEALTH RESOURCES AND HOW THAT MAY IMPACT HEALTH DISPARITIES AS WELL AS LIMITED ENGLISH PROFICIENCY. NEXT. THIS FIGURE HERE WAS DEVELOPED BY OUR COLLEAGUES, GILBERT GEE AND ANNIE ROE, WHO WROTE A CHAPTER IN OUR TEXTBOOK THAT WAS PUBLISHED IN 2009 ON ASIAN AMERICAN COMMUNITIES AND HEALTH. THEY TALK ABOUT RACISM AS AN IMAGE AS AN ICEBERG. INTERPERSONAL AND OVERT RACISM, WHICH IS WHAT WE TEND TO THINK ABOUT WHEN WE SEE RACISM AND THAT REFERS TO EXPLICIT RACISM, DISCRIMINATION AND MICROAGGRESSIONS. THAT REPRESENTS THE TIP OF THE ICEBERG. WHAT EXISTS BELOW THE SURFACE IS OFTEN FOUNDATIONAL AND THAT IS STRUCTURAL OR SYSTEMIC RACISM EMBEDDED, NORMALIZED WITHIN EVERY U.S. INSTITUTION. IT HAS LED IN MANY WAYS TO UNEQUAL ACCESS TO QUALITY EDUCATION, TO LIVING WAGES, TO ACCESS TO CARE AND ACCESS TO OTHER RESOURCES. NEXT. I'M GOING TO TALK ABOUT HEALTH EQUITY FOR A MOMENT. HEALTH EQUITY DEFINED IN SOME WAYS AS THE HIGHEST ATTAINMENT OF HEALTH. THERE ARE VARIOUS DEPICTIONS OF EQUALITY AND EQUITY. SO IF YOU LOOK AT THE BIGGER, AT THE TOP LEFT, THIS ONE ILLUSTRATES THAT LIMITATIONS AND DISPARITIES ARE NOT INDIVIDUAL LEVEL CHARACTERISTICS, BUT INSTEAD ARE INHERENT TO THE SYSTEM OR THE TRACK. SO IN THE TOP EQUALITY FIGURE, EVERYONE STARTS THE RACE OFF AT THE SAME LEVEL, BUT THERE ARE TANGIBLE ADVANTAGES TO BEING THE BLUE RUNNER, IT REPRESENTS THE SHORTEST DISTANCE. SOME GROUPS START OFF THE RACE WITH A CLEAR ADVANTAGE AND REMAIN THAT WAY THROUGHOUT THE RACE. NOW IF YOU LOOK AT THE BOTTOM LEFT FIGURE, YOU SEE IF YOU WANT TO ACHIEVE EQUITY, YOU HAVE TO ADJUST THE STARTING POINTS FOR EACH OF THE LANES. IN THE LAST 15 MONTHS IT HAS REALLY BECOME APPARENT THAT SYSTEMIC RACISM IS A FUNDAMENTAL AND STRUCTURAL DETERMINANT OF HEALTH AND BEGS THE QUESTION OF WHETHER THE WAY WE ARE THINKING ABOUT EQUITY IS ENOUGH. WE ACTUALLY NEED TO BEGIN TO UNDERSTAND AND SYSTEMATICALLY DISMANTLE THE STRUCTURES BY WHICH POWER IS CONFERRED AND THOSE WHO ARE DISEMPOWERED REMAIN POURLESS AND REALLY MOVE TOWARDS A JUSTICE PERSPECTIVE, OF DISMANTLING THE ROOTS OF RACISM IF WE EVER WANT TO ACHIEVE HEALTH EQUITY. NEXT, PLEASE. THE BLACK LIVES MATTER MOVEMENT UNDERSCORED THIS POINT. AND THEN THE VIOLENCE OF THE LAST 15 MONTHS TOWARDS ASIAN AMERICANS AND PARTICULARLY IN THE LAST FEW MONTHS HAVE ALSO MADE THIS POINT SALIENT, OF THINKING ABOUT STRUCTURAL RACISM AND ITS IMPACT ON HEALTH, ON HEALTH D DISPARITIES AND HOW IT IS SYSTEMATICALLY ROOTED IN OUR SYSTEM. HISTORICALLY ASIAN AMERICANS HAVE A LONG HISTORY OF EXPERIENCING STRUCTURAL RACISM AND DISCRIMINATION ROOTED IN ANTI-ASIAN IMMIGRANT LAWS. THE 1882 CHINESE EXCLUSION ACT WAS THE FIRST PIECE OF U.S. LEGISLATION THAT BARRED A SPECIFIC ETHNIC GROUP FROM IMMIGRATION AND NATURALIZATION. AND THIS CARTOON FROM SEPTEMBER OF 1879 DEPICTS THE RACIALIZED POSITION OF BOTH BLACKS AND CHINESE IN THIS PERIOD. THIS DIDN'T CHANGE MARKEDLY UNTIL 1965 WHEN THE FOR IMMIGRANTS WERE INCREASED FOR ALL COUNTRIES OUTSIDE OF THE U.S. ESSENTIALLY THAT INCREASED THE NUMBER OF ASIAN IMMIGRANTS THAT CAME INTO THE COUNTRY. IT ALSO HAD SELECTIVE PREFERENCE FOR FAMILIES AND SELECTIVE PREFERENCES FOR PROFESSIONAL LEVEL IMMIGRANTS. THIS LAST PREFERENCE OF HIGHLY SKILLED, HIGHLY PROFESSIONAL LEVEL IMMIGRANTS HELPED TO UNDERGIRD THIS NOTION OF THE MODERN MINORITY STEREOTYPE. SO THE MODEL MINORITY STEREOTYPE PAINT ASIAN AMERICANS AS A MONOLITHIC COMMUNITY, HIGH EDUCATION ATTAINMENT, HIGH MEDIAN FAMILY INCOME, LOW CRIME RATES, LACK OF JUVENILE DELINQUENCY, LACK OF MENTAL ILLNESS, CLOSE FAMILY TIES, LAW ABIDING, HARD WORK ETHIC AND THESE INDIVIDUALS HAVE OVERCOME ALL BARRIERS AND HAVE SUCCEEDED PROFESSIONALLY AND ECONOMICALLY. IN MANY WAYS IT SEEMS LIKE A VERY POSITIVE STEREOTYPE. NEXT, PLEASE. THIS STEREOTYPE IS A HARDY ONE. IT BEGAN IN THE 1960s AND IT PERSISTS TODAY AND IT HAS HELPED TO RENDER ASIAN AMERICANS INVISIBLE. WHAT DOES IT MEAN TO BE A MODEL MINORITY, WHERE INVISIBLE IN MANY CIRCUMSTANCES BECAUSE WE ARE DOING WHAT WE ARE SUPPOSED TO BE DOING UNTIL WE BECOME HYPERVISIBLE, LIKE THE COVER OF THIS "TIME" MAGAZINE OF DOING WHAT WE DO TOO WELL. NEXT, PLEASE. BUT THE STEREOTYPE OF THE MODEL MINORITY WAS ACTUALLY DEVELOPED AND ROOTED IN ANTI-BLACKNESS. IT WAS DEVELOPED AT A TIME BY A CONSERVATIVE MAJORITY TO OPPOSE THE BLACK POWER MOVEMENT OF THE 1960s. THAT MOVEMENT HIGHLIGHTED THE EXISTENCE OF INSTITUTIONAL RACISM AND THAT POLICIES WERE STRUCTURED TO KEEP MINORITIES IN A SUBORDINATE POSITION. THE CONCEPT OF THE MODEL MINORITY BECAME A STRATEGY THEN TO DENY THE EXISTENCE OF INSTITUTIONALIZED RACIAL INEQUALI INEQUALITIES. ASIAN AMERICANS WERE THE COMMUNITIES, THE MINORITY COMMUNITIES THAT WERE DOING SO WELL AND AS MENTIONED, THE IMMIGRATION POLICIES WERE ALLOWING HIGHLY SKILLED ASIAN IMMIGRANTS TO COME INTO THE COUNTRY. THEY WERE THE NOTABLE EXAMPLES OF PROFESSIONAL SUCCESS AS HARD WORKING INDIVIDUALS. AND SO THE IDEA OF ASIANS ALSO BEING ALL ONE BIG POPULATION AND THE NOTION OF THE MODEL MINORITY TOOK HOLD AND PERSISTED TO THIS DAY. AND SO THIS CONCEPT OF THE MODEL MINORITY ALSO SWITCHED FOCUS TO INDIVIDUAL AND COMMUNITY RESPONSIBILITY. INDIVIDUAL UNDERPERFORMANCE WAS THE REASON FOR RACIAL INEQUALITY. IF BLACK COMMUNITIES, FOR EXAMPLE, JUST WORKED HARDER, THEY, TOO, WOULD MOVE UP THE SOCIAL LADDER. ESSENTIALLY THE SUCCESS OF ASIAN AMERICANS AT THAT TIME WAS UTILIZED AS A TOOL AGAINST THE BLACK -- AGAINST THE MOVEMENT OF ENSURING THAT REALLY DENY THAT EXISTENCE OF INSTITUTIONAL RACISM. IT ALSO BECAME A VERY CUNNING STRATEGY TO WITHHOLD RESOURCES TO ASIAN AMERICAN COMMUNITIES BECAUSE THEY WERE ALREADY DOING SO WELL. THIS STEREOTYPE WAS INTRACTABLE TO CHANGE. INTERNALIZED BY ASIAN AMERICAN COMMUNITIES AND ALSO BY MAINSTREAM AMERICA. SO TO THE POINT THAT WE SEE IMAGES OF CRAZY RICH ASIANS AND OTHER STEREOTYPES BECOMING GLORIFIED, YET WE FLOW THERE IS A BINOMIAL SOCIAL ECONOMIC DISTRIBUTION WE SEE THAT WITHIN ACROSS AND WITHIN ASIAN SUBGROUPS, FOR EXAMPLE, EVEN WITHIN THE CHINESE COMMUNITY HIGHEST INCOME EARNERS AND YET THEY HAVE THE HIGHEST PROPORTION OF INDIVIDUALS LIVING IN POVERTY. THAT STORY CAN BE TOLD FOR THE SOUTH ASIAN POPULATION. WHAT IT ALSO DOES IN A VERY INSIDIOUS WAY, IS THE MODEL MINORITY STEREOTYPE, FOR THOSE WHO FAIL TO REACH THAT IDEAL, THERE'S AN INTERNALIZED STIGMA AND FRUSTRATION THAT OCCURS. NEXT, PLEASE. ALONGSIDE THE MODEL MINORITY STEREOTYPE, IS THIS NOTION OF A PERPETUAL FOREIGNER. AN HISTORICAL EXAMPLE IS, OF COURSE, THE INTERNMENT OF JAPANESE AMERICANS DURING WORLD WAR II. THIS TOP PHOTO IS THAT OF A JAPANESE-OWNED GROCERY STORE IN OAKLAND TAKEN ONE MONTH AFTER THE EXECUTIVE ORDER. THE OWNER HAS TO ASSERT HIM OR HERSELF THEY ARE ALSO AN AMERICAN. RECENT EXAMPLES OF THE PERPETUAL FOREIGNER INCLUDE THE COVID-RELATED ANTI-RACE SIMPLE AND XENOPHOBIA WE HAVE BEEN SEEING SINCE THE PANDEMIC AND CONTINUING TO SEE NOW. NEXT, PLEASE. IN 1999, A SOCIOLOGIST, CLARA JEAN KIM USED THIS FIGURE TO ILLUSTRATE THIS RACIAL TRIAINGEULATION SHOWS WHITE PRIVILEGE AND RACIAL HIRE ARKANSASY ARE UPHELD. ON THE Y AXIS, ASIAN AMERICANS ARE SUPERIOR TO BLACKS OND ON THE X AX SITUATION, INFERIOR. THE PERPETUAL FOREIGNER. THE RESULT OF THE COMPETING NARRATIVES FOR ASIAN AMERICANS HAVE LARGELY HELPED TO SUPPORT THE OMISSION OF ASIAN AMERICANS IN SOCIAL, HEALTH AND POLICY DEBATES. WE ARE OFTEN NOT REPRESENTED OR UNDERREPRESENTED IN DEBATES, INCLUDING THE RECENT ISSUES EMERGED WITH ADDRESSING THE IMPACT OF COVID-19. NEXT. IT IS SO CLEAR THAT FEAR FUELS HATE AND RACISM. FROM A COMMUNITY PERSPECTIVE, IT HAS BEEN DEVASTATING TO WITNESS AND EXPERIENCE THE PSYCHOLOGICAL TRAUMA OF XENOPHOBIA AND RACIST ATTACKS TOWARDS ASIAN AMERICANS. HISTORY HAS REPEATED ITSELF IN THE YELLOW PERIL AND THE KUNG FU AND CHINESE VIRUS. MORE THAN 1,800 RACIST INCIDENTS HAVE OCCURRED SINCE MAY OF 2020. AND THE ANTI-ASIAN VIOLENCE ARE OFTEN NOT REPORTED. SO THAT NUMBER IS AN UNDERESTIMATE. IN NEW YORK CITY THE POLICE SAW AND 80 FOLD INCREASE IN 2020 COMPARED TO THE PRIOR YEAR AGAINST ASIAN AMERICANS. NEXT. THE INTERSECTIONALITY OF OCCUPYING MULTIPLE MARGINALIZED SOCIAL POSITIONS HAS DEEP IMPLICATIONS ON HEALTH EQUITY. THROUGH IMMIGRANT POLICIES THAT ARE OFTEN UNIQUELY RACIALIZED AGAINST NON-WHITE IMMIGRANT COMMUNITIES, RACIST POLICIES CAN BE REINFORCED AND USED AS A MEANS TO RESTRICT AND MARGINALIZE. WE NEED TO MOVE AWAY FROM THIS ASSESSMENT OF IMMIGRANT HEALTH FROM NUMBER OF YEARS IN THE COUNTRY, LOOKING AT LIMITED ENGLISH PROFICIENCY, BUT ALSO TO THINK THROUGH HOW DO WE APPLY A STRUCTURAL RACIST LENS TO IMMIGRANT DISPARITIES AND TO UNDERSTAND HOW IMMIGRANT DISPARITIES OCCUR. THINK THROUGH THE MULTIPLE PATHWAYS THAT MIGHT BE DONE, WHETHER THROUGH FORMAL CHANNELS, IMMIGRATION POLICY AND CITIZENSHIP STATUS THAT CURTAILS ACCESS TO RESOURCES AND POLITICAL PARTICIPATION OF IMMIGRANT COMMUNITIES OF COLOR TO THE MORE INFORMAL RACIALIZATION, THROUGH DISPROPORTIONATE IMMIGRANT ENFORCEMENT OF COMMUNITIES OF COLOR FROM IMMIGRANT POPULATIONS AND THINK THROUGH THE INTERSECTIONS OF ECONOMIC EXPLOITATION. FOR EXAMPLE, MANY RECENT IMMIGRANTS COME FROM, ARE WORKING IN MANY LOW-PAYING POSITIONS ARE OFTEN IN FRONTLINE POSITIONS AND HAVE MORE ISSUES WITH RESPECT TO NOT HAVING HEALTH INSURANCE ACCESS, NOT BEING ABLE TO HAVE ACCESS TO SICK LEAVE. A NUMBER OF CHALLENGES WITH RESPECT TO ECONOMIC EXPLOITATION, YET THEY ARE ALSO LIVING IN NEIGHBORHOODS THAT MAY BE HISTORICALLY DISINVESTED, SO WHETHER SHELTER IN PLACE POLICIES ARE ALSO VERY CHALLENGING. NEXT. I WANT TO SWITCH GEARS TO HOW THE MODEL MINORITY HAS PLAYED OUT IN HEALTH AND RESEARCH. IN 1985, SECRETARY OF HEALTH MARGARET HECKLER ISSUED THIS GROUNDBREAKING REPORT ON MINORITY HEALTH AND THE REPORT WAS SIGNIFICANT IN ITS IMPACT IN ADVANCING AWARENESS AND ATTENTION TO MINORITY HEALTH. AND SO IT WAS A REPORT THAT HELPED IN MANY WAYS TO IMPROVE THE HEALTH OF COMMUNITIES OF COLOR. IT ALSO, UNFORTUNATELY, CONTAIN CONTAINED LIMITED INFORMATION ON ASIAN AMERICANS AND REPORTED IN THE AGGREGATE, THE DATA ON ASIANS WERE THAT WERE WERE HEALTHIER THAN ALL OTHER GROUPS. THAT DIRECTLY ALIGNED TO THE MODEL MINORITY STEREOTYPE AND PERCEIVED SOCIETAL BIASES AND CONTINUED TO SHAPE THE NARRATIVE AND DISCUSSION ON ASIAN AMERICAN HEALTH AND HEALTH DISPARITIES TO THIS DAY. NEXT. WE HAVE SEEN THIS PLAY OUT IN THE PRESENTATION OF DATA IN A NUMBER OF PEER-REVIEWED JOURNALS. MANY CONDITIONS AND HEALTH ISSUES, THIS IS JUST ONE EXAMPLE OF WHERE WE KNOW FROM OUR OWN WORK IN HELPING TO FACILITATE LINKAGES TO THE HEALTH EXCHANGE THAT WAS BROUGHT UPON BY THE AFFORDABLE CARE ACT, THAT THERE WAS SIGNIFICANT AMOUNT OF DATA ON ASIAN AMERICANS THAT COULD HAVE BEEN INCLUDED IN THIS ANALYSIS, HOWEVER, THE AUTHORS CHOSE NOT TO PRESENT THE DATA AND THEIR RESPONSE WAS IT WAS IN LINE WITH MUCH OF THE LITERATURE ON HEALTH DISPARITIES. THIS IS NOT AN UNCOMMON EXAMPLE. MANY AUTHORS CHOOSE NOT TO PRESENT DATA WHEN IT IS AVAILABLE. IN SOME WAYS HEALTH SYSTEMS MAY CONTINUE TO SYSTEMATICALLY PERPETUATE STEREOTYPES. CLEARLY WITH THAT DATA PRESENTED THE VISUAL IS THERE ARE NO HEALTH DISPARITIES. A COMMUNITY WITHOUT HEALTH DISPARITIES IS A COMMUNITY NOT IN NEED OF RESOURCES OR ATTENTION. THIS EXTENDS TO WHAT WE SEE IN COVID. DURING THE SPRING AND SUMMER THE DATA PRESENTED BY THE CDC SHARED THE NARRATIVE ON COVID. THE COVID-19 HIGHLIGHTS THE DEEP STRUCTURAL INEK WITYS FOR RACIAL -- INEQUITIES AND DEVASTATING ON LATINX AND BLACK COMMUNITIES. IT WAS CLEAR THERE WAS EVIDENCE OF DISPROPORTIONATE BURDEN ON ASIAN AMERICANS. STRUCTURAL CHALLENGES AND BIASES CONTINUE TO LEAVE OUT ASIAN AMERICANS WHEN THE DATA IS AVAILABLE. THIS FIRST FIGURE WAS RELEASED IN MID SEPTEMBER 2020. BLACK AND HISPANIC AND ASIAN PATIENTS REMAINED AT HIGHER RISK OF HOSPITALIZATION AND DEATH. THAT DID NOT RECEIVE MUCH PRESS. IT WAS COUNTER TO TREND STEREOTYPES OF A MODEL MINORITY. IT RAN COUNTER TO A AMERICA THAT WAS ALREADY ESTABLISHED IN APRIL OF 2020, FOCUSING ATTENTION TO OTHER MINORITY COMMUNITIES. MY COLLEAGUES, DR. NADIA ISLAM AND STELLA YE HAVE FOUND SIMILAR FINDINGS IN DATA WITH NEW YORK CITY WORKING WITH THE NEW YORK CITY HEALTHAND HOSPITALS. IT IS THE CITY'S LARGEST SAFETY NET PROVIDER AND THE COUNTRY'S LARGEST MUNICIPAL HEALTH CARE PROVIDER. THEY SERVE OVER 1 MILLION NEW YORK CITY RESIDENTS. WORKING WITH COLLEAGUES AT HEALTH + HOSPITALS THEY WERE ABLE TO IMPROVE DATA QUALITY AND CLASSIFICATION OF ASIAN AMERICAN COMMUNITIES. WITH THAT, WE WERE ABLE TO IDENTIFY 10,000 ASIAN PATIENTS IN THEIR DATABASE. THAT ALLOWED US TO DISAGGREGATE FOR SOUTH ASIANS AND THE CHINESE COMMUNITY. WE ALSO FOUND HIGHER INFECTION AND HOSPITALIZATION RATES AMONG SOUTH ASIANS, SECOND ONLY TO HISPANICS AND SECOND TO BLACKS FOR HOSPITALIZATION. WE FOUND THAT CHINESE PATIENTS HAD THE HIGHEST MORTALITY RATE COMPARED TO ALL OTHER GROUPS, YET DESPITE THE FINDINGS FROM CDC AND DATA FROM CALIFORNIA AND NEW YORK CITY, NEXT, PLEASE, ASIAN AMERICANS HAVE LARGELY BEEN INVISIBLE DURING THE PANDEMIC IN RESEARCH. NEXT. AND WE'VE ALSO BEEN INVISIBLE DURING THE PANDEMIC IN THE MEDIA. NEXT, PLEASE. AND THIS ALSO CAME UP WITH RESPECT TO RESEARCH FUNDING AND VACCINE ALLOCATION POLICIES. THE RADX-UP PROGRAM IS GREAT, FOCUSING ON DIFFERENT COMMUNITIES OF COLOR. IT HAS, UNFORTUNATELY, PAID ATTENTION TO ASIAN AMERICAN COMMUNITIES, EVEN IN THEIR FIRST AND IN THEIR SECOND PRESS RELEASE, ASIAN AMERICANS WERE NOT INCLUDED AS A COMMUNITY, SOME OF THE COMMUNITIES THAT WERE BEING TARGETED BY THE RAD-X-UP INITIATIVE. WE WERE ABLE TO IDENTIFY SOME OF THE STUDIES THAT INCLUDED ASIAN AMERICANS BUT NOT SHOWING DIVERSITY AND NONE OF SOUTH ASIANS WHO WE KNOW HAD A HIGH DISPROPORTIONATE BURDEN OF COVID-19 AS WELL AS RISK FACTORS SUCH AS DIABETES AND HYPERTENSION THAT WOULD PUT THEM AT GREATER RISK FOR COVID-19-RELATED OUTCOMES. IN ADDITION, THE NASEM REPORT WITH RESPECT TO VACCINE ALLOCATION TO VULNERABLE POPULATIONS LEFT OUT ASIAN AMERICANS AS WELL AS NATIVE HAWAIIANS AND PACIFIC ISLANDERS. WORKING WITH OUR COLLEAGUES AND COMMUNITY PARTNERS ACROSS THE COUNTRY, WE PRESENTED DATA THAT WE HAD FROM VARIOUS SOURCES AROUND COVID-19 AND ITS IMPACT ON OUR COMMUNITIES AND IN THE FINAL REPORT WE WERE GLAD TO SEE THEY INCLUDED NATIVE HAWAIIAN AND PACIFIC ISLANDER AMONG THOSE COMMUNITIES THAT NEED TO BE FOCUSED ON WITH RESPECT TO VACCINE ALLOCATION. UNFORTUNATELY, ASIAN AMERICANS WERE LEFT OUT OF THAT. A REFERENCE OF OTHER COMMUNITIES WERE NOTED INSTEAD. NEXT, PLEASE. THESE EXAMPLES ARE A REFLECTION OF A LONG HISTORY OF STEREOTYPE AND BIASES THAT OFTEN WORK AGAINST ASIAN AMERICANS. AND WE KNOW THAT THE END RESULT IS THAT FUNDING FOR HEALTH-RELATED RESEARCH, FOR PROGRAMS AND INTERVENTIONS FOR ASIAN AMERICANS IS SPARSE. WE ALSO KNOW THAT FEDERAL INITIATIVES THAT PRIORITIZE DATA DISAGGREGATION AND ADVANCING HEALTH DISPARITIES RESEARCH OVERALL IS LIMITED FOR ASIAN AMERICANS AS WELL AS NATIVE HAWAIIANS AND PACIFIC ISLANDERS. .17% OF THE NIH BUDGET WAS ALLOCATED TO BOTH OF THESE POPULATIONS. THIS RESULTS IN A SEVERE LACK OF ASIAN AMERICAN DATA IN THE SEARCH. IT IMPEDES HEALTH PLANNING AT THE DEVELOPMENT OF EVIDENCE-BASED STRATEGIES AND PRACTICES. AS I MENTIONED EARLIER, WITHOUT DATA AND RESEARCH, ASIAN AMERICANS HISTORICALLY DON'T RECEIVE ACCESS TO FEDERAL PROGRAMS, RESOURCESES. ASIAN AMERICANS ARE NEARLY 15% OF THE CITY'S POPULATION IN NEW YORK CITY YET RECEIVED 1.4% OF THE CITY'S SOCIAL SERVICE CONTRACTS. THUS, THE IMPACT OF THE LACK OF DATA, EQUITY AND RESEARCH FUNDING IS THAT ASIAN AMERICANS ARE INVISIBLE IN MANY WAYS AND SYSTEMATICALLY EXCLUDED IN HEALTH DISPARITIES DISCUSSIONS. WHAT ARE THE WAYS TO ADDRESS THAT IN TERMS OF THINKING ABOUT HOW TO IMPROVE RESEARCH, HOW TO IMPROVE EVIDENCE WITH RESPECT TO TARGETING AND SUBORDINATING ASIAN AMERICANS. NEXT, PLEASE. OUR CENTER HAS HELPED IN MANY WAYS TO ADDRESS SOME OF THE GAPS, BUT WE KNOW THAT WE ARE NOT ALONE. AND WE ARE WORKING IN CONCERT WITH A NUMBER OF COMMUNITY PARTNERS, NATIONALLY, TO THINK THROUGH HOW DO WE HELP TO CHANGE AND EFFECT POLICY TO REALLY SUPPORT MORE CENTERS ACROSS THE COUNTRY TO REACH AND ENGAGE THE DIVERSITY OF ASIAN AMERICAN SUBGROUPS. SO LET ME TALK A LITTLE BIT ABOUT THE WORK OUR CENTER, THE NYU CENTER FOR THE STUDY OF ASIAN AMERICAN HEALTH WHICH, I WILL FONDLY REFER TO AS CSAAH. SOME OF THE WORK WE HAVE BEEN DOING FOR THE LAST 19 YEARS. NEXT, PLEASE. I CO-LEAD THE NYU CENTER OF STUDY OF ASIAN AMERICAN HEALTH WITH DR. SIMONEA KWON. THIS CENTER WAS ESTABLISHED IN 2003 THROUGH A CENTER OF EXCELLENCE AWARD AT THE TIME IT WAS THE NATIONAL CENTER FOR MINORITY HEALTH AND HEALTH DISPARITIES. WE ARE GOING INTO OUR 19th YEAR AS A CENTER OF EXCELLENCE. IN 2007 WE TRANSITIONED OUR WORK FROM BEING FOCUSED IN NEW YORK CITY TO BEING A NATIONAL CENTER, GIVEN THE GREAT NEED TO BUILD COLLABORATION AND SOLIDARITY AMONG ASIAN AMERICAN RESEARCHERS AND COMMUNITY PARTNERS. AT ITS HEIGHT, THERE WERE PROBABLY 76 CENTERS THAT WERE SUPPORTED THROUGH NIMHD. AND NOW CURRENTLY THERE ARE ABOUT, I WOULD SAY, I THINK 12 CENTERS THAT ARE FUNDED. WE STILL REMAIN THE ONLY CENTER FOCUSED ON THE HEALTH AND HEALTH DISPARITIES OF ASIAN AMERICAN COMMUNITIES. NEXT, PLEASE. WE HAVE DEVELOPED AN INTEGRATED FRAMEWORK TO GUIDE OUR WORK AND WE OPERATE AT MULTIPLE LEVELS OF INFLUENCE, RELYING ON THIS WONDERFUL FRAMEWORK THAT NIHT DEVELOPED IN TERMS OF LOOKING AT HEALTH DISPARITIES. WE PLAY SPECIAL ATTENTION TO THE TEXTURE THAT LEAD TO HEALTH INEQUITIES. WE WORK TO APPLY MULTISECTOR APPROACHED TO OUR COALITION BUILDING, WORKING WITH COMMUNITY PARTNERS USING A COMMUNITY BASED PARTICIPANT APPROACH TO STRENGTHENING LEADERSHIP AND BUILD VERY STRONG COMMUNITY LINKAGES. WE ARE HUGE ADVOCATES OF THE COMMUNITY HEALTH WORKER MODEL. NOT ONLY WITH RESPECT TO HEALTH INTERVENTI INTERVENTIONS, BUT PART OF THE HEALTH CARE TEAM AND VITAL STRATEGY OF SOCIAL DETERMINANTS OF HEALTH AND A STRONG COMMITMENT OF BUILDING THE PIPELINE IN THE NEXT GENERATION OF HEALTH CARE PROVIDERS AND RESEARCHERS. NEXT, PLEASE. SO THIS BUSY SLIDE HERE ILLUSTRATES OUR GROWTH OVER TIME. INITIALLY WE BEGAN IN 2003 WITH A FOCUS ON THREE SCIENTIFIC TRACKS, CANCER, CARDIOVASCULAR DISEASE AND DIABETES AND MENTAL HEALTH. AND WE HAVE DEEPENED OUR RESEARCH PORTFOLIO FOR THESE TRACKS THROUGH NIH AND CDC FUNDING. IN 2017, WITH OUR CURRENT RENEWAL, WE ESTABLISHED TWO NEW TRACKS. ONE ON HEALTHY AGING AND ALZHEIMER'S DISEASE AND SECOND ON GENDER EQUITY. JUST TO ILLUSTRATE THE SIGNIFICANCE OF HAVING A CENTER OF EXCELLENCE AWARD, WHEN WE ESTABLISHED THE HEALTHY AGING AND ALZHEIMER'S DISEASE TRACK, WE WERE ABLE TO MOBILIZE ACADEMIC AND COMMUNITY PARTNERS TO SECURE THREE NIA ALDS ALZHEIMER'S DISEASE SUPPLEMENTS TO OUR GRANT IN THREE CONSECUTIVE YEARS AND AS A CONSEQUENCE WE WERE ABLE TO SOLIDIFY COLLABORATION WITH GERIATRIC MEDICINE AND ALZHEIMER'S AT OUR SUBSTITUTION AND NATIONAL PARTNERS LIKE THE AARP AND CITY DEPARTMENT FOR AGING. AS A RESULT OF THOSE EFFORTS, WE THEN RECEIVED, ELISEO MENTIONED, AN NIAR24 GRANT TO STRENGTHEN COMMUNITY ENGAGEMENT AND RECRUITMENT OF OLDER ADULT POPULATIONS UNDERREPRESENTED IN THE SEARCH. ACADEMIC AWARD TO BUILD A RESEARCH PROGRAM ON ALZHEIMER'S AND AGES HEALTH DISPARITIES. WE ARE ONE OF THREE CDC FOCUSED ON ALZHEIMER'S DISEASE DISPARITIES. ALZHEIMER'S DISEASE HAS BECOME A GROWING AND TREMENDOUS DISPARITY FOR ASIAN AMERICAN COMMUNITIES. TO UTILIZE THE CENTER OF EXCELLENCE TO GROW THE RESEARCH WHERE THERE HAS BEEN LACK OF RESEARCH HAS BEEN INSTRUMENTAL. NEXT, PLEASE. THIS FIGURE HERE DEPICTS OR TRAJECTORY OF WHAT THE CENTER OF EXCELLENCE INFRASTRUCTURE HAS ENABLED US TO DO. SINCE OUR INCEPTION IN 2003 AND EACH CONSECUTIVE CYCLE WE HAVE INCREASED GRANT AWARTDS. THESE RESOURCES HAVE BOLSTERED EACH OF OUR SCIENTIFIC TRACKS. WHAT IS NOT REFLECTED IS THE INSTITUTIONAL AWARTDS TO -- AWARTDS TO NYU. THESE INCLUDE THE NCATS, NCI CANCER CENTER, NCI CANCER SUPPORT GRANT AND NIHS VIMPLTAL CENTERS AND AGING AND ALZHEIMER'S INFRASTRUCTURE GRANT, THE CDC PREVENTION RESEARCH CENTER AND RESEARCH NETWORK CENTER. A BOLD CENTER OF EXCELLENCE ON ALZHEIMER'S DISEASE PREVENTION AND JUST RECENTLY AN NIH COMMUNITY ENGAGEMENT IN COVID-19 DISPARITIES, A SEAL AWARD. NEXT, PLEASE. I'M GOING TO SHARE A LITTLE OF MY CENTER'S CURRENT CYCLE, IN TERMS OF SOME OF THE RESEARCH WE ARE DOING NOW. NEXT. WE HARMONIZE TWO RESEARCH PROJECTS FUNDED THROUGH THE NIMHD CENTER OF EXCELLENCE AWARD BUILDING OFF THE NIHC FRAMEWORK. BOTH HAVE A CDPR APPROACH, A PARTICIPATORY APPROACH AND MULTISYSTEM PARTNERSHIPS. WE HAVE REAIM AND THE CONSOLIDATED FRAMEWORK FOR IMPLEMENTATION OF RESEARCH TO HELP PROVIDE A PRACTICAL GUIDE TO SYSTEMATICALLY ASSESS BARRIERS AND FACILITATORS AND HELP SUPPORT RESEARCH TRANSLATION, SCALEABILITY ACROSS DIFFERENT STUDIES AND SUBGROUPS. WE ALSO ARE WORKING IN BOTH PROJECTS TO HARNESS COMMUNITY ASSETS BY FOSTERING COMMUNITY LINKAGES. I WILL TALK ABOUT THAT IN A LITTLE BIT. NAMELY, WE ARE CAPITALIZING ON THE IMPORTANT ROLE OF COMMUNITY HEALTH WORKERS AND THE OPPORTUNITY OF EHR, ELECTRONIC HEALTH RECORD BASED INITIATIVES TO SEE THROUGH SUSTAINABLE INTERVENTION STRATEGIES. FINALLY, BOTH RESEARCH PROJEBLCTS ARE COMMITTED TO POLICY AND PRACTICE CHANGE. ONE RESEARCH PROJECT IS LED BY NADIA ISLAM. IT FOCUSES ON DIABETES MANAGEMENT. IT IS TESTING A COMMUNITY CLINICAL LINKAGE MODEL WORKING WITH SMALL PRIMARY CARE PRACTICES. IN NEW YORK CITY SMALL PRIMARY CARE PRACTICES ARE THE PRIMARY PROVIDER OF CARE FOR MINORITY AND IMMIGRANT POPULATIONS. THEY ALSO PROVIDE 40% OF PRIMARY CARE IN THE CITY. OFTENTIMES THESE SMALL PRIMARY CARE PRACTICES, IN THE CASE OF THE SOUTH ASIAN POPULATION, ARE TRUSTED IN THEIR COMMUNITIES. THEY HAVE BICULTURAL, BILINGUAL STAFF. THE PATIENT POPULATIONS HAVE HIGH CHRONIC CO-MORBID HEALTH DISPARITIES. THEY ARE LIMITED TO STAFFING SUPPORT AS WELL AS ACCESS TO EHR-BASED SUPPORT TO HELP IMPROVE PROARE VIDER ADHERENCE TO RECOMMENDED GUIDELINES. -- PROVIDERED ADHERENCE TO RECOMMENDED GUIDELINES. WE ARE STILL IN OUR STUDY SO THE FINDINGS ARE NOT RELEASED YET. WE HAVE MADE GREAT PROGRESS IN ACTIVITIES. I WILL BRIEFLY OUTLINE SOME OF THE ACTIVITIES WE HAVE DONE TO ENGAGE COMMUNITY PARTICIPANTS AND COMMUNITY MEMBERS IN A NUMBER OF EVENTS AS WELL AS OUR IMPACT IN OUR REACH. WE HAVE ALSO BEEN ABLE TO SECURE EIGHT ADDITIONAL GRANTS TO HELP LEVERAGE WHAT WE DO AND REALLY THINK ABOUT SCALEABILITY OF THOSE EFFORTS TO OTHER COMMUNITIES AND TO OTHER SETTINGS. NEXT. I JUST WANT TO TOUCH IN LIGHT OF THE LAST 15 MONTHS WE HAD TO PIVOT REALLY QUICKLY TO DO OUR INTERVENTION, TO DO OUR RESEARCH IN THE CONTEXT OF COVID-19. AND SO WE'VE PIVOTED QUICKLY TO DEVELOP OUR HEALTH EDUCATION SESSIONS AND DATA COLLECTION, WHICH WERE INITIALLY IN PERSON, TO REMOTE. TRAINING OUR COMMUNITY HEALTH WORKERS AND HELPING THEM TO SUPPORT THAT, TO BE ABLE TO DO THAT VIRTUAL SETUP AND BE ABLE TO SUPPORT THEIR PARTICIPANTS SUCCESSFULLY. I DID MENTION EARLIER, COMMUNITY HEALTH WORKERS, WE TEND TO HIRE FROM THE COMMUNITY. AND WE TEND TO HIRE INDIVIDUALS BASED ON THEIR LONG HISTORY OF COMMUNITY ORGANIZING OR THEIR WORK IN THEIR COMMUNITIES AND LESS ON HAVING A HIGHER EDUCATION DEGREE. SO THERE WAS SOME EFFORT TO SUPPORT DIGITAL LITERACY, TO TRAIN COMMUNITY HEALTH WORKERS TO WORK IN ZOOM SHL, IN WEBEX, AND DO INTERVENTION SESSIONS WITH HIGH FIDELITY. WE HAD TO PIVOT IN TERMS OF MOVING AWAY, AS I MENTIONED, FROM IN-PERSON ONE-ON-ONE SESSIONS OF PHYSICAL ACTIVITY TO DIGITAL VIDEOS THAT SUPPLEMENTED SOME OF THE CURRICULUM CONTENT. SOME OF OUR EXERCISE DEMONSTRATIONS, OUR COOKING DEMONSTRATIONS, TALKING ABOUT RECOMMENDED GUIDELINES FOR DIABETES MANAGEMENT WERE ALL PIVOTED QUICKLY TO DOING MORE VIDEO, MORE VIDEO ACCESS, BEING ABLE TO SUPPORT THAT ACCESS THROUGH YOUTUBE SO PARTICIPANTS COULD REALLY SIMPLIFY THEIR ABILITY TO ENGAGE AND PARTICIPATE IN THE STUDY. NEXT. AND SO THE OTHER STUDY IS FOCUSED ON STOMACH CANCER PREVENTION AMONG CHINESE AMERICANS THAT IS ALSO A RANDOMIZED CONTROL TRIAL TO TEST TO ASSESS THE EFFICACY ADOPTED AT IMPACT OF AN INTEGRATED COMMUNITY HEALTH WORKER AND EHR-BASED INTERVENTION STRATEGY TO IMPROVE ADHERENCE TO TREATMENT FOR COMMUNITIES AT RISK FOR STOMACH CANCER DISPARITIES, PARTICULARLY FOR CHINESE AMERICAN COMMUNITIES, WHERE THERE WAS A HIGH PERCENTAGE OF INDIVIDUALS WITH HIGH RATES OF LIMITED ENGLISH PROFICIENCY. WE WORKED WITH THE HEALTH + HOSPITALS CORPORATION AND WITH THE FAMILY HEALTH CENTERS, WHICH IS A FEDERALLY QUALIFIED HEALTH NETWORK THAT SERVES A DIVERSE POPULATION, INCLUDING A DIVERSE, HIGH PROPORTION OF LIMITED ENGLISH PROFICIENT CHINESE AMERICAN PATIENTS. AND THROUGH THAT EFFORT, WE WERE ABLE TO CREATE EHR-BASED TOOLS TO HELP BUSY PHYSICIANS AT THE HEALTH + HOSPITALS CORPSE AND THE FAMILY HEALTH CENTERS INTEGRATED INTO THE EHR, INTO THE EPIC SYSTEM, WHICH IS ACTUALLY A SYSTEM THAT MANY HEALTH CARE PROVIDERS ARE USING ACROSS THE COUNTRY, SO THERE ARE OPPORTUNITIES TO THINK ABOUT REPLICATION AND SCALEABILITY OF THAT WORK. IN OTHER SETTINGS FOR OTHER COMMUNITIES. AND WE DEVELOPED PATIENT EDUCATION MATERIALS IN ENGLISH, CHINESE AND SPANISH. SO THAT IT IS VERY EASY FOR PROVIDERS TO LINK UP AND HAVE ACCESS TO THOSE MATERIALS. CURRENTLY THE STUDY IS FOCUSED ON THE CHINESE AMERICAN POPULATION, BUT WE HOPE EVENTUALLY WE WILL BE ABLE TO TEST THIS MODEL FOR SPANISH SPEAKING POPULATIONS AT HIGH RISK FOR STOMACH CANCER DISPARITIES. ONE OF THE MOST SIGNIFICANT THINGS ABOUT THIS PROJECT IS INTEGRATION INTO THE LARGEST HEALTH CARE SYSTEM IN THE U.S. AND TO SUPPORT PROVIDERS TO BE ABLE TO DO MORE TARGETED AND TAILORED INTERVENTION STRATEGIES AND ALSO SUPPORT PATIENTS BY MAKING THEM INTO COMMUNITY HEALTH WORKERS TO FOLLOW UP WITH APPROPRIATE EDUCATION, TO SUPPORT ADHERENCE AND TO SUPPORT HEALTHY LIFESTYLES CHANGE TO FURTHER REDUCE STOMACH CANCER DISPARITIES. WE HAVE MADE GREAT PROGRESS IN ACTIVITIES AND IMPACT. WE HAVE LEVERAGED THAT WORK TO SECURE ADDITIONAL GRANT FUNDING TO DO MORE OF WHAT WE ARE DOING WITH RESPECT TO CHW AND EHR-BASED INTERVENTION STRATEGIES. NEXT. WE'VE ALSO HAD TO TRANSITION OUR WORK AND TRANSITIONED IT VERY SUCCESSFULLY TO BE ABLE TO DELIVER OUR INTERVENTION IN THE CONTEXT OF COVID. THIS HAS REALLY -- THOSE EFFORTS IN TERMS OF ADAPTING OUR RESEARCH AND OUR ABILITY TO PIVOT QUICKLY WITH RESPECT TO PROVIDING DIGITAL LITERACY TRAININGS TO COMMUNITY PARTICIPANTS AND WORKING WITH OUR COMMUNITY ORGANIZATIONS HELPED TO SET THE STAGE FOR US TO ENGAGE COMMUNITY MEMBERS AND COMMUNITY PARTNERS AROUND COVID-19 VACCINATION. NEXT, PLEASE. IN TERMS OF ONE OF OUR AIMS, WE HAVE A STRONG FOCUS ON SUPPORTING THE NEXT GENERATION OF HEALTH DISPARITIES RESEARCHERS. SO WE HAVE THIS TERRIFIC INVESTIGATOR DEVELOPMENT CORE THAT IS CO-LED BY DR. LORNA THORPE AND THADDAEUS TARPEY. WE HAVE A HEALTH DISPARITIES RESEARCH TRAINING PROGRAM DEVELOPED IN 2003 IN OUR FIRST CYCLE AND IN ITS CURRENT CYCLE, WE HAVE WORKED WITH 82 TRAINEES THROUGH THE HEALTH DISPARITIES RESEARCH TRAINING PROGRAM AND 411 SINCE OUR INCEPTION. IN TERMS OF OUR PILOT PROJECT PROGRAM, WE PROVIDE PILOT PROJECT AWARDS TO EARLY STAGE INVESTIGATORS, PRIMARILY JUNIOR FACULTY AND POST DOCTORAL FELLOWS WHO HAVE NOT RECEIVED THEIR FIRST INVESTIGATOR INITIATED AWARD, THEIR FIRST R1. SO WE WORK WITH THEM WITH RESPECT TO DEVELOPING PILOT PROJECTS, TO SECURING PRELIMINARY DATA THAT IS NEEDED FOR EFFECTIVE APPLICATIONS FOR A K AWARD, A CAREER DEVELOPMENT AWARD AS WELL AS FOR INDEPENDENT INVESTIGATOR AWARDS, THE R-LEVEL GRANTS. IN TERMS OF THE IMPACT, OUR, YOU KNOW, THIS IS BASED ON JUST THREE COHORTS OF PILOT PROJECT GRANTEES. WE HAVE BEEN ABLE TO SECURE FIVE K AWARDS, FOUR R AWARTDS AND 2U54 SUPPLEMENTS TO EXTEND THE WORK THEY ARE DOING WITH FOUNDATION OR INTERNAL FUNDING TO FURTHER EXTEND PILOT PROJECT RESEARCH. THEY HAVE BEEN VERY ACTIVE WITH RESPECT TO PUBLISHING. ONE OF THE THINGS WE DO IS PROVIDE INTENSE WORKSHOPS SUPPORTING THEM IN TERMS OF WRITING AND DEVELOPMENT. OUR AWARDEES HAVE PUBLISHED OVER 130 PUBLICATION TS. -- PUBLICATIONS. THE LAST FEW COHORTS HAVE HAD 16 PUBLICATIONS DIRECTLY RELATED TO THEIR PILOT PROJECTS. NEXT. IN TERMS OF COMMUNITY ENGAGEMENT AND DISSEMINATION, THIS IS AN AREA I'M VERY PROUD OF. WE PARTNER WITH THE ASIAN PACIFIC ISLANDER MEMPB HEALTH FORUM. THEY ARE THE OLDEST AND LARGEST POLICY AND ADVOCACY ORGANIZATION SERVING ASIAN AMERICAN AND NATIVE HAWAIIAN AND PACIFIC ISLANDER COMMUNITIES. THEY WORK WITH LOCAL COALITIONS ACROSS THE COUNTRY AND ACROSS THE PACIFIC BASIN. THEY HAVE BEEN A KEY PARTNER ON A NUMBER OF INITIATIVES SINCE 2007 AND HAVE BEEN A CRITICAL PART OF WHAT WE HAVE BEEN DOING IN THIS CURRENT CYCLE WITH RESPECT TO DATA DISSEMINATION AND WITH RESPECT TO POLICY. WE ALSO -- OUR COMMUNITY ENGAGEMENT DISSEMINATION CORE FACILITATES OUR NATIONAL ADVISORY COMMITTEE AND SCIENTIFIC COMMITTEE WHICH IS COMPRISED OF MEMBERS FROM COMMUNITY ORGANIZATIONS AS WELL AS ACADEMIC INSTITUTIONS AND FOUNDATIONS FROM ACROSS THE COUNTRY. AND THEY ALSO REPRESENT, NOT ONLY THE ASIAN AMERICAN POPULATION, BUT THEY ALSO REPRESENT COMMUNITIES REFLECTED IN THE NATIVE HAWAIIAN AND PACIFIC ISLANDERS COMMUNITY. WE ARE RECOGNIZING, AS I MENTIONED EARLIER, FOR ASIAN AMERICANS OVERALL AND OTHER ASIAN ETHNIC MINORITY COMMUNITIES WE OFTEN NEED TO WORK TOGETHER TO INFORM POLICY CHANGE AND TO REALLY THINK THROUGH WHAT ARE THE BEST STRATEGIES TO SUPPORT HEALTH EQUITY. NEXT, PLEASE. SO WORKING IN CONCERT WITH OUR NATIONAL ADVISORY COMMITTEE, OUR SCIENTIFIC COMMITTEE AND THE ASIAN PACIFIC ISLANDER AMERICAN HEALTH FORUM, WE ARE CONDUCTING HEALTH FORUMS AND NEEDS ASSESSMENTS. CSAAH HAS DONE NEEDS ASSESSMENT IN EVERY CYCLE TO INFORM STRATEGIC PRIORITIES, TO MAKE SURE WHAT WE DO IS RELEVANT TO COMMUNITY NEEDS AND PRIORITIES. AND WE ADDRESS ANY EMERGING ISSUES IN THE NEXT CYCLE OF LENTING. IN THIS CURRENT CYCLE, IN PARTNERSHIP WITH OUR NATIONAL ADVISORY AND SCIENTIFIC COMMUNITY WE HAVE BEEN ABLE TO THINK THROUGH WHAT ARE THE WAYS WE CAN DO ASSESSMENTS. WE ARE WORKING WITH COMMUNITY ORGANIZATIONS, IN ATLANTA, GEORGIA, PHOENIX, ARIZONA, AND SALT LAKE CITY, UTAH. AND WE'LL BE ABLE TO TAKE THAT DATA AND COMPARE IT TO DATA WE HAD IN NEW YORK CITY. AND THROUGH THIS INTENSIVE PROCESS WE HAVE BEEN ABLE TO WORK WITH OUR COMMUNITY CO -- COALITIONS IN NEW YORK CITY TO DEVELOP A SUITE OF TRAININGS TO STRENGTHEN COMMUNITY CAPACITY TO CONDUCT COMMUNITY-BASED DATA COLLECTION AND TO CREATE A DATA SHARING AND EQUITY AGREEMENT THAT FEELS GOOD TO ALL OUR PARTNERS. THEY ARE INVESTED IN OWNING THIS DATA, TOO, AND BEING ABLE TO DISSEMINATE THAT DATA IN WAYS THAT HAVE PRACTICAL BENEFIT TO THEIR COMMUNITIES. NEXT, PLEASE. WE ARE ACTIVELY ENGAGING IN A MULTIPRONGED EFFORT TO DISSEMINATE WORK FROM CONFERENCES, SOCIAL MEDIA, DIGITAL STORIES, YOUTUBE AND ALSO WORKING ON OUR SECOND TEKBOOK ON ASIAN AMERICAN COMMUNITIES IN HEALTH, WHICH WILL BE PUBLISHED HOPEFULLY BY THE END OF THIS YEAR, IF NOT, EARLY NEXT YEAR. NEXT, PLEASE. AND SO BUILDING ON OUR WORK WITH THE ASIAN PACIFIC ID LANDER AMERICAN HEALTH FORUM AND FUNDS THROUGH THE NATIONAL LIBRARY OF MEDICINE, WE ARE DEVELOPING A SEARCHABLE CURATED WEBSITE, RESEARCH TOOLS, RESOURCES AND DATA LINKING TO EXTERNAL AND CSAAH DEVELOPED CONTENT FOR ASIAN AMERICANS AND NATIVE HAWAIIAN AND PACIFIC ISLANDER COMMUNITIES. WE HAVE ALSO LEARNED THAT COMMUNITIES WANT INFORMATION AND DATA THAT HAS PRACTICAL BENEFIT TO THEIR COMMUNITIES AND ORGANIZATIONS. THEY WANT INFORMATION THAT IS TANGIBLE. INFORMATION THAT WOULD INFORM WHAT THEY NEED TO DO TO SERVE THEIR COMMUNITIES BETTER. THEY DON'T WANT IT NECESSARILY IN JOURNAL PEER REVIEW PUBLICATIONS, POLICY BRIEFS, GRAPHICS THAT ARE EASY TO UNDERSTAND THAT CAN SUPPORT ACTUAL WORK AND THEY ALSO WANT INFORMATION THAT IS ACCESSIBLE IN MULTIPLE LANGUAGES AND MULTIPLE FORMATS AS WELL AS INFORMATION IMMEDIATELY ACCESSED AND PUBLICLY AVAILABLE. AND SO LED MY MY COLLEAGUE STELLA YE, THE HEALTH ATLAS SHOWCASES HEALTH RELATED PREVALENCE ESTIMATES TO VISUALIZE EXISTS DATA AND DATA GAPS FOR ASIAN AMERICAN AND NATIVE HAWAIIAN AND PACIFIC ISLANDER COMMUNITIES. THE HEALTH ATLAS FOCUSES ON ASIAN AMERICAN SUBGROUPS AND NATIVE HAWAIIAN AND PACIFIC ISLANDER POPULATIONS. IT UTILIZED FIVE STATE LEVEL DATA SETS THAT CAPTURE HEALTH BEHAVIOR, LIFESTYLE BEHAVIORS AND RISK FACTORS. I JUST WANT TO UNDERSCORE WHILE THIS IS A HELPFUL TOOL IN TERMS OF PROVIDING A SENSE OF DISEASE PREVALENCE AND RISK OF PROTECTIVE FACTORS, WE STILL NEED LONGITUDINAL DATA TO REALLY UNDERSTAND RISK AND PROTECTIVE FACTORS AND THEIR RELATIONSHIP. TO UNDERSTAND CAUSAL FACTORS IN THE IMPACT OF SOCIAL DETERMINANTS AND ACROSS ASIAN AMERICAN COMMUNITIES AND HAWAIIAN AND PACIFIC ISLANDER GROUPS. WE HAVE PARTNERED WITH THE CITY HEALTH DASH BOARD WHICH IS LED BY OUR COLLEAGUES DR. MARK RAVIC AND TRKTS HRKT ORK R. THE CITY HEALTH DASH BOARD DISPLAYED 35 DIFFERENT HEALTH INTD OKAYTORS IN 750 OF THE LARGEST CITIES IN THE U.S. I WANT TO TALK ABOUT HOW THIS CITY HEALTH DASH BOARD WAS CREATED. MARK AND LORNA WORKED CLOSELY WITH LOCAL MUNICIPALITIES, MAYORS AND OTHER PUBLIC FACILITIES WHAT DATA WOULD BE INFORMATIVE. THEY WERE ABLE TO CREATE THE CITY HEALTH DASH BOARD THAT COULD BE UTILIZED ACROSS THE 750 CITIES. IN COLLABORATION WITH THEM AND THROUGH ONE OF THE PILOT PROJECT AWARDS THAT WE WERE ABLE TO PROVIDE, WE WERE ABLE TO ADD ASIAN AND LATINX SUBGROUPS TO THE DASHBOARD TO SUPPORT VISUALIZATION OF THOSE DIFFERENT SUBGROUPS ACROSS THOSE 750 CITIES. THESE ARE SAMPLE MAPS FOR HOUSTON AND HAWAII. I URGE YOU TO CHECK OUT THE CITY HEALTH DASHBOARD, IF YOU HAVEN'T ALREADY. NEXT, PLEASE. IN AN EFFORT TO ADDRESS THE DATA DEFICITS THAT WERE RECOGNIZED AT THE NATIONAL LEVEL, SINCE JUNE OF 2020, ONE OF THE ACTIVITIES WE HAVE BEEN ENGAGED IN WITH ASIAN PACIFIC ISLANDER HEALTH FORUM IS CDC FUNDED FORGING PARTNERSHIPS, THIS IS COMMUNITY HEALTH FORUM AND SIX COMMUNITY COALITIONS. NEXT, PLEASE. ONE, OUR PROJECT IS DRIVEN BY THIS SET OF COORDINATED ACTIVITIES AROUND DATA AND THE NEED FOR DATA TO UNDERSTAND THE IMPACT OF COVID-19 ON ASIAN AMERICANS, NATIVE HAWAIIAN AND PACIFIC ISLANDER COMMUNITIES. IT BEGINS WITH DIRECT COMMUNITY INPUT WE RECEIVED FROM OUR COMMUNITY PARTNERS ACROSS THE COUNTRY, FROM COMMUNITY HEALTH WORKERS AND COMMUNITY MEMBERS THEMSELVES. NEXT. THIS INPUT IS ANCHORS BY EIGHT COMMUNITY-BASED PRIMARY DATA COLLECTION THAT USES THE SAME QUESTIONS ACROSS DIFFERENT SURVEYS. NEXT. IT ALSO UTILIZES SECONDARY DATA ANALYSES FROM SIX LOCAL STATE AND NATIONAL DATA RESOURCES AS WELL AS COORDINATION WITH 15 DATA COLLECTION AND COLLABORATIVE EFFORTS. THESE ACTIVITIES EQUATE TO 360 ORGANIZATIONS AND 65 INDIVIDUALS ACROSS THE COUNTRY WORKING TOGETHER. NEXT. WE'VE ALSO ACTIVELY TRACKED ALL OF THE PUBLISHED SICIENTIFIC LITERATURE, NEWS ON COVID-19 ON ASIAN AMERICAN AND NATIVE HAWAIIAN AND PACIFIC ISLANDER COMMUNITIES WHICH IS BEING SHARED WITH THE CDC AND NIH AND OTHER COMMUNITY PARTNER ORGANIZATIONS. NEXT. THROUGH MULTIPLE RESOURCES WE HAVE BEEN ABLE TO PIECE TOGETHER INFORMATION ABOUT HOW DIFFERENT ASIAN SUBGROUPS ARE EXPERIENCING THE COVID-19 PANDEMIC. AND HAVE COMPILED THEM INTO A SUCCINCT RESOURCE WE CAN SHARE. THIS RESOURCE HELPS TO APPRECIATE THAT DESPITE SOME OF THE COMMONALITIES ACROSS ASIAN SUBGROUPS IN THEIR EXPERIENCE OF THIS PANDEMIC, FOR EXAMPLE, NEXT, FOR EXAMPLE FACING CHALLENGES DUE TO LIMITED ENGLISH PROFICIENCY, FEARS AROUND PUBLIC CHARGE, IT ALSO HIGHLIGHTS DIFFERENCES ACROSS SUBGROUPS. NEXT. BEING ABLE TO CAPTURE DATA DISAGGREGATED FOR THE FIVE LARGEst SUBGROUPS. WE NEED TO DO MORE WITH RESPECT TO UNDERSTANDING THE SMALLER EMERGING COMMUNITIES ACROSS THE COUNTRY AND EXAMINE REGIONAL DIFFERENCES FOR THOSE COMMUNITIES. NEXT, PLEASE. SO OUR WORK AT CSAAH, WHICH RESPECT TO COVID HAS EVOLVED QUICKLY AND SPANS, COMMUNITY, DATA, CLINICAL AND POLICY ARENAS. NEXT. AS I MENTIONED EARLIER, WE HAVE PIVOTED REALLY QUICKLY TO DEVELOPING COMMUNITY FACING IN-LANGUAGE CONTENT IN RESPONSE TO OUR PARTNERS' NEEDS. THE PANDEMIC, NEW YORK CITY WAS AT THE HEIGHT OF THE PANDEMIC IN MARCH AND APRIL AND MAY. IT WAS A VERY STRESSFUL TIME FOR THE CITY, BUT ALSO STRESSFUL FOR LIMITED ENGLISH PROFICIENT COMMUNITIES AND LOW-INCOME IMMIGRANT COMMUNITIES WHERE SHELTERING IN PLACE WAS CHALLENGING ON A NUMBER OF LEVELS. MANY OF THEM WERE WORKING IN LOW-WAGE, FRONTLINE POSITIONS, HAD VERY LIMITED OPTIONS AND OFTEN COMMUTED IN PUBLIC TRANSPORTATION AND AS I MENTIONED BEFORE, THERE WERE FEARS RELATED TO XENOPHOBIA AND STIGMA AROUND COVID-19 IN ASIAN AMERICAN COMMUNITIES. AND SO DURING THAT TIME AT THE HEIGHT OF THE PANDEMIC, WE HAD TO REALLY PIVOT QUICKLY TO WORKING WITH OUR COMMUNITY PARTNERS TO DEVELOPING COMMUNITY FACING IN-LANGUAGE MATERIALS IN THE FORM OF BROCHURES AND PAMPHLETS AND PALM CARDS. AND ALSO IN WEBINARS AND YOUTUBE SESSIONS. AND INFOGRAPHICS DO BE ABLE TO SHARE INFORMATION ABOUT COVID-19, ABOUT COMMUNICATION AND REALLY WE DO SEE THAT RISK. VERY RECENTLY AROUND COVID-19 VACCINE. CSAAH HAS ALSO BEEN VERY ACTIVE IN RAISING AWARENESS, PROVIDING TESTIMONY ON THE ASIAN AMERICAN EXPERIENCE WITH THE PANDEMIC. WE HAVE SPOKEN AT THE WHITE HOUSE COVID-19 HEALTH EQUITY TASK FORCE, WITH THE CITY AND STATE HEALTH DEPARTMENTS, TO A NUMBER OF STATE AND FEDERAL GOVERNMENT OFFICIALS, HAVE PROVIDED TESTIMONY WHICH HAVE BEEN INCLUDED IN REPORTS THAT HAVE BEEN PRESENTED TO CONGRESS AROUND THE IMPACT OF COVID-19 ON ASIAN AMERICAN COMMUNITIES. NEXT. AND I JUST WANT TO TOUCH ON THE ROLE OF THE COMMUNITY HEALTH WORKER DURING THIS TIME. WE ARE LONG ADVOCATES OF THIS MODEL. GIVEN THEIR VITAL ROLE IN BRIDGING ACCESS TO CARE AND IMPARTING CULTURALLY AND LINGUISTICALLY RELEVANT INFORMATION TO IMPROVE SCREENING AND TREATMENT ADHERENCE. THEY ARE ALSO A POWERFUL IN THEIR ABILITY TO ADDRESS SOCIAL DETERMINANTS OF HEALTH, WHICH WAS MADE EVEN MORE EVIDENT DURING COVID AS THEY SUPPORTED NAVIGATION TO HEALTH CARE RESOURCESES, HEALTH INSURANCE ACCESS FOR NEWLY UNEMPLOYED INDIVIDUAL, FINANCIAL ASSISTANCE, FOOD ACCESS, MEDICATION DELIVERIES AND NEW INFORMATION ON COVID AND AVAILABLE VACCINES. NEXT. DESPITE HIGH LIMITED ENGLISH PROFICIENCY BARRIERS AND THE STIGMA ATTACHED TO THE CORONAVIRUS PARTICULARLY FOR ASIAN AMERICANS, CSAAH HAS WORKED SUCCESSFULLY TO ENGAGE ASIAN AMERICAN COMMUNITIES AROUND COVID, VACCINE ACCESS, HELPING TO NAVIGATE, PARTICULARLY FOR COMMUNITIES WHERE LOW DIGITAL LITERACY OR JUST MUCH MORE CHALLENGING TO BE ABLE TO SCHEDULE APPOINTMENTS. WE HAVE BEEN ABLE TO FACILITATE THAT ACCESS. TIMES RECENTLY IN EARLY MAY HIGHLIGHTED THIS PHENOMENON IN NEW YORK CITY THE FACT ASIAN AMERICANS WERE THE MOST VACCINATED GROUP IN NEW YORK CITY. THIS IS NOT THE CASE ACROSS THE COUNTRY IN MANY AREAS, AND EVEN WITHIN NEW YORK CITY NEIGHBORHOODS. WE ARE STILL ADDRESSING POCKETS WHERE THERE ARE HIGH CONCERNS AROUND VACCINE HESITANCY. WE DO KNOW WORKING WITH OUR TRUSTED COMMUNITY PARTNERS AND COMMUNITY HEALTH WORKERS, IT GOES A LONG WAY IN TERMS OF ADDRESSING VACCINE HESITANCY AND CONCERNS AS WELL AS A LONG WAY FOR FACILITATING ACCESS TO VACCINES. NEXT. WE ARE FORTUNATE TO LEAD ONE OF 21 REGIONAL CEAL AWARTDS IN PARTNERSHIP WITH MOUNT SINAI AND INSTITUTE FOR FAMILY HEALTH AS WELL AS COLLEAGUES AT COLUMBIA UNIVERSITY AND EINSTEIN ACADEMIC CENTERS THAT HAVE TRADITIONALLY SERVED MINORITY COMMUNITIES AND HAVE A NETWORK OF COMMUNITY PARTNERS WHO ARE BOOTS ON THE GROUND AND WHO CAN REALLY ENGAGE HARD TO REACH, UNDERSERVED COMMUNITIES. AROUND VACCINE HESITANCY AND ALSO TO BE ABLE TO UNDERSTAND SOME OF THOSE ISSUES. THE CEAL AWARD HAS BEEN A CATALYST FOR OUR COMMUNITY PARTNERS. WE HAVE WORKED WITH THEM TO COORDINATE EFFORTS WITH RESPECT TO COMMUNICATION AND DECEMBER SE DRN DISSEMINATION. WHERE THERE IS A LACK OF TRLS, THAT IS IN-LANGUAGE, WE ARE WORKING TO DEVELOP THOSE MATERIALS WITH OUR PARTNERS AND DELIVER THE EDUCATION AND INFORMATION THROUGH OUR COMMUNITY HEALTH WORKERS OR COMMUNITY NAVIGATORS BASED AT OUR COMMUNITY ORGANIZATION. WE'VE ALSO BEEN ABLE TO WORK WITH OUR COMMUNITY-BASED ORGANIZATIONS TO OPTIMIZE THEIR CAPACITY AND LEADERSHIP. WE HAVE BEEN ABLE TO SECURE ADDITIONAL FUNDING FROM THE CDC FOUNDATION AS WELL AS ADDITIONAL SUPPLEMENTS IN OTHER COLLABORATIONS ARE RAD X-UP, TO EXTEND THAT IMPACT AND PROVIDE THE RESOURCES COMMUNITIES NEED AROUND UNDERSTANDING IMPACT OF COVID-19 AND REALLY DISPELLING MEDICAL MISTRUST. AND DISPELLING SOME OF THE MYTHS AROUND THE VACCINE. NEXT. AND I JUST WANT TO HIGHLIGHT, WE HAVE HAD MEASURABLE IMPACT IN TERMS OF PUBLICATIONS, TRAININGS AND GRANTS. TRADITIONAL METRICS THAT WE WOULD UTILIZE IN OUR GRANT RENEWAL, BUT THERE IS THIS IMMEASURABLE AND QUALITATIVE IMPACT FOR CENTERS OF EXCELLENCE IN ADVANCIE ININE INING RACIAL EQUITY. WHEN WE RESPONDED TO THE RFA TO DEVELOP A COMPREHENSIVE CENTER, HEALTH DISPARITY COMMUNITIES ELIGIBLE INCLUDED AFRICAN-AMERICAN, LATINO, AMERICAN INDIANS. ASIAN AMERICANS WERE NOT INCLUDED. WE HAD TO MAKE THE CASE THAT WE WERE A MEDICALLY UNDERSERVED COMMUNITIES AND THE VARIOUS DISPARITIES EXPERIENCED BY OUR COMMUNITIES IN NEW YORK CITY. IMMEDIATELY AFTER RECEIVELING -- RECEIVING THE AWARD THAT FORMED CSAAH, ASIAN AMERICANS WERE RECOGNIZED. IT THIS IS A MILESTONE, BUT STILL AN UPHILL BATTLE WITH RESPECT TO HIGHLIGHTING SIGNIFICANCE OF FOCUSING OR SUPPORTING RESEARCH ON ASIAN AMERICANS GIVEN THE STEREOTYPES I MENTIONED OF MODEL MINORITY OR THE PERPETUAL FOREIGNER. DESPITE THAT, THE CENTER OF EXCELLENCE INFRASTRUCTURE HAS BEEN REALLY A CRITICAL AWARD IN TERMS OF MOBILIZING PARTNERS, MULTISECTOR PARTNERS, COMMUNITY ORGANIZATIONS TO WORK WITH US LOCALLY AND NATIONALLY. HAS ALSO BEEN ABLE TO SUPPORT A DEEP COMMUNITY ENGAGEMENT THAT HAS BECOME A CENTRALIZED PLATFORM FOR EMERGING ISSUES. WE WERE ABLE TO RESPOND QUICKLY TO THE COVID-19 PANDEMIC TO ADDRESS THE TIME SENSITIVE RESEARCH AND PUBLIC ISSUES THAT OUR COMMUNITIES WERE IMMEDIATELY CONFRONTED OVERNIGHT. BECAUSE WE HAD ALREADY DEVELOPED THAT TRUST AND RAPPORT WITH MANY COMMUNITY ORGANIZATIONS. UTILIZING PARTICIPATORY APPROACHES AND ENGAGING THEM IN CONVERSATI CONVERSATIONS. ANOTHER ASPECT IS WE ARE NOW A NATIONAL RESOURCE FOR DATA DISSEMINATION AND POLICY. NEXT, PLEASE. THROUGH THE CENTER OF EXCELLENCE WE CAN AT VANCE DIALOGUE WITH POLICY MAKERS AND COMMUNITY STAKEHOLDERS WITH DATA DISAGGREGATION AND INCLUSION. NEXT. WE'VE BEEN ABLE TO BE INVOLVED IN A NUMBER OF INITIATIVE AND PRESENT THOSE FINDINGS TO VARIOUS AUDIENCES, INCLUDING POLICY MAKERS AND ONE OF THE MAJOR FINDINGS FROM A NEEDS ASSESSMENT ILLUSTRATED THE HIGH BURDEN OF MENTAL HEALTH AMONG ASIAN AMERICAN AND NATIVE HAWAIIAN AND PACIFIC ISLANDER COMMUNITIES AS A RESULT OF COVID-19 PANDEMIC. AS A CONSEQUENCE, REPRESENTATIVE JUDY CHU ARE INTRODUCED THE STOP MENTAL HEALTH STIGMA IN OUR COMMUNITIES ACT RECENTLY ON MAY 28. NEXT, PLEASE. IT IS ALSO HAS BEEN A PLATFORM TO HELP IMPROVE DISAGGREGATED DATA. WE ARE PARTNERS WITH THE HEALTH FORUM TO DO THIS NAMLY AND WITHIN OUR OWN INSTITUTION, CHANGING BEST PRACTICES WITH OUR COLLEAGUES AT THE NEW YORK CITY HEALTH + HOSPITALS CORPORATION AND OUR RECOMMENDATIONS HAVE BEEN INCLUDED IN A REPORT TO CONGRESS PREPARED BY THE CONGRESSIONAL TRICAUCUS AND THE NATIONAL URBAN LEAGUE. NEXT. IT HAS ALLOWED US TO PIVOT AND TO BE ABLE TO, AFTER MANY YEARS OF ADVOCACY FOR DISAGGREGATED DATA COLLECTION TO BE ABLE TO RECEIVE FUNDING TO SUPPORT DISAGGREGATED DATA COLLECTION FOR ASIAN AMERICANS AND NOW JUST RECENTLY EXPANDING THAT TO BLACK AND LATINX GROUPS IN NEW YORK STATE. NEXT, PLEASE. THE CENTER OF EXCELLENCE AWARD HAS HELPED TO ADVANCE COMMUNITY-DRIVEN PRIORITIES AND STRENGTHEN POLICY. THESE ARE JUST SOME OF THE EXAMPLES FROM UNDERSTANDING AND SUPPORTING AND ADVANCING THE COMMUNITY HEALTH WORKER MODEL TO ADDRESS LIVER CANCER AND POLICY SYSTEMS AND ENVIRONMENTAL LEVEL CHANGES TO DOING COMMUNITY-DRIVEN RESEARCH AROUND ENVIRONMENTAL HEALTH HARMS THAT ARE MADE UNINTENTIONALLY BY CITY EFFO EFFORTS. FOR EXAMPLE, ERECTING A DETENTION CENTER IN THE MIDDLE OF CHINA TOWN AND ADDRESSING THE COVID-19 IMPACT. NEXT, PLEASE. I WILL TOUCH QUICKLY ON RECOMMENDATIONS TO ADVANCE HEALTH EQUITY. NEXT. FIRST AND FOREMOST, WE NEED TO CONTINUE TO CHALLENGE PERSISTENT STEREOTYPES THAT UNDERGIRD AND REINFORCE STRUCTURAL RACISM. WE NEED TO PUSH BACK AGAINST THOSE STEREOTYPES AND TO, NORTD TO ALLOW AND SUPPORT MORE REPRESENTATION, MORE ENGAGEMENT OF ASIAN AMERICANS, SUPPORT RESEARCH FUNDING ON ASIAN AMERICAN HEALTH DISPARITIES AND THE HEALTH AND LOOK K AT DATA DISAGGREGATED. NEXT. ANOTHER AREA THAT WE WANT TO -- THAT I WANT TO RECOMMEND IN TERMS OF ADVANCING HEALTH EQUITY, DECENTER WHITENESS, FROM BEING THE EVIDENCE BASE. WHEN WE ARE WORKING WITH COMMUNITIES WITH SUBSTANTIAL HEALTH DISPARITIES AND MOST OF THEM ARE IMPACTED BY SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH, IT DOESN'T MAKE SENSE TO CENTER THE EVIDENCE OR CENTER THE GOLD STANDARD ON A POPULATION THAT IS NOT REFLECTED IN THOSE COMMUNITIES. WHEN WE UTILIZE EVIDENCE-BASED PROGRAMS FROM STUDIES THAT ARE PREDOMINANTLY HAVE A WHITE POPULATION IN THEIR STUDY POPULATI POPULATION, IT DOESN'T TRANSLATE WELL WITHOUT SIGNIFICANT MODIFICATIONS. WE NEED TO THINK ABOUT CENTERING THE DEVELOPMENT OF EFFECTIVE STRATEGIES ON RACIAL AND ETHNIC MINORITY POPULATIONS AND ON THOSE COMMUNITIES EXPERIENCING THOSE DISPARITIES. WE NEED TO NORMAL CULTURES THAT IMPACT SOCIAL NORMS AND VALUES AND RELABEL WHAT IS A CHALLENGE OR DEFICIT, A CULTURAL STIGMA OR PASIVE TRAIT AND MOVE AWAY FROM NEGATIVE FRAMING. NEXT. WE NEED TO RETHINK HOW WE ARE PROVIDING HEALTH CARE. PARTICULARLY WHEN WE ARE THINKING ABOUT IMPROVING HEALTH AND WE DO SEE HEALTH DISPARITIES AMONG MINORITY IMMIGRANT POPULATIONS. WE NEED TO THINK ABOUT THE INCLUSION OF OTHERS WHO MAY BE ABLE TO ENGAGE AND REALLY ADDRESS SOME OF THE OTHER FACTORS THAT IMPACT HEALTH PROMOTION, IMPACT TREATMENT ADHERENCE AND DISEASES PREVENTION. THAT WOULD WORKING, INTEGRATING COMMUNITY HEALTH WORKERS AS PART OF THE HEALTH CARE TEAM, PARTICULARLY IN SITUATIONS WHERE WE ARE WORKING IN LOW-INCOME AREAS. WE NEED TO INCORPORATE SOCIAL WORKERS GIVEN THAT MANY OF THE COMMUNITIES WE KNOW EXPERIENCING PHYSICAL HEALTH DISPARITIES ARE EXPERIENCING HIGH LEVEL OF MENTAL HEALTH NEEDS AND ALSO STRESS. AND WE ALSO NEED TO THINK ABOUT HOW DO WE BUILD HUMAN AND SOCIAL CAPITAL BY HIRING FROM WITHIN THE COMMUNITIES THEMSELVES. NEXT. NUTRITION IS A GREAT EXAMPLE OF HOW WE CENTER PREVENTION AND INTERVENTION BASED ON THE COMMUNITIES WE WANT TO TARGET OR SERVE. EMPOWERING COMMUNITIES TO ATTAIN THEIR CULTURAL AND SOCIAL IDENTITY, CENTERING NUTRITION AND FOOD CHOICE IN WAYS THAT ARE MEANINGFUL AND POTENTIALLY MUCH MORE SUSTAINABLE. NEXT. WE ALSO WANT TO CHALLENGE THE NOTION OF WHAT IS GOOD DATA. I THINK OF THE POWER OF THICK DATA. OF THINKING ABOUT MIXED METHOD APPROACHES, OF UNDERSTANDING HOW WE UTILIZE QUALITATIVE DATA. THE QUALITATIVE DATA STILL REMAINS THE GOLD STANDARD AND WE STILL NEED GOOD KWAN TATIVE AND EP DEEM -- EPIDEMIOLOGY DATA. WE NEED TO UNDERSTAND THE SOCIAL CULTURAL CONTEXT. THICK DATA AND DATA THAT IS SHARED THROUGH STORY TELLING PROVIDE POWERFUL WAY TO INCORPORATE AND INTEGRATE COMMUNITY VOICES WHEN WE ARE DOING RESEARCH. NEXT, PLEASE. WE ALSO WANT TO IMPROVE DISAGGREGATED DATA COLLECTION FOR ALL RACIAL AND ETHNIC GROUP TS. THIS IS MY SUMMARY OF RECOMMENDATIONS. I REALIZE I'M RUNNING SOON OUT OF TIME. UNDERSTAND AND APE DRESS STRUCTURAL RACISM, DISPEL MYTHS AND STEREOTYPES REGARDING POP LAGTSS, TO SUPPORT LONGITUDINAL COHORT STUDY TS FOR CANCER, DIE BYTES AND CARDIOVASCULAR DISEASE AS WELL AS ALZHEIMER'S DISEASE AND TO CONTINUE TO UTILIZE GENUINE COMMUNITY AND PATIENT ENGAGEMENT STRATEGIES. FINALLY, WHICH I DIDN'T GET A CHANCE TO TOUCH ON, WE NEED TOP INCREASE THE DISPARITY OF HEALTH CARE WORKERS. NEXT. THANK YOU. >> THANK YOU SO MUCH, CHAU. WE HAVE JUST A FEW MINUTES FOR QUESTIONS AS YOU WENT OVER VERY COMPREHENSIVE REVIEW OF THE FIELD. I JUST WANT TO ASK YOU, ONE, THAT WE COULD FOLLOW UP AT SOME POTENTIAL POINT. THE ISSUE OF THE MODEL MINORITY IS CLEAR, IT IS WRONG. I THINK IT IS A MYTH. I APPRECIATE YOUR TRACING THE HISTORY OF IT, ANTI-BLACKNESS. I THINK THAT WILL HELP US GET A BETTER HANDLE ON IT. THOSE PREVIOUS NOT FAMILIAR WITH IT. IN REALITY, THE POOR PEOPLE AND PEOPLE WHO ARE DISADVANTAGED EXIST IN ALL POPULATIONS, RIGHT? WHITE AMERICANS HAVE THE LARGEST NUMBER, NOT PROPORTION, BUT NUMBER OF POOR PEOPLE IN THE COUNTRY. AND I THINK THE ROOTING OF THE POPULATION STATISTICS, SO IF YOU LOOK AT NATIONAL STATISTICS FOR ASIAN AMERICANS GRANTED WITH THE HETEROGENEITY, I'M LEAVING NATIVE HAWAIIANS ASIDE. THEY DON'T HAVE GOOD TRACKING DATA. ASIANS DO BETTER THAN OTHERS. LIKE LATINOS, FREQUENTLY WE HAVE THE LONGEST LIFE EXPECTANCY OF THE THREE GROUPS MEASURED. WE CALL THAT THE PARADOX AND PEOPLE ARE STILL GRAPPLING WITH WHY THAT IS. SOME PEOPLE THINK THAT IS GOING TO GO AWAY WITH TIME, OF ACCULTURATION, 70% OF LATINOS IN THIS COUNTRY BORN IN THIS COUNTRY AND ASIANS ARE EVENTUALLY GOING TO BE THERE MAYBE. BUT THEY ARE AT ANOTHER STAGE. I THINK IT WOULD PROBABLY BE GOOD TO ROOT IT IN THAT CONTEXT AS WELL. LET ME TURN TO GINA. DO YOU HAVE QUESTIONS FOR ME? FOR CHAU, I'M SORRY, TO ANSWER. >> YES. IT IS IN THE CHAT BOX. >> CAN YOU READ THAT, PLEASE. I CAN'T FIND IT. >> SURE. THIS QUESTION IS, I WAS WONDERING WHAT ADVICE YOU HAVE FOR A POST BAC LOOKING TO GET MORE INVOLVED IN RESEARCH IN ASIAN AMERICAN POPULATIONS. >> THERE'S A NUMBER OF RESEARCHERS YOU CAN REACH OUT TO. YOU SHOULD REACH OUT TO OUR CENTER. THERE ARE A NUMBER OF OPPORTUNITIES. I DON'T EVEN KNOW WHERE TO BEGIN. PLEASE FEEL FREE TO REACH OUT TO ME IN TERMS OF SOME OF THE RESEARCH. ARE YOU A POSTBAC WITH NIMHD. >> YES. >> I WOULD SUGGEST YOU REACH OUT TO MYSELF OR ALSO THERE ARE A NUMBER OF GRANTEES WORKING WITHIN WHO ARE DOING WORK AROUND ASIAN AMERICAN HEALTH. DEPENDING ON YOUR INTEREST WE CAN CONNECT YOU. >> WHAT ARE THE MISSING OPPORTUNITIES IN ADDRESSING ASIAN AMERICAN AND NATIVE HAWAIIAN DURING THE COVID-19 PANDEMIC? >> THE MISSING OPPORTUNITIES? THAT IS A GOOD QUESTION. WE RECENTLY, MY COLLEAGUES STELLA YE AND OTHERS RECENTLY RELEASED THIS REPORT, I'M SORRY, PUBLISHED A HEALTH AFFAIRS BLOG OF WHAT WE DO KNOW AND DON'T KNOW. WE KNOW A LITTLE MORE OF THE LARGER ASIAN SUBGROUPS, BUT THERE IS A LOT WE DON'T KNOW IN SMALLER EMERGING GROUPS. WE WANT TO DO MORE TARGETED WORK, DATA COLLECTION AND WORKING WITH OUR COMMUNITY ORGANIZATIONS ON UNDERSTANDING THAT. WE RECOGNIZE THE REGIONAL DIFFERENCES, TOO. SO EVEN THOUGH THERE ARE HIGHER VAK -- VACCINATION RATES IN NEW YORK CITY, BUT IN RURAL AREAS WITH EMERGING ASIAN AMERICAN COMMUNITIES THE VACCINATION RATES ARE LOW, FROM OUR UNDERSTANDING. THINKING THROUGH HOW BEST TO ENGAGE THOSE INDIVIDUALS. WE KNOW THERE'S ISSUES RELATED TO FEARS AROUND PUBLIC CHARGE, IMMIGRANT STATUS, AROUND TAKING TIME OFF. THIS INFORMATION ABOUT THE VACCINE MAKES IT VERY DIFFICULT. AND SO ONE OF THE THINGS I WOULD AGAIN URGE MORE DISAGGREGATED DATA COLLECTION AND REACHING OUT TO THE SMALLER EMERGING POPULATIONS. FOR EXAMPLE, THE BHUTANESE COMMUNITY. AND WITHIN THE SOUTH ASIAN COMMUNITY, THE BANGLADESHEE COMMUNITY, HAVE HIGHER BARRIERS WITH RESPECT TO ACCESS IN MANY WAYS. UNDERSTANDING THOSE BARRIERS AND FACILITATORS. >> THANK YOU. LET ME ASK YOU A MORE SORT OF COMPLICATED SENSITIVE QUESTION. AT THE BEGINNING YOU MENTIONED THE BMI23 OR ISSUE OF SCREENING FOR DIABETES OR THINKING ABOUT DIABETES RISK, I GUESS IS THE CONTEXT. WHICH IN THE PAST, PARTICULARLY IN DIFFERENT SETTINGS, OUR -- ONE OF OUR COUNCIL MEMBERS PRESENTED ON THIS ON ONE OF HER TALKS. HAS BEEN A MAJOR EFFORT TO MAKE PEOPLE AWARE OF IT. AS YOU MAY BE AWARE, THERE'S BEEN IN THE PAST YEAR, PROBABLY, TREMENDOUS PUSHBACK ON CREATING ANY KIND OF RACE-BASED CLINICAL MEASURES. MOST NOTABLY THE ESTIMATED GFR FOR KIDNEY FUNCTION THAT HAD BEEN IN MOST LABORATORIES HAD ADJUSTED IT AND SAID FOR AFRICAN-AMERICANS THIS IS FOR NON-BLACKS, IS THIS FOR BLACKS? IS THAT OTHERS INCLUDING PULMONARY FUNCTION TESTS OR BONE DENSITY MEASURES HAVE BEEN ADOPTED IN CLINICAL PRACTICE. WHAT IS THE PERSPECTIVE OF ASIAN AMERICAN RESEARCHERS NOW ON THAT ISSUE WITH THE BMI 23? >> I THINK WE WOULD RECK MEANT THAT WE USE LOWER BMI CUTOFFS GIVEN THERE ARE IS HIGH DIABETES RISK AT LOWER LEVELS. I MENTIONED EARLIER, MANY ASIAN AMERICANS THEMSELVES BELIEVE THEY ARE ALSO A MODEL MINORITY. THEY, YOU KNOW, BECAUSE THEY MIGHT NOT FIT CERTAIN BMI GUIDELINES THEY ARE NOT AT RISK. SO ENSURING THAT WE CAN IDENTIFY THOSE INDIVIDUALS EARLIER ON SO THEY DON'T GET TO THE POINT WHERE THEY HAVE DIABETES OR UNCONTROLLED DIABETES, IS REALLY KEY. I WOULD THINK FOR OUR GROUP OF RESEARCHERS THAT WE WOULD RECOMMEND UTILIZING THE LOWER BMI CUTOFFS TO REALLY MAKE SURE WE GET AT THOSE INDIVIDUALS. IN THE FILIPINO AND SOUTH ASIAN COMMUNITIES, THEY HAVE HIGH RATES OF DIABETES AND ALSO HYPERTENSION AND OFTEN CO-OCCURRING. WE ARE IDENTIFYING INDIVIDUALS EARLY ON TO REDUCE COMPLICATIONS ASSOCIATED WITH THAT. >> ALL RIGHT. I DON'T DISAGREE WITH THAT AT ALL. I'M JUST SAYING THERE IS THIS SORT OF LINE OF THINKING THIS INHERENTLY IS RACIST. AND COMING AT IT FROM THAT PERSPECTIVE, WHICH I HAVEN'T GOTTEN MY FULL HEAD AROUND THAT WHOLE DISCUSSION. BUT IT CLEARLY IS A VERY ACTIVE ONE IN THE CLINICAL CONTEXT AND PERHAPS THAT'S MORE ON THE BASIS OF WHAT HAD BEEN ADJUSTED FOR BLACKS COMPARED TO WHITES. SO BE ON THE LOOK OUT FOR THAT. I THINK IT IS SOMETHING THAT WILL BE GOOD FOR EVERYONE TO WEIGH IN ON. I'M GOING TO CLOSE OUR DIRECTORS' SEMINAR NOW. I WANT TO EXPRESS MY APPRECIATION FOR CHAU FOR A VERY COMPREHENSIVE AND THOROUGH REVIEW OF A NUMBER OF ISSUES RELATED NOT JUST ASIAN AMERICAN HEALTH AND ALSO YOUR EXTENSIVE WORK IN THIS SPACE ACROSS THE DIFFERENT GROUPS. AND I REALLY APPRECIATED EARLY ON AS YOU PRESENTED THE HETEROGENEITY OF THE POPULATION IN THE CATEGORIES YOU DID. I THINK THAT IS A STEP IN THE RIGHT DIRECTION OF HOW WE THINK ABOUT THIS GROUP. THANK YOU AGAIN VERY MUCH. I HOPE EVERYONE ENJOYS THE REST OF THEIR AFTERNOON. >> THANK YOU.