May is Asian Pacific American Heritage Month. The month celebrates Asians and Pacific Islanders in the United States. A rather broad term, Asian/Pacific encompasses all of the Asian continent and the Pacific islands.
According to the NSGC’s 2021 Professional Status Survey, almost 9% of survey participants identified as Asian American or Pacific Islander (AAPI). These individuals have made priceless contributions to our profession from its inception. This blog series is dedicated to our AAPI colleagues who empower me every day and instill hope in me that the promise of the genome will reach all Americans. I want to especially acknowledge genetic counselors Nadine Channaoui, Caiqian Copper, Sylvia Mann, Vivian Ota Wang and Vivian Pan who have shared the tumultuous journey to equity and justice with me over the years.
This blog series is a tribute to my dear friend and mentor, Dr. Jane Lin-Fu, an ethnic Chinese woman, who pioneered health equity in genetic care.
This is Part 1 of a 3 part series, please stay tuned for Parts 2 and 3 in the coming weeks.
Setting the Stage
The past five-years have seen a troubling rise in bigotry and prejudice in the U.S. Expressions of intolerance have become emboldened leading to hate crimes against select groups ranging from burning black churches to mass shootings in synagogues, and individual acts of hostility and violence.
The COVID-19 pandemic lead to the singling out of Asian Americans around the U.S., as responsible for the pandemic’s spread. In the U.S., an elderly Thai immigrant died after being pushed to the ground. A Filipino-American was slashed in the face with a box cutter. A Chinese woman was slapped and then set on fire. The culmination of these acts was the Atlanta area targeting of massage parlors where six Asian women were among those killed in the shooting sprees. These are just examples of recent violent attacks on Asian Americans, part of a surge in abuse since the start of the pandemic over a year ago. There have been thousands of reported cases of hate crimes against Asian Americans in recent months in the U.S. alone, a trend seen in other countries as well. The medical field shows no exception. According to a 2017 survey targeting 800 physicians in the U.S., 69% of Asian American doctors said they endured biased remarks and personally offensive comments from patients.
Asian Americans and Pacific Islanders (AAPI), who have diverse cultures, religions, languages, and geographical origins, have been typically lumped into one group, and often viewed as a “model minority,” ignoring a vast socioeconomic heterogeneity with a myth of a community pulling itself up by the bootstraps to uniformly become high achieving.
In reality, Asian Americans, who have immigrated to the U.S. or sought refuge to escape persecution since the mid-1800s have been the target of discrimination and exclusion, which include federal prohibitions from entering the U.S. and partaking in its workforce.
AAPIs, the fastest growing minority group in the U.S., play a key role in the country’s history from the laying of the Pacific Railroad, to pioneering several technological advances we enjoy today including web portals, email services, and high capacity storage devices. In medicine, an Asian American woman, Dr. Katherine Luzuriaga, championed treating HIV infection in children, and Dr. Jane Lin-Fu, an ethnic Chinese physician, put a devastating and preventable public health crisis on the national agenda. Dr. Lin-Fu also started laying the infrastructure for the implementation of the largest medical research undertaking ever, the Human Genome Project.
In her role as the Director of the Genetic Disease Branch within the Maternal and Child Health Bureau of the Health Resources and Services Administration (HRSA), Dr. Lin-Fu set a special priority area for federal funding to reduce the “ethnocultural barriers to genetic services among underserved communities in the U.S.” That priority funding was administered through Special Projects for Regional and National Significance program (SPRANS).
Working at San Francisco General Hospital in the Northern California Comprehensive Sickle Cell Center, I served Southeast Asian refugees and Latin American immigrants who experienced formidable barriers to accessing genetic care. It was a grant from Dr. Lin-Fu’s branch that allowed us the hire of two bi-cultural, bi-lingual genetic aides to provide culturally and linguistically appropriate genetic care in San Francisco’s refugee center, and community clinics in China Town and the Mission District.
I met Dr. Lin-Fu for the first time, at a grantees’ event in California. Dr. Lin-Fu, was warm, supportive and very eager to learn everything about our program at San Francisco General Hospital. We felt comfortable with one another instantly. Me, a recent immigrant from the Middle East, and a Jewish woman believed to belong to a “model minority” myself, and Dr. Lin-Fu, an immigrant herself, admittedly still struggling to acculturate in a government bureaucracy dominated by white males. After we met in person, we talked on the phone once a week. I will never forget these passionate conversations about genomic medicine and the need to assure that its promise is realized by all communities. A few years after I first met Dr. Lin-Fu, I moved to Baltimore with my family, as my husband started his residency at Johns Hopkins. I kept in touch with Dr. Lin-Fu, and even visited her a few times. It was Dr. Lin-Fu in fact, that told me about the W.K. Kellogg Foundation’s pre-doctoral fellowship in public health. She was insistent that a doctoral degree in health policy was what I needed to be even a more powerful advocate for equity in the genome. It was Dr. Lin-Fu’s encouragement and support that led me to apply to graduate school at age 45, and persevere through five grueling years of doctoral studies at Johns Hopkins Bloomberg School of Public Health. After my graduation, and Dr. Lin-Fu’s retirement we slowly lost touch.