AHA SmartMarket and the Institute Interview Ram Raju, M.D.

May 8, 2015

May marks Asian Pacific American Heritage Month -  a celebration of the culture, traditions, and history of Asian Americans and Pacific Islanders in the United States.  According to the most recent U.S. Census, the Asian population grew faster than any other racial group in the United States between 2000 and 2010.  The implications of this rapidly expanding population on the future health care delivery system are myriad.

A recent Institute Diversity Dialogue, led by Ram Raju, M.D., president and CEO of New York City Health and Hospitals Corporation, focused on Asian health care and disparities reduction, as well as the importance of remedial action in solving these disparities.    The Institute, in collaboration with AHA SmartMarket, also interviewed Dr. Raju on the implications of the Affordable Care Act on Asian health care disparities, as well as cultural and linguistic barriers Asian-Americans face that can impede access to equitable care.   The full interview is available below:


AHA SmartMarket: Solving health care disparities is a passionate subject for you. Why?


Dr. Ram Raju: We have the best health care system which is dream of every nation in this universe…In this richest country and most compassionate country health care disparities are rife, is a painful subject for me. I truly believe that access to health care should be fundamental right and human right. Solving health care disparities requires us to provide geographically convenient and culturally competent access for all.


AHA SmartMarket: Some Asian Americans face cultural and linguistic barriers that may prevent them from accessing needed health care services. What strategies/initiatives would you recommend hospitals and health care systems follow to care and communicate effectively?


Dr. Raju: The “nirvana” of culturally competent care is to have a health care workforce that reflects the communities we serve. In our system our patients look like us and we look like our patient. But it is not universal.

Since present care workforce lacks that kind of diversity and since it will take us time to develop a truly reflective work force, we need to train our present work force to appreciate cultural beliefs of Asian Americans. 

We need to remove the cultural and linguistic barriers by culturally competent staff and language access efforts to connect the Asian Americans to care.


AHA SmartMarket: The Asian-American population is affected by several cardiovascular disease risk factors including obesity, high blood pressure, and high cholesterol. In the era of value-based care, what are some strategies to target this population before medical intervention is needed?


Dr. Ram Raju: Part of the risk is due to hereditary factors and part of then the risk is due to the environmental and life style factors. Since we can only mitigate hereditary factors by early testing and preventive measures such stop smoking, weight management and better dietary habits.

 We need to teach them how to cook and eat their ethnic food, which will also beneficial in controlling the high blood pressure and high cholesterol. Better eating habits and early testing are the most important strategies we need to implement to keep this population healthy.


AHA SmartMarket: With the Affordable Care Act likely to expand, what are the short-term and long-term effects on health care disparities for Asian Americans?


Dr. Ram Raju: Affordable health care act is one of greatest hallmarks of our health care delivery system but it will remain only as an insurance reform unless we build on it to transform the health care delivery.

 We need to build on the ACA to do delivery system reforms and access reforms. The delivery system reforms should include a welcoming and culturally competent delivery system. Simply having an insurance card does not guarantee culturally competent access. We need to build such a system.


AHA SmartMarket: Employing community health workers helps to meet population needs outlined in the ACA-mandated community health needs assessments. Will the ACA encourage more work with community health workers? Will it focus more attention to social determinants that affect health outcomes for Asian Americans?


Dr. Ram Raju: Delivery system reforms under the ACA will and must involve the community health care workers both to connect the communities to care and advocate for culturally competent care.

As we move from inpatient based system to outpatient based preventive and primary care system to a population health model we need to understand and appreciate that effective population health cannot be delivered in a vacuum. The socio-economic, cultural, and education factors play a major and vital role in health of the communities.

It is up to the health care leaders to realize that factoid and delivery a health care that takes into consideration the social, ethnic, and the educational factors. If we learn how to do this in an effective manner we will reach the holy grail of patient centered care in our country.


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