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Ethics Talk: Anti-Asian Racism During COVID and Beyond

Learning Objective
Identify key ethical values or principles at stake, as described in the program
0.5 Credit CME

In this video edition of Ethics Talk, journal editor in chief, Dr Audiey Kao, talks with Dr Vivian Shaw and Susanna Park about the resurgence of anti-Asian racism and xenophobia during the COVID-19 pandemic.

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The AMA Journal of Ethics exists to help medical students, physicians and all health care professionals navigate ethical decisions in service to patients and society. The journal publishes cases and expert commentary, medical education articles, policy discussions, peer-reviewed articles for journal-based, video CME, audio CME, visuals, and more. Learn more

Video Transcript

Tim Hoff: Welcome to Ethics Talk, the American Medical Association Journal of Ethics podcast on ethics in health and health care. I'm your host, Tim Hoff.

This episode is an audio version of a video interview conducted by the journal's Editor in Chief, Dr Audiey Kao, with Dr Vivian Shaw, a College Fellow at the Department of Sociology at Harvard University, and Susanna Park, a PhD candidate at Oregon State University College of Public Health and Human Sciences. They joined us to discuss the resurgence of anti-Asian racism and xenophobia during the COVID-19 pandemic. To watch the full video interview, head to our site, JournalOfEthics.org, or check out our YouTube channel.

Dr Audiey Kao: Dr Shaw, Ms Park, thanks for being guests on Ethics Talk today.

Dr Vivian Shaw: Thank you so much for having us.

Susanna Park: Thank you for having us.

Kao: So, despite the pandemic surge in violence directed at Asians and Asian Americans in the US, anti-Asian racism is invisible to many of us. What should we understand about how Asian Americans have been thinking and talking about this invisibility during this pandemic?

Park: The seeming invisibility that you mentioned, it's scripted into how the US history is taught and how racism is taught and understood. So, it's not new, right? It's not some kind of new concept or anything. And we tend to think of racism as a result of how it's taught in our education system in a very black and white binary. So, literally, people will think about the Civil Rights Movement or how people are either racist or anti-racist. And I think what we're seeing is with, you know, now with increased access to technology over the years and the use of social media as a means to communicate to the masses, Asian-American voices have been amplified in different ways. And so, while the incidents of racism have historically always been there against Asian folks, the intensification due to the pandemic and the spotlighting of it through means of social media has introduced newer spaces for people to engage and to be exposed.

Shaw: In Environmental Sociology and Environmental Studies in an interdisciplinary context, there's this concept called “slow violence.” And what that concept talks about is how oftentimes, when people discuss violence, racism, there's really a focus on very dramatic events, right? So, we can think about this ongoing murder of Black people by police, right, and how this has received a lot of attention and these being acts of violence that we can very much understand very quickly. What often does not get looked at is the structural foundations of violence and the ways in which people suffer in their lives on an everyday basis. That very much is part of how Asian-Americans have experienced feeling invisible within this context. We're seeing right now a lot of attention to these very extreme and visible forms of violence. But some of the deeper structures of how Asian-Americans have experienced discrimination and how that takes place, not only in terms of stereotypes such as being treated like foreigners, but also really embedded within structural inequality, labor issues, immigration issues, how that has just not really received the kind of attention because it's not necessarily as dramatic in the same way that we can understand things.

Kao: Some would make us believe that Asian Americans are all physicians or engineers or professors, when in fact, many labor in low-paying jobs. In fact, Asian Americans actually have the highest percentage of long-term unemployed during this pandemic. How do you think the model of the so-called, the label, the so-called model minority has affected Asian Americans during this pandemic?

Park: So, you mentioned the very stereotypical ones—doctor, engineer, lawyer—that is common among certain circles. But we also have folks who are artists or who are in the movie industry, acting industry. And not to say that, of course, there are many who are in those low-paying jobs that you mentioned. I think the model minority myth really perpetuates this idea that regardless of what job we have, Asian Americans have achieved a level of success because of those that have reached some kind of economic success, right? And so, it's equated to this idea of perfection, overcoming racism, overcoming structural racism specifically. When someone says “Asian,” people tend to think someone that looks like me and Vivian or even you, Dr Kao, someone who looks of Asian descent. But we then forget about our South Asians, our Southeast Asians. And then we have the clumping of Pacific Islanders and Native Hawaiians under this umbrella, too. And so, I think we lose out on a lot of nuance and on a lot of very diverse and rich experiences when we have this model minority myth applied, especially during the pandemic.

Shaw: First, I want to talk about how the model minority myth impacts, as Susanna had touched upon, the sense of identity and the sense of who we are as human beings, as well as the sort of broader political implications of the model minority myth and the impact on cross-racial collaboration with other communities of color. So first, I wanted to share a story from an interview that we conducted in the fall where I had interviewed a young man who is a frontline worker working at a very well-resourced hospital in Boston that nonetheless had to deal with enormous constraints that then impacted his job directly. So, he had been doing medical research as a research assistant. And so, he went from doing research on cancer to then monitoring ventilators. He described himself as not feeling like a frontline worker. The way that he mentioned this story, he didn't say, “I don't see myself this way,” right? But really, it came out in a story that he was telling about there being times when people would donate food or different types of snacks for frontline workers at the hospital. And he said that he always made sure to let other people go first and wait before helping himself to things because he did not see himself as frontline, as a frontline worker.

And within this conversation, he was talking about then-President Trump and Mike Pence about how he said they want to be the heroes of this story, right? They want to be the protagonist. And so, I was thinking about that story, and I was thinking about another interview that I conducted with an Asian-American health care worker and how they tended to downplay their own role in helping to fight this pandemic. You know, what I heard from these stories is that when people are told they are not the important people in a country, right, that they are not the people who are contributing and sacrificing, when they are kind of made to feel left out of that, it's hard for them to see themselves in those roles and to recognize the contributions that they're making.

And so, I think that much of what the model minority myth focuses on is a certain measure of success. But what often gets erased—and we see this in many conversations—is this feeling of who are you as a human, and how do you see your value in society? And how do you feel you're recognized for that? And so, we can see people through these stories in very, very stressful positions doing very, very important but difficult work, then not feeling like they're part of the story, right? And perhaps cutting themselves off from different types of support because they don't see themselves as the heroes, right? Even though they are doing that work.

Kao: The very body of an Asian or Asian-American person is seen as a symbol to be feared and as a source of contagion during this pandemic. And this phenomenon has a long history in the global West. So, how has the West's portrayal of the exotic Orient continued to exacerbate anti-Asian racism and xenophobia?

Park: I think when it comes to specifically viewing Asians as a source of contagion, something dirty, something that spreads, and it's insidious, you're totally right, Dr Kao. This phenomenon has a long history in the global West. And it's not just from things like the Chinese Exclusion Act or the murder of Vincent Chin, which was tied to labor. But we also see it in the burning of Chinatowns, or we see it in using Asians as a medical scapegoat with the bubonic plague. Those events highlight just beyond individual acts of racism and violence, right? These are state sanctioned. These are things that have happened at structural levels. And so, when we look at the pandemic and the acts of racism and violence against Asians, it really came to a point where six women died a whole year later after March 2020 into the pandemic for there to be just more widespread attention on anti-Asian racism.

And when I was looking back at some of our interviews that we've done at our project, there was one quote that really struck me, because this person says, “So then, in early April, as I was reading more and more news stories about anti-Asian racism and especially as a president,” which was then-President Trump, “and Republicans kept saying ‘China virus’ and ‘Wuhan virus’ and the wonderful ‘Kung flu,’ I thought, okay. We have to do something about this because it is a matter of time before someone gets killed.” And so, this interview was done last fall. And I am reading back on it now, spring 2021, and it's saddening, frustrating at the same time.

Shaw: I think that it's important as scholars to return to an analysis of how is it that racism has become so entrenched in society or foundational to society, really, and how has it changed over time? And so, if we just kind of zoom back or take a step back into the past, we know that in the later part of the 19th century, into the earlier 20th century, racism was often postulated around these ideas around biological difference, right? So, people literally would measure skull sizes that then create these hierarchies of superiority and inferiority. After World War II, a lot of the discussions around race and racial difference then tended to get mapped onto culture, right? So, we can think about things like culture of poverty as an example of the ways in which certain communities are seen as having cultures of deficit, right, that then lead to these different forms of inequality, right? And we can see how this idea of, oh, this community doesn't emphasize or care about education, or this community is violent, right? And how that kind of then reproduces certain types of racial logics in that way. What racist ideas around culture do is they really invisibilize the structures of power that actually shape a lot of these problems.

Kao: The recent shootings in Atlanta targeted Asian-owned massage and spa small businesses. What does this violence say about the triad of misogyny, hyper-sexualization, and racism against Asian-American women?

Park: When we reflect on the Atlanta shooting, we see white supremacy at play: a white man targeting Asian spas. And then we see the response from the police and saying, “Oh, he was just having a bad day.” We also see misogyny and hyper-sexualization of Asian women, which we saw from the shooter specifically targeting Asian women to relieve, in his own words, his sex addiction. And what we also see is that when the news first started reporting and talking about the six women who died, media reports and people on social media talked about how these women were sex workers. The interesting thing, though, is that there were all these discussions happening about how sex workers deserve equal rights, and others may have been on the opposite end where they found the killings more justified because the woman were sex workers. But when you actually look at the timeline of how these news reports came out before the victims' names were even identified or their jobs were even identified, there were reports that they were sex workers. And that was actually an assumption that was made when they heard “Asian women” and “spas.”

And so, I think that's really kind of taking a step back and examining that a little bit and analyzing why is that? Why is it that that assumption was made, and then it was automatically accepted? And I think it speaks to this overall idea of what people envision Asian women to be. And it's not just based on media portrayal or anything like that. It has deep roots in US imperialism and the sexualization of Asian women and how Asian women were even brought over here by US soldiers and how society, over time, has kind of entrenched or ingrained this idea of what it means to be this Oriental, submissive Asian woman that is hyper-sexualized.

And I think back on one of our interviewees whose mother actually worked as an esthetician and had a, owned a massage parlor in New York City. And there was a lot of racist encounters that she had: you know, people joking like, “Oh, do you give your customers happy endings?” And the building owner at that time, he passed away, and then their son took over. And their son embodied very much this racist view towards Asian women. And so, he was very horrible towards this interviewee's mother in making racist remarks and being not a very good building owner. And eventually, her mom was like, I can't do this anymore. I don't want to do this anymore. And there were some legal things. And she decided to not keep her place open anymore to her patrons, even though her patrons were like, “We'll help you with your legal fees. We want you to continue your business.” She was like, “I'm just tired. I can't do this anymore.”

Shaw: A lot of these media portrayals assume that Asian women working in certain types of industries are sex workers, right, that they're doing that sex labor, but specifically that they are human trafficking victims, right? And so, this is mapped onto Asian immigrant women. And it is very much related to, once again, global structural inequalities and poverty and how that is, and the kind of pervasiveness of that. But the narratives around human trafficking create a lot of consequences that many people may not expect to begin with. And here right now, I'm drawing upon the really wonderful and rich work from my colleague Elena Shih, who is an Assistant Professor at Brown. Her work, she has, her expertise is ethnographic work.

And so, what she has found in her research looking at massage parlor workers in the US is that first, many of them are not documented, right, or have precarious citizenship. And by being labeled broadly as human trafficking victims, they have to deal with a lot of police intervention and surveillance. And this has had many devastating consequences. So, police have led numerous raids on Asian massage parlors. And it's worthwhile to know that these are Asian massage parlors and not massage parlors by white immigrants, for instance. And people have died in these raids, right? Because some of these workers had to flee the police because they were in fear of being deported or in fear of being put into jail, right? And even though they were not human trafficking victims, they still had to kind of, they had to, they felt that the potential risk of getting arrested was so great that some of them resorted to things such as jumping out of a window and dying to avoid the police, right? And so, part of the story is the story of policing as well, which is also highly gendered. We know that not only Asian women, but many women and many femmes as well, when they, in their encounters with the police, often have to deal with sexual violence.

Kao: So, as I'm hearing you both reflect on the interviews that you've conducted as a part of the Asian American Pacific Islander COVID-19 research project, you've unearthed a lot of important issues and topics. So, what do you see as some of the most important neglected topics to promoting Asians' and Asian Americans' health, safety, personhood, and citizenship right now?

Park: I don't know how familiar folks are with this discussion of data disaggregation for AAPIs that has been happening. But essentially, this call for disaggregation is speaking to how when you look at data and how data is gathered on Asians, that's a huge, huge category. And so, how can you actually understand and accurately and effectively distribute resources to this huge category of Asians when it looks so different for Indian Americans versus Burmese versus Thai versus Koreans? You know, it's just, there's just so much variety. Our project name right now is the AAPI COVID-19 Project, but we're very aware of our limitations. Our team is mostly comprised of people who are Asian, and a lot of our interviewees at this time are also of Asian descent, right? And so, we're very intentional in putting our positionality in saying, hey, we understand our limitations as not having ample NHPI representation. And so, we also recognize that in terms of us as researchers and working on this project, right?

And another thing that I'll say is currently, there is something called the UNITE initiative through the NIH, and their mission is to end structural racism. But then their RFI had actually no mention of Asians, Asian Americans, and Native Hawaiian Pacific Islanders. So, they included Black, African American, American Indian, Alaska Native, and Hispanic Latino populations, but AA and NHPIs were actually left out of that description. And so, whether this is intentional or not, the exclusion still happened, right? The exclusion of mentioning AA and NHPI still happened. And that does this further disservice to well, if we're all aiming to end structural racism in this body of research and area of academia, then we have to include everyone. And that includes Asian Americans and NHPIs.

Shaw: You know, many of us on my team have a political commitment to wanting to uplift and support community-based organizations. But I think even beyond the sort of political standpoint, there is also an importance from a research perspective of why it is very important to collaborate with community-based organizations. So first, these are the organizations that are doing the work. These are the organizations that, even before a pandemic or even before a massacre, have already been attentive to these issues of structural inequality and have been working with populations. But from a research perspective why it is so important to have this kind of awareness and a commitment to working with community-based organizations is that researchers often have this bias of researching what is most visible, right: talking to the people who will speak to us and talking to the people who speak loudest. And this is an issue because there's this kind of confirmation bias where we hear the people who speak loudest, and we assume that this is a story.

So, really, as researchers, we need to go deeper, right? We need to think about the people who often get excluded, and make inroads to work with them. But to do so ethically, we need to also collaborate and consult with the organizations and communities that have established these relationships for a much longer period of time. And so, trust in collecting research is very, very important.

Why I kind of mention this is because I'm thinking about a set of interviews that an undergraduate student who is at Harvard and she's Laotian, and her family has this kind of background with working with the meatpacking industry in the Midwest. One of the stories that she uncovered was that many of these people working in the meatpacking industry had experienced tremendous loss of life and community members from COVID. But rather than articulating that as something very upsetting to them, they had normalized it. Because they're so, they had had so much loss that they had come to normalize it. The loss of life had not become this rare event; it had become something that had unfortunately become part of the everyday. And so, because of that, we have to, as researchers, to really understand inequality. We have to go beyond the surface and try to find the information that does not always immediately present itself.

Kao: So, with that goal to go beyond the surface and to explore more deeply the rich stories of Asians, Asian Americans, Native Hawaiians, and Pacific Islanders in the US and their experiences, I want to thank Dr Shaw and Ms Park for sharing their expertise and insights with our audience today. Dr Shaw, Ms Park, thanks again for being guests on Ethics Talk.

Shaw: Thank you so much.

Park: Thank you.

Shaw: Thank you.

Kao: For more COVID ethics resources, please visit the AMA Journal of Ethics at JournalOfEthics.org. Thank you for joining us today. We'll see you next time on Ethics Talk. [bright theme music plays]

Video Information

Credit Designation Statement: The American Medical Association designates this enduring material activity for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships.

If applicable, all relevant financial relationships have been mitigated.

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Enduring Material activity for a maximum of 0.50  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 0.50 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 0.50 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 0.50 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 0.50 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 0.50 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.


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