What does it mean to be Southeast Asian? Disentangling the labels of language, ethnicity and country of birth

BACKGROUND: Language is vital to health communication, especially for immigrants. However, health databases do not necessarily track primary language but often rely on race/ethnicity for classification (the Census 2000 short form that was used in most households did not ask about language). SE Asian immigrants have been identified as an at-risk population for poor health outcomes. Circumstances in SE Asia have led to extensive regional migration before relocation to the US, resulting in great diversity of language, ethnicity and nationality. There is an unclear understanding of how these characteristics overlay each other, and decisions on how to ask immigrants to describe themselves are often quite arbitrary.

OBJECTIVE: To assess the interplay between language, ethnicity, and national origin in a diverse sample of SE Asian immigrants, and to discuss potential implications.

METHOD: Data were reviewed from an interviewer-administered community survey conducted in 9 languages (n=415 SE Asian immigrants). Ethnicity and country of birth were evaluated with respect to primary language.

RESULTS: 94.5% of respondents spoke a language other than English at home, and 24.8% spoke no English. A significant portion of Vietnamese-born respondents spoke Cantonese (14%), and 20% of Laotians spoke Hmong. Among ethnically Chinese SE Asian immigrants in this sample, 85% spoke Indonesian. Ten percent of immigrants reporting Thai ethnicity spoke Laotian.

CONCLUSION: Ethnicity and country of birth do not reliably predict primary language of SE Asians. In order to assess health communication needs, policymakers should rely upon language data rather than ethnicity or country of origin.