Vietnamese American health – chronic disease and COVID-19: A discussion of structural factors as health policies

Vietnamese Americans are one of the largest Asian American subgroups in the United States. However, they have not been well-studied, possibly due to aggregation of Asian American data and assumed good health of Asian Americans. This population leads other Asian American subgroups in mortality rates of cancers, heart disease, and cerebrovascular diseases, as well as in incidence of hypertension and type 2 diabetes. Vietnamese Americans have also been disproportionately impacted by the COVID-19 pandemic demonstrated in infection rates and economic impact. After a brief overview of the Vietnam War timeline and Vietnamese refugee pathways, this paper explores how three structural factors – immigration policies, resettlement policies, and occupational practices – impact the health of Vietnamese Americans. Each of these structural factors, established in support of Vietnamese Americans, has shortcomings that may contribute to adverse health outcomes lasting generations. In conclusion, these three structural factors should be considered health policies and can inform policy change, interventions, and resource allocation.