By Cynthia Lopez-Dee
Filipinas
March 2001

When Tessie Guillermo likens the health status of the Asian Americans and Pacific Islanders to a puzzle that has to be uncovered, she says it with the authority of someone who has been involved in community health for 21 years.

First the facts. The enigma of Asians and Pacific Islanders in this country, as far as health and well being is concerned, is understandable. There are up to 26 different ethnicities within this racial group and among them they speak hundreds of languages.

"That is part of the problem. The little that we know of the health status of Asian Americans and Pacific Islanders (AAPI) is based on the majority of AAPI, primarily made up of Chinese, Japanese, and to a certain extent, Filipinos. The AAPI are so varied and inconsistent that it is hard to make any generalized statement," says Guillermo.

Yet another obstacle is that some government agencies misrepresent Asians in America neither as a minority group nor mainstream. Guillermo cites, for example, as far as the Department of Education is concerned, Asians are not a minority and thus not recruited for certain federal programs.

She adds that in research programs funded by the National Institutes of Health (NIH), Asians are seen as making up more science and engineering doctorates in proportion to the population. Asians, as an aggregate category, make up 10% of the science and engineering Ph.D.s in the population, a count the NIH sees as an overrepresentation. Thus, Asians are not tapped for participation in minority programs.

Guillermo claims this overrepresentation is untrue. She reasons, "If you break down the Asian Americans and Pacific Islanders-Filipinos, Cambodians, Hawaiians, Chinese, Vietnamese, etc.-the proportions of any ethnic group in reasearch varies widely. The majority of science and engineering Ph.D.s are in fact Asian Indians and Chinese. But we get caught up in this aggregation of the AAPI and that doesn't tell you much of any thing."

"For whatever reason, either because we are not on the map or because there is some myth about us not needing to participate in federal government programs, we are not designated as underserved or the minority (along with Hispanics, African Americans, American Indians) that can participate in these programs."

On the one hand, Asian diversity and misrepresentation may be factors beyond the AAPI's control. On the other hand, they may have also brought it upon themselves partly because the Asians have been non-participatory in the policy or political arena.

Guillermo laments that "for so many years those of us who have been advocating for governmental services, everything from small business loans to housing to increased levels of health services, have also been frustrated by the fact that Asian Americans and Pacific Islanders oftentimes do not show up as a constituency."

Nevertheless, that time may be past. People like Guillermo and 14 others of impressive backgrounds appointed and sworn in last May 18 as commissioners, will galvanize existing federal agencies, services, and programs to be more inclusive of AAPI. They are the watchdogs that ensure that the federal government does its job of implementing former President Clinton's executive order that ultimately recognizes AAPI as an integral part of the overall well-being of the American society. They will identify, monitor, and ensure that federal programs target Asian Americans and Pacific Islanders and recommend funding and other resources for the needs of this population.

The Commission, which is accountable directly to the President, is now in the process of establishing its priorities.

In Guillermo's problem solving equation, priority means listening first to the people in this community. However, there is a bottleneck there: the problem of aggregation.

"I think it will be more helpful if we break down the aggregation to be able to mark the differences in needs, achievements, and so on among the different Asian populations. So then you can go directly to the right population and address health education and treatment specifically," Guillermo says.

"It does help to break down the categories (of ethnicity)," she reiterates. "That's part of what we are trying to do to make sure that federal data collection breaks down the aggregate category into the ethnic groups as much as possible so we can target programs more efficiently. And target them appropriately to the population they belong in."

For now, in that problem solving equation, what Guillermo has are some of the givens:

Fact 1: Cancer incidence has increased 100%-200% to become the leading cause of death for Asian Americans and Pacific Islanders while cancer has dropped down as the second leading cause of death for the rest of the U.S. population.

Fact 2: Asians and Mediterraneans have high rates of thalassemia, a genetic disorder of the blood caused by deficient synthesis of hemoglobin, than any other population in the U.S..

Fact 3: Filipino men living in California who are over the age of 45 have higher rates of hypertension than almost any population in the US.

Fact 4: Vietnamese women have five times the rate of cervical cancer among all population in the US.

"We know some of the whats concerning the health of AAPI but we don't know the whys." Indeed, says Tessie Guillermo, the facts do not say much about the health of AAPI in this country.

Limited by a two-year term as a commissioner, Guillermo hopes to pave the way to making Asian Americans and Pacific Islanders count in this country. For the next generation of commissioners, that may as well be hers and the 14 other commissioners' legacy.

In the Guillermo scheme of things, the solution is "getting something started at this point." That "something" may be as simple and yet as astounding and influential as putting the Asians on the American map. She says, "I think one of the things that we hope to do is to make sure that we get the AAPI community on the map, in the consciousness of the federal agencies and in the general public."

"We have to make people understand that it is to the benefit of the overall U.S. society to do this because we are an integral part of the society. We are here to stay. We have been making contributions for decades and will continue to do that and so it is in the country's best interest to incorporate us and to make sure that our health is preserved."

The idealism and the drive are constant in Guillermo's activist life. Having gone to the University of California at Berkeley, where she majored in economics, in the 1970s says a lot about her community involvement.

From college, her advocacy led her to work instead at the Asian Health Services in Oakland, a community health center serving indigent monolingual Asian Americans, where she was involved for 8 years. She served another 13 years as the executive director of the Asian and Pacific Islander American Health Forum, a national health policy and advocacy organization based in San Francisco, California, with a satellite office in Washington, D.C. The organization spent 2-1/2 years in generating the movement and mobilization for this Executive Order, a factor she believes led to her appointment as a commissioner by the White House.

A second generation Filipino American, Tessie Guillermo says she has no regrets being where she is. The coveted fortune may not be there but "if being appointed by the President as a member of this commission, the first time a commission has ever been established, is any measure of success, it is definitely something that I can write home about."

Just as her work is her vocation, Guillermo also takes satisfaction in her family of two daughters, Melanie, 11, Veronica, 15, and son Rennie, 5, and her husband of 15 years, Reggie Regino. Her husband Reggie is also a Filipino and works in a commercial bank. Although born and raised here, Tessie says she ensures that her children are aware of their culture and takes effort to teach them of their cultural heritage.

Guillermo's expertise in the health and welfare concerns of Asian Americans and Pacific Islanders has been recognized in California and throughout the United States through numerous appointments. She was appointed to the California Department of Health Services Task Force on Multicultural Health in 1993, and served on the U.S. Secretary of Health and Human Services Blue Ribbon Committee on Violence Prevention in 1992. In 1997, Guillermo was appointed to the federal office of Women's Health Minority Women's Panel of Experts. Guillermo is on the boards of several nonprofit organizations and has co-founded several groups, including the Community Technology Policy Council, the Asian and Pacific Islanders' California Action Network and the Filipino Task Force on AIDS. She currently serves as vice Chair of both the community Technology Foundation of California, and the California Pan Ethnic Health Network, as well as on the advisory board of the Chinese Community Health Care Association. Among numerous awards, Guillermo has been honored by the Filipino American Women's Network, the National Institutes of Health Office of Research on Minority Health, and the American Journal of Health Promotion.

As Guillermo proceeds with her life, she does not lose sight of the basis for her work. "I think that if there is any legacy to leave behind it is to know and be able to look back and say we got this stuff started; it didn't exist before," she says.

The President's Advisory Commission on Asian Americans and Pacific Islanders:

Mr. Norman Mineta, Secretary of Transportation, chairs the Commission; Ms. Haunani Apoliona, of Honolulu, Hawaii, is currently serving her fourth year as a Trustee of the Office of Hawaiian Affairs of the State of Hawaii; Ms. Gloria Caoile, another Filipino, of Springfield, Virginia, is Special Assistant to the President of the American Federation of State, County, and Municipal Employees, a 1.3 million-member labor union. In this capacity, Ms. Caoile is considered the highest-ranking Asian Pacific American in the American labor movement.

Ms. Martha Choe, of Seattle, Washington, is the Director of the Department of Community, Trade and Economic Development of the State of Washington; Ms. Susan Soon-Keum Cox, of Eugene, Oregon, is a nationally recognized expert in the fields of international adoption and child welfare; Mr. Vinod Dham, of Fremont, California, is the Chairman, President, and Chief Executive Officer of Silicon Spice, Inc., a communications technology development firm in Silicon Valley.

Dr. Wilfred Leon Guerrero, of Asan, Guam, is a prominent advocate of education, having served as President of the University of Guam, in addition to being the Founding Dean of the College of Agriculture and Life Sciences, Dean of the Land Grant Program, and Associate Dean of the College of Education; Mr. Dennis Hayashi, of Sacramento, California, currently serves as the Director of the State of California Department of Fair Employment and Housing, the first Asian American appointed to this post; Dr. David Ho, of Chappaqua, New York, is a distinguished AIDS researcher who was named Time Magazine's 1996 Man of the Year for his groundbreaking work in HIV research.

Ms. Ngoan Le, of Chicago, Illinois, currently serves as the Deputy Commissioner of Human Services for the City of Chicago; Mr. Jonathan Leong, of Piedmont, California, is a businessman and is the founder of the Asian Business Association and a past board member of the Council of Asian American Business Associations; Mr. Mukesh Patel, of Atlanta, Georgia, is a leader in the hospitality industry and is a founding member of the Asian American Hotel Owners Association and served as its Chairman from 1997-1999; Ms. Jacinta Folasa Titialii, of Philadelphia, Pennsylvania, has been involved in the health care industry for 15 years and is currently Vice President and Assistant General Counsel for Tenet Healthcare Corporation, the second largest investor-owned health care management company in the US; Mr. Lee Pao Xiong, of St. Paul, Minnesota, is the Director of Government and Community Relations for Concordia University in St. Paul.

The Advisory Commission on AAPI was established by Executive Order 13125, which was signed on June 7, 1999, to advise the president on: 1) the development, monitoring, and coordination of federal efforts to improve the quality of life of AAPI through increased participation in federal programs where they may be underserved and the collection of data related to AAPI populations and sub-populations; 2) ways to increase public sector, private sector, and community involvement in improving the health and well-being of AAPI; and, 3) ways to foster research and data on AAPI, including research and data on public health.

Cynthia Lopez Dee worked for eight years as a journalist for the defunct Manila Chronicle in Manila.