Asian American Elders: Caught in the Crosshairs of a Syndemic of Racism, Misogyny, and Ageism During Coronavirus Disease 2019.

In 2020, coronavirus disease 2019 (COVID-19) began its deathly march across the globe, at the onset impacting persons 65 years of age and older most severely (Sharma, 2021). Deaths in this age group soared to 317,688 in 2021, slowing to 127,580 by mid-July, 2022 (Centers for Disease Control and Prevention [CDC], 2022). In the United States, the number of persons of all ages who died due to the virus and its variants reached nearly 1.02 million as of July 2022 (CDC, 2022). With origins hypothesized to be in Wuhan City in the People’s Republic of China, “China Virus” or “Kung Flu” were handles used by then-President Donald Trump and other public figures to fan anti-Asian, and specifically anti-Chinese, racism when the China-US geopolitical relationship was already competitive and testy. According to Human Rights Watch, hostile rhetoric and incidents worldwide heightened with racially and geopolitically derived derision, scapegoating, and discriminatory invectives about Asians in public spaces and via social media (Human Rights Watch, 2020; The Week, 2021).

This article examines emerging data on anti-Asian hate and violence incidents as they pertain to older Asian women, primarily in the United States. We note competing characterizations of the incidents and the intersections of age, race, and gender within a syndemic framework, which emphasizes the compound, exacerbated effects of embedded racism, xenophobia, and social inequalities in the context of the pandemic (Saw et al., 2022). We identify the membership of the politically defined Asian American population, discuss unprovoked violence in the community against older Asian women by unfamiliar perpetrators, and distinguish misogyny from gender inequality. Sadly, we anticipate that hate and violence against Asians may persist as the nation approaches 2043, when the United States population will be majority minority. We also expect that global reactions to Asians will be less than welcoming until economic and political relationships with China, North Korea, and other Eastern nations ease.

Asian Americans

Since 2000, Asian Americans have comprised the fastest-growing racialized group (Sasa & Yellow Horse, 2021). In 2020, 24 million Asian Americans accounted for 7.2% of the US population (Jones et al., 2021). Persons of Asian ancestry come from more than 50 countries on the Asian continent, Indian subcontinent, and the nations of Indonesia, Japan, the Philippines, Brunei, Sri Lanka, Taiwan, and the lesser-known Timor-Leste. Subsumed under the panethnic Asian category in the United States, they have different immigration histories, cultures, and languages (Lee & Ramakrishnan, 2020; Okamoto, 2014).

Hate Crimes or Incidents

Hate-based attacks against Asian Americans are referred to frequently as crimes. The US Department of Justice defines a “hate crime” as, “at the federal level, a crime motivated by bias against race, color, religion, national origin, sexual orientation, gender, gender identity, or disability” (The United States Department of Justice [US DOJ], 2021). In comparison, “bias or hate incidents” are “acts of prejudice that are not crimes and do not involve violence, threats, or property damage” (US DOJ, 2021).

We have chosen to refer to these attacks as “incidents” to highlight the range of acts of hate perpetrated against Asian Americans. Unfortunately, summarily labeling them as crimes could pit Asians and other racial or ethnic groups against each other, maintain racial hierarchies, and valorize a group through the indiscriminate use of “crime” (Kim, 1999). We believe race, age, and gender-based perpetrations to be reinforced by embedded assumptions that can skew our individual, group, and community relations. Hence, community education, not sentencing and incarceration, are likely to result in better societal outcomes for all.

Hate-Motivated Violence Against Persons of Color

The nation’s history is filled with hate-based violence against Black, Brown, Indigenous, and Asian persons and their communities. From enslavement and lynchings in the South to hundreds of Chinese communities that were dispossessed en masse in the 19th century to the murder of George Floyd and others, embedded, systemic racism underpins the harassment, bullying, and murders of persons of color. Using real-time police department data from 27 cities in 2021 (not including New York City)—undifferentiated as to victims or perpetrators by race, gender, and other variables, the Council on Criminal Justice noted a slowing pace of homicides in major cities (Rosenfeld & Lopez, 2022). Meanwhile, based on incident reports from 15,136 law-enforcement agencies, the Federal Bureau of Investigation found that hate crimes in 2020 related to race, ethnicity, or ancestry had reached the highest levels in more than a decade. Among these, anti-Black hate incidents rose by 30.4%, from 2,202 in 2010 to 28,71 in 2020, while anti-Asian incidents increased by 86%, from 150 in 2010 to 279 in 2020 (Federal Bureau of Investigation, 2021). Reliable data unfortunately are not readily available, as data collection requirements and standards vary across federal, state, and local agencies.

Violence Against Older Persons

Violence against older persons has been surging worldwide for at least four decades, almost equally among older women and men. Explanations for this include the ubiquitous dominance of negative social constructions of age, manifested as ageism or stereotyping, prejudice, and discrimination against old age and older persons (World Health Organization, 2021a). The perceptions that older persons are physically and otherwise more vulnerable and that they are less likely to report or fight back are believed to contribute to the probability of their victimization (Rosen et al., 2019). However, incidents against older Asian Americans, particularly women, during the height of COVID-19 appear to require more nuanced explanations.

Almost 400 member organizations of the Global Alliance for the Rights of Older Persons and numerous nongovernmental working groups and committees on ageing from countries around the world have called for a United Nations Convention on the Rights of Older Persons. A convention would ensure the incorporation of international human rights standards in national aging policies. It would address the dramatic increases in all forms of violence, including assaults; physical, psychological, emotional, and sexual abuse; intimate partner violence; and self-directed aggression, such as self-neglect and suicide. It would frame the victimization of older persons as human rights violations, not just as public health concerns (HelpAge International, n.d.). These organizations recognize that violence occurs in public spaces, not just in institutions.

Such a convention, i.e., a multilateral human rights treaty, is unlikely to fare better in the United States than the Convention on the Rights of the Child, released for ratification in 1989, or the Convention to End All Forms of Discrimination Against Women, introduced in 1979 and ratified by 186 countries. Neither convention has been ratified by the United States. The US Constitution and the authority vested in three branches of government disallow the sanctity of US democratic governance processes to be relinquished to an international body.

In the United States, a 2019 CDC report documented the rise in pre-COVID-19 rates of violence against persons 60 years of age and older (Logan et al., 2019). The intersectional nature of vulnerability is undeniable in these data. Men of all races were more frequently victims of nonfatal assaults. Moreover, data analyzed from a representative sample of hospital emergency rooms for the National Electronic Injury Surveillance System–All Injury Program and from the National Vital Statistics System found that nonfatal assault rates for men were up by 75.4% between 2002 and 2016. By comparison, rates for women rose by 35.4% between 2007 and 2016. Similarly, the rates of homicides in men aged 60 and older grew significantly, with an increase of 7.1% from 2010 to 2016, compared to a decrease of 9.9% from 2002 to 2016 for women (CDC, 2019) for all populations. While post-2020 data are not yet available, intersectional data for Asian American older adults diverge almost diametrically from national gender violence trends and point to the syndemic discussed below.

The Older Americans Act (OAA), as amended, gives considerable attention to community-based older persons. Among the act’s strengths is its acknowledgment of persons who are vulnerable because of socioeconomic status, culture, language, and other distinctions, most of whom reside in community settings. The OAA defines abuse as “the knowing infliction of physical or psychological harm or the knowing deprivation of goods or services that are essential to meet essential needs or to avoid physical or psychological harm” (OAA Section 102[1], 2020).

The OAA also defines elder justice, from a societal perspective, as “efforts to—(i) prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation” and as “protect[ing] older individuals with diminished capacity while maximizing their autonomy. Elder justice also recognizes an older individual’s rights, including the right to be free of abuse, neglect, and exploitation” (OAA, Section 102[17]). However, the OAA Title VII, which speaks directly to elder rights and protection, and the Elder Justice Act are examples of laws that are heavily focused on older persons cared for in institutions or in the home or community.

The Administration on Community Living’s National Center on Elder Abuse and national organizations have used available state data to report on the rise in elder abuse in facilities. Meanwhile, research on abuse and neglect by informal and formal caregivers in home and community settings is growing. Anti-Asian hate incidents have revealed what is missing: much less is known about assaults and other violent acts in public contexts by strangers on persons of color, cultural minorities, and those with limited English proficiency. Vulnerable, older adults are reliant upon community public safety systems and police departments, which generally do not have systematic, disaggregated data collection and reporting requirements.

Gender and Misogyny

Gender discrimination refers to the unfavorable treatment, including all forms of harassment, of a person because of their sex, whether the actions are sexual in nature or not. In contrast, misogyny has at its core a hatred of women, primarily by men, manifested by gender discrimination, coercion, and slut shaming, which are aggressions that sexually objectify, are violent towards, and/or seek to control women, whether physically or in the cyber environment (World Health Organization, 2021b). Misogyny is a global issue. The World Health Organization has estimated 736 million women—almost one in three—have been victims of physical and/or sexual, intimate-partner violence; nonpartner sexual violence; or both at least once in their life (30% of women aged 15 and older). Misogyny shapes women’s lives differentially through multiple, unrelenting oppressions, including racism, ageism, and heterosexism. While most older women face gendered ageism, the vulnerabilities of Asian American women are also heightened by their race and ethnicity, immigrant status, and life course (Fang, 2021; Pillai et al., 2021).

The Syndemic: Anti-Asian Hate and Violence and Older Asian Americans, 2020 to the Present

Like those of other communities of color, Asian American histories are filled with systemic exclusion, overt and covert discrimination, harassment, beatings, murders, and other existential threats in the United States. Asian Americans were targets of hate and violence long before the pandemic, as evidenced, by the Yellow Peril ideology, which racialized Asians as dangers to US and Western culture; the 1871 Chinatown Massacre; the exclusion of Asian immigrants (e.g., the Chinese Exclusion Act of 1882); the incarceration of Japanese Americans during World War II; the terrorization of Vietnamese shrimpers in 1981 in Galveston; the brutal, racially motivated murder of Vincent Chin; and deadly Islamophobia faced by South Asians and Arab Americans (Lee, 2007; Wu, 2009).

Anti-Asian hate incidents and violence since COVID-19 have been fierce. Stop AAPI Hate (SAH)—the academic and community organization coalition to document first-hand reports of hate incidents against Asian Americans as well as Pacific Islanders—reported nearly 11,000 hate incidents from March 19, 2020, to December 31, 2021 (Yellow Horse et al., 2022). An estimated one in five Asian Americans (21.2%) have experienced hate incidents as of late 2021 (Yellow Horse et al., 2021a). Of 11,000 hate incidents reported overall, 62% of the reports were from women (31% from men); about 53% of reported older Asian American hate incidents were from women (40% from men).

Previous research has focused on hate crimes, which must meet specific law enforcement standards (Yellow Horse & Andryc, 2021) and noted more male victims. Firsthand reports of hate incidents show that Asian American women are more likely to experience substantial, disproportionately hate-motivated aggression. Asian American women may be less reluctant to report than men and may seek interpersonal and community-based support rather than legal interventions (McCart et al., 2010). There is evidence that Asian American women experience substantial gendered, racial microaggressions daily within the interlocking systems of oppression, including racism and heteropatriarchy (Felipe, 2016; Keum et al., 2018).

Of all hate incident reports, nearly 7.6% of hate incidents targeted Asian Americans 60 years of age and older (Jeung et al., 2022). Compared to individuals younger than 60 years of age, older Asian Americans were significantly more likely to have experienced physical assault, at almost one out of four persons (26.2%, compared to 15.4% of those under 60 years of aged). Aggression against older Asian Americans involving graffiti, vandalism, robbery, or theft accounted for 7.2% of incidents, compared to 4.2% for younger persons. More hate incidents occurred on public streets and spaces for older Asian Americans (36.7%) compared to younger Asian Americans (32.0%) as well as in the private residences of older vs. younger Asian Americans (15.8% vs. 9.8%).

Policy Mechanisms to Combat Hate and Violence against Older Americans, With a Particular Focus on Older Asian Americans

Absent granular, reliable, representative national, state, and local data, SAH’s and the National Asian Pacific American Women’s Forum findings are especially valuable. SAH data reveal four categories of discrimination: verbal harassment (63.7%) and shunning (16.5%), physical assaults (13.7%) and coughed at/spit upon (8.5%), civil rights violations (11%), and online harassment (8.3%) (Yellow Horse et al., 2021). An incident may involve multiple categories. Microaggressions, such as verbal harassment and deliberate shunning, account for 63.7% of the reported cases. Physical assaults constitute 13.7% and coughing and spitting 8.5%. Civil rights violations, such as service denials, totaled 11%. Cyber racism accounted for 8.3% of the cases (Yellow Horse et al., 2021b).

Thus, the multifaceted nature of anti-AAPI hate requires the engagement of policy and research professionals who can inform and shape policies that attend to the intersections of race, gender, and age.

To start, we propose the following.

The Expansion of Civil Rights Protections

As a nation committed to civil rights under the law, the United States can incorporate the spirit of the Convention on the Rights of Older Persons into public policies. The OAA can be amended to protect older persons in public community settings, emphasizing protections for those at risk because of minority identities by race or ethnicity, gender, sexual orientation, socioeconomic status, ability, and/or community of residence (rural and inner cities), for example.

Expansion of civil rights protections nationally and at the state and local levels would address the harassment that constitutes most SAH incidents. Fear is a deterrent to Asian Americans resuming everyday public activities including the use of public transportation. Asian Americans need better information on their rights. In California, SAH is sponsoring “No Place for Hate” legislation, framing street harassment as a public health issue and raising awareness of its harm among vulnerable groups, especially women of color. In New York City, rides for older Asian Americans and community service self-defense training by martial arts groups are examples of volunteer interventions. These need broad support.

Federal Initiatives

Within the first week of his presidency, President Biden issued a memo denouncing anti–Asian and Pacific Islander racism and providing guidance on data collection and incident reporting. The memo informs the implementation of the 2021 COVID-19 Anti-Asian Hate Crime law. Also in 2021, President Biden established the White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders, “charged with driving an ambitious, whole-of-government agenda to advance equity, justice, and opportunity for Asian Americans and NHPI [Native Hawaiian and Pacific Islander] communities ….” Two foci respond to xenophobic hate incidents against adults, using the initiative’s assistance to (The White House, 2021): (a) coordinating “a comprehensive Federal response to the rise in acts of anti-Asian bias and violence”; and (b) addressing the need for “disaggregated data on Asian Americans and NHPI communities in Federal statistical systems” (White House Executive Office of the President, 2021). The White House Initiative can bring together aging, women’s, civil rights, justice, public safety, and education representatives to work as allies on anti-Asian hate concerns. Aging and public safety policies can attend to safety in public places for older Americans. Women’s groups can expand their Violence Against Women Act foci that prioritize interpersonal violence and call for policies protective of older women. Civil rights and justice communities can work with ethnic studies programs to provide an understanding of diverse communities. Two options for responsive, intersectional, best-practice demonstrations can be through the OAA Title IV or Title VII, section 721. At a minimum, the Departments of Health and Human Services, Justice, and Energy; and the White House Gender Policy Council can invite demonstrations of multisectoral collaborations to prevent and diminish hate incidents.

Additionally, an amendment to the OAA to expand the definition of elder abuse and section 321 to include hate incidents, would protect older persons who are not institutionalized or receiving home or community-based care.

Reliable Disaggregated and Intersectional Data

Data on discrimination, hate incidents, and violence directed at older Asian American women must be collected and disaggregated. This includes national data from the Department of Justice and the Administration on Community Living, state-level data, and local police data.

Ending hate incidents will also require data clarification, transparency, and accountability. Although many women in the United States are at risk for gender-based violence, Asian American women must contend with the intersecting challenges of gender and race (Pillai et al., 2021). Intersectional research deliberates on ways in which data on socially constructed and dynamic identity markers and phenomenon such as race, class, gender, sexual orientation, and poverty can reveal the probability of certain life options, experiences, behaviors, and actions (Collins, 1992; Misra et al., 2021). It provides a more complex and nuanced understanding of inequality. The collection and use of intersectional data can reveal whether the rights of older Asian American women are being honored and, if not, the necessary courses of action and allocation of resources. Intersectional data require praxis or action (Feree, 2018). Collaborations involving national and local aging, women’s, justice, public safety, and Asian American organizations are essential.

Education and Public Information to Increase Understanding of Ageism, Racism, and Misogyny

To prevent hate against older Asian Americans, education and awareness are key to unlearning ageism, racism, and misogyny as an extreme form of gender discrimination. With respect to racism, for example, the SAH movement has stimulated a national effort to include Asian American history and narratives in K–12 state curricula. California, Illinois, and New Jersey require it, and 12 states have legislation pending. Ethnic studies—interdisciplinary studies of race and racism—reduces prejudicial attitudes and racial bullying, improves the academic performance of particularly at-risk students of color, and addresses most hate incidents (Dee & Penner, 2017; de Novais & Spencer, 2019; Nojan, 2020; Sleeter, 2010; Sueyoshi & Sujitparapitaya, 2020).

Conclusion

One of the many tragic byproducts of the COVID-19 pandemic has been the heightening of anti-Asian hate incidents in the United States and the world. Anti-Asian racism has had a long history in the United States. This may worsen if our relationship with China continues to be geopolitically and economically competitive, if COVID-19 persists, and if racial stereotypes and faulty histories are not unlearned through education. The syndemic of anti-Asian racism, ageism, and misogyny that has been emergent since 2020 is most apparent in the victimization of older Asian American women, who are caught in the crosshairs of formidable vectors of hate and violence. Among the policy redirections that would honor the rights of and protect all older persons, including older Asian American women in the United States and in the world, would be a commitment to also addressing hate and violence in public spaces and noninstitutional settings in the community. Ultimately, this will require the engagement of multiple sectors of our society: gerontology professionals, the justice and public safety communities, public health, the health-care industry, higher and lower education, transportation and other public systems, nonprofit organizations, and our policymakers at the national, state, and local levels.

Among the policy redirections that would honor the rights of and protect all older persons, including older, Asian American women in the United States and in the world, would be a commitment to also addressing hate and violence in public spaces and noninstitutional settings in the community.