‘Asian Americans aren’t Monolithic’
Milkie Vu Continues to be a Changemaker in Public Health
“As a Vietnamese immigrant woman, my work is deeply influenced by my personal journey,” says Milkie Vu, PhD. “My past has shaped my future and the commitment I have to implementing culturally relevant, community-centered public health solutions.”
As an assistant professor of Preventive Medicine in the Division of Behavioral Medicine, Vu’s work serves not only as an academic assessment, but a mission to address health disparities affecting Asian American populations. Her dedication to confronting public health barriers is seen in a pair of research topics disproportionately affecting Asian Americans: food insecurity and cardiovascular disease. Supported by K12 funding from the Northwestern University Clinical and Translational Sciences (NUCATS) Institute, Vu’s research examines often-overlooked issues in minoritized communities while offering sustainable pathways for long-lasting impact.
“A Scoping Review on Food Insecurity Among Asian Americans,” published in the Journal of Health Care for the Poor and Underserved, reveals that although Asian Americans are among the fastest-growing groups in the United States, they often face unique barriers to food access. Vu’s systematic review of 35 papers revealed a significant variation in food insecurity across Asian subgroups, highlighting the need for more nuanced, subgroup-specific research.
The findings challenge the assumption that Asian Americans don’t face food insecurity problems and underscores the importance of disaggregating data by origin group.”
“This variability in experiences shows that we can’t treat Asian Americans as a monolithic group,” Vu says. “The findings challenge the assumption that Asian Americans don’t face food insecurity problems and underscores the importance of disaggregating data by origin group.”
Further, the research reveals systemic obstacles Asian Americans face in accessing food, including cultural misunderstandings, concerns related to immigration status, and language barriers. For example, Filipino participants noted difficulties accessing food programs due to residency status and Vietnamese individuals often reported negative interactions with social workers. Vu advocates for “culturally competent solutions involving community voices that address the specific challenges faced by each origin group,” with a desire to influence future policy development.
Mentoring a team of undergraduate students, Vu guided her lab through the process of conducting the literature review: “Mentoring these students and seeing them develop essential research skills was one of the most rewarding parts of the project,” Vu says. Team members Victoria Huynh, Nhat-Ha Pham, and Suji Ro collaborated alongside Q. Eileen Wafford, a health sciences librarian at Galter, who ensured a thorough process of data gathering and review.
A parallel research paper, “A Mixed-Methods, Theory-Driven Assessment of the Sustainability of a Multi-Sectoral Preventive Intervention for South Asian Americans at Risk for Cardiovascular Disease,” was recently published in Implementation Science Communications. It examines research focused on the South Asian Healthy Lifestyle Initiative (SAHELI). This program addresses exercise, diet, and stress management among South Asian Americans, a population disproportionately affected by heart disease. While SAHELI’s success is rooted in its community-centered approach, Vu’s research revealed the difficulties in sustaining such programming as it competes for resources in a strained public health and healthcare system.
“These findings challenge the idea that once a culturally adapted program is developed, it will automatically continue,” Vu said. “In reality, such programs can struggle to survive when they have to compete with other needs and limited resources.”
The publication also identified strategies to support the longevity of these programming efforts, including integrating these initiatives with other health services offered by community partners and promoting community leadership in program development. It also benefited from strong team collaboration; Vu mentored Saihariharan Nedunchezhian, a medical student at Tulane, who assisted in qualitative data analysis, alongside a group of Feinberg co-authors. Importantly, Namratha Kandula, MD, MPH, a long-time collaborator and Vu’s K12 mentor, played an integral role in developing SAHELI and fostering partnerships essential for its success in Chicago’s South Asian communities.
Vu’s work in food insecurity has sparked national discussions, challenging the misconception that Asian Americans do not face notable barriers to food access. These discussions include Vu’s participation in a Health Affairs virtual forum and podcast, where she vocalized the importance of both cultural and linguistic competency in food assistance programming for immigrant communities.
In addition, her advocacy efforts for SAHELI’s long-term sustainability contribute novel insights to the field of implementation science, especially concerning the lasting viability of culturally adapted health interventions for underrepresented populations.
Vu is currently in the second year of her K12 fellowship, where she is developing a culturally cognizant digital health intervention aimed at improving HPV vaccination rates among Vietnamese individuals living in the United States. The intervention, which she aims to test in a 2025 clinical trial, will be inclusive of culturally tailored resources “such as educational videos featuring Vietnamese healthcare providers, storytelling videos with parents, and interactive remote consultations with community health workers,” Vu says.
Through this work and future projects, Vu aims to foster lasting impact in the healthcare landscape for immigrant and minoritized communities, ensuring that her research addresses disparities, builds a foundation for sustainable solutions in public health, and inspires the next generation of researchers.
Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number K12TR005104. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Written by Alex Miranda
