immigrants; new destinations; smaller cities; Asian Americans; health care; social services; cultural competence


Community Health and Preventive Medicine | Health Policy | Health Services Research | Inequality and Stratification | Public Health | Race and Ethnicity | Social Policy | Social Welfare | Urban Studies and Planning


Asian immigrants to the U.S. are settling in "new destinations," but there has been little research on their health care and social service needs. Our analysis of Census data to identify cities with the fastest Asian immigrant population growth (1990-2000) yielded 33 smaller cities in 13 states. The cities ranged in population from 7,677 to 86,660; were spread across 13 states in the Northeast, South, and Midwest regions of the US; and varied widely demographically. Pilot surveys conducted in 2009 indicated that, although many residents had positive attitudes towards immigrants, many were also concerned about job competition and dilution of American culture. Respondents reported a number of immigrant-targeted services but also service gaps and intergroup violence. We characterize smaller new destination cities' mixed response to their fast-growing immigrant populations as an "ambivalent embrace." Service gaps may be related to small city size and relatively small Asian immigrant population size, despite rapid population growth. Funding shortages were also cited as obstacles to cities' responsiveness, suggesting the importance of state and federal government aid.