My grandmother, born Aileen Yumiko Hamamoto, remembers World War II vividly. At age 3, my grandma was fingerprinted and received her very first ID tag that marked her as Japanese. She can recall soldiers patrolling the beaches of Maui, and her father digging up a bomb shelter in their backyard.

Through it all she rooted for the Americans against the Japanese. She felt American –– but she was not labeled as such.

Fast forward 79 years to March 2020: the COVID-19 pandemic struck, bypassed national borders and killed thousands in just a few months. My grandmother hunkered down in her home, facing yet another world-altering event. COVID-19 shone a light on persistent health inequities in the United States.

Black, American Indian, Alaska Native, Pacific Islander, Latino/a/é and Asian Americans were dying from COVID-19 at disproportionate rates compared to white Americans.The reason? Structural racism. Structural racism creates conditions that make white Americans generally healthier than minoritized Americans. COVID-19 inserted itself into this racist system, wreaking havoc on communities of color.

For Asian Americans, structural racism is at its most insidious as the “model minority myth.” The model minority myth asserts that Asian Americans are the gold standard for immigrants, the ones who have “made it” in America. During COVID-19, hateful rhetoric spurred on by the Trump Administration gave people the confidence to hurl insults, beat elders and attack Asians on the streets. Asian Americans were scapegoated with phrases like “kung flu” and “the Chinese virus” that positioned COVID-19 as a distinctly Asian problem. COVID-19 violently proved there is no such thing as a model minority.

At the root of this anti-Asian hate lay the assumption that Asians in America are not American. Just like my grandmother during World War II, Asian Americans in 2020 were labeled as “other.” 

The racism and othering of Asian Americans during COVID-19 produced immediate and long-term mental health impacts, especially for women. Recent studies demonstrate the link between racism and poor mental health for Asian Americans during the pandemic and Asian American women reported the highest number of racist incidents.

Racial discrimination and sexism created a unique set of mental health challenges during the pandemic, including emotional strain (e.g., feeling hopeless, stressed, angry), social anxiety and concern for other Asian Americans. Asian American women were also at higher risk for worry and psychological distress during the height of COVID-19. My grandmother was lucky, in some ways. Although she lost her husband seven years ago, she had an oversized Miniature Pinscher named Buddy and had my parents a 25-minute drive away. But when the rise in anti-Asian hate crimes took off, I told my mom how scared I was for my grandma.

My mom responded with a memorable anecdote, in which my grandmother proudly proclaimed she would fight anyone who tried to hurt her (Buddy, for the record, would have been no help). I laughed, but I also felt a deep pang.

What must that be like, to have lived your whole life as an American, but only conditionally? 

Structural racism is vicious. Asian Americans live in an imposed façade of invisibility in the United States. We are the “good” minorities, the ones who have assimilated just enough to satisfy white America.

But if COVID-19 taught me anything, it is that Asian Americans are not in control of their own narratives. So how do we break the cycle of othering Asian Americans, of treating Asian Americans like they will always be visitors in this country?

First, we need to collect data separately for different Asian American ethnicities. Asian Americans are a beautifully diverse group, with different languages, ethnicities, cultures and immigration histories. Let’s tell their stories.

Second, we need to teach Asian American histories.

Japanese internment during World War II was a footnote in my high school history courses, a shameful attempt to hide the culpability of the U.S. government.

Third, we need to acknowledge that historical and contemporary trauma impact the mental health of Asian Americans and offer culturally responsive mental health care.

And finally, we need to address the violence of structural racism and use a lens of intersectionality to better understand the experiences of people like my grandmother. I wish for a country where my Japanese American grandmother no longer feels like she must fend off violence because she is not seen as American. A country where people won’t insist, “but where are you from?” when she says she lives in Seattle.

Aileen Yumiko Carter (née, Hamamoto) was born in the territory of Hawaii, got married the year it became a state and has lived her entire adult life in Washington state. She is no longer that little girl carrying around an ID tag.

Why does this country still see her as such?

Tonayo Crow is a Master of Public Health Student in the Community Health Promotion program at the University of Minnesota School of Public Health.