Health status of Asian Americans

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Asian Americans have historically been perceived as a "

health disparities
have only gained focus in the past 10 years, with policy initiatives geared towards promoting healthcare access to Asian Americans rising to prominence even later. Asian Americans are defined as Americans of Asian ancestry and constitute nearly 5% of American's population as of 2003, according to the U.S. Census Bureau.[3] Yet, the Asian American population can hardly be described as homogenous. The term applies to members of over 25 groups that have been classified as a single group because of similar appearances, cultural values, and common ethnic backgrounds.[4] The Asian Americans commonly studied have been limited primarily to individuals of Cambodian, Chinese, Filipino, Hmong, Japanese, Korean, Lao, Mien, or Vietnamese descent.[5]

Health disparities

Asian Americans are a heterogeneous group. The racial class is composed of many different ethnicities and cultures. In addition to country of origin, individuals can differ in socioeconomic status, education level, immigration status, level of acculturation, and English proficiency.

hemophilia) were reported to be uncommon in all Asian ethnic groups.[10]

Cardiovascular disease

high blood pressure, cigarette smoking, obesity, and diabetes mellitus.[13] According to American Heart Association in 2016, around 19.5% of Asian Americans have high blood pressure.[12] In 2013, 18,819 deaths among Asians and Pacific Islanders were due to cardiovascular disease; 8,477 due to chronic heart disease; and 2,616 due to myocardial infarction.[12] Cancer, the second leading cause of death, contributed to 21.3% in 2017.[11] The prevalence of coronary heart disease among Asian Americans is estimated to be around 4.9%.[14]

Cardiovascular disease remains the leading cause of death for all Americans, and continues to disproportionally affect the Asian Americans who are disadvantageous in society due to various social determinants. These social determinants leading to health disparity include lack of language proficiency, health illiteracy due to lower education attainment, racial discrimination, economic instability and poor community engagement.[13][15] According to the National Institute on Minority Health and Health Disparity (NIMHD) sponsored lecture "Health Disparity Research in Diverse Asian American Populations in 2016", 70% of foreign-born Asian Americans were identified as having limited English proficiency, dissimilar cultural beliefs and behaviors, as well as unfamiliarity with the Western health care system and difficulty following instructions at the doctor's office.[16] Addressing the health disparities requires significant awareness, comprehension, and consideration for the growing diversity of Asian population, especially for the foreign-born older Asian Americans. Understanding the impact of social determinants on health equity is crucial to health care professionals and policy makers to reduce health disparities and improve the health equality among Asian Americans and the underserved populations.

Diabetes

With the adaptation of American culture, immigrant populations can be seen to have increased risks of diseases as Western diets are being introduced into their daily food consumption.[17] However, there is a heightened risk of type 2 diabetes amongst Asian Americans as its presence makes up 21% of the Asian American population, twice as high as non-Hispanic whites.[18][19] Due to various genetic and environmental factors, Asian Americans are more likely to develop type 2 diabetes than other racial and ethnic groups, even though their body mass index (BMI) tends to be lower.[19] Asian Americans have a higher percentage of body fat for their BMIs, which in turn elevates the risk of type 2 diabetes when BMIs are lowered;[20] they in fact may have a higher percentage of body fat which contributes to a greater risk of developing diabetes and other health concerns that are commonly overseen.[21] Because of their BMIs, which are usually lower than other racial and ethnic groups, there is a common misconception that they are not at much of a risk for developing type 2 diabetes. The World Health Organization, however, has suggested a lower BMI cutoff point in order to properly diagnose obesity for Asian Americans because of such low BMI levels.[22]

Though it is expected that as there is a higher risk of type 2 diabetes within the Asian American population that much research is being done to screen for diabetes efficiently, the rate of not diagnosing type 2 diabetes for Asian Americans is three times as high as non-Hispanic whites.[19] More than one in three people with diabetes are undiagnosed from improper screening, and this is particularly high for Asian Americans and Hispanics.[19] A possible reason for why this may be the case is because Asian Americans are not aware of their elevated risk of developing type 2 diabetes and therefore refrain from screenings. Having no access to health insurance or lack of utilization of health care due to language barriers as Asian immigrants may also contribute to the lack of screenings and increased likelihoods of undiagnosed type two diabetes.[23] Research on language barriers showed differences in diagnoses of diabetes for Asian Americans and Hispanics particularly compared to whites in America as clinicians are lacking physician-patient communication.[23] Another possibility is that the existence of the "model minority myth" prevents physicians from recognizing that such an elevated risk exists in Asian Americans, along with other common health issues.[24] Based on these possibilities, Chinese and Korean Americans are also less likely than other Asian American subgroups to take part in self-management practices for their diabetes while Asian Americans as a whole are not given the physician-led management resources to treat diabetes like other racial groups.[24]

In 2015, the American Diabetes Association (ADA) changed its guidelines for testing for diabetes for all Asian American adults who have a BMI of 23 or more instead of 25,[25] which launched campaigns like "Screen at 23".[26] Older Asian Americans have increased odds of diabetes or hypertension that still needs to be addressed.[23]

Hepatitis B

Hepatitis B is especially prevalent amongst Asian Americans. A study conducted between 2001 and 2006 that provided hepatitis B virus screenings to 3163 Asian Americans found that 8.9% of the population was chronically infected. Notably, 65.4% of those who were infected were unaware of their condition. Men were more likely to be infected than women, and hepatitis B infections were 19.4 times more likely in foreign born Asian Americans than in those born in the United States.[27] Hepatitis B is one of the leading causes of the development of cirrhosis and hepatocellular carcinoma (HCC). Cirrhosis and liver cancer are often interconnected, and having cirrhosis may heighten the risk in development of liver cancer.[28] Additionally, incidences of liver cancer amongst Asian Americans are 2 to 11 times higher than that of White Americans, depending on gender and ethnic group.[29]

Cancer

For Asian Americans, the leading cause of death is cancer, a factor unique to their racial/ethnic group. For every other racial/ethnic category, heart disease is the leading cause of death. Asian Americans exhibit the highest rates of cancers of the liver, cervix, and stomach. Additionally, Asian Americans have the highest rate of cancer for age categories 25–44 and 45–64, while it is just 45–64 for White people.[30]

The cancer burden that affects Asian Americans is unusual because of the nature of the cancers. Those with higher rates in Asian American populations are of infectious origin, such as

human papillomavirus leading to cervical cancer, hepatitis B virus leading to liver cancer, and Helicobacter pylori-induced stomach cancer.[31]
As more and more Asians immigrate to the United States, they adapt American customs, a phenomenon known as acculturation. This transition in lifestyles is associated with cancers attributed to dietary changes and sedentary living. There is an increase in colon and rectal cancer in Asian Americans due to dietary changes. This may be attributed to the increase in consumption of red meat, which is consumed less in Asia than in America. This manifests itself in the Asian American population in the San Francisco Bay area, where colorectal cancer rates are higher compared with rates of cancer in mainland China.[32]

Additionally, Asians born and raised in the United States experience a greater risk of getting breast cancer. Asian American women who reside in the United States for more than 10 years have an 80% greater risk for breast cancer compared with more recent immigrants from Asia.[33] Breast cancer is not the only cancer where this can be seen.

Overall, Asian and Pacific Islander men and women had lower rates of HPV-associated cancers than White men and women.[34]

High rates of smoking also contribute to high rates of lung cancer. Lung cancer rates for Southeast Asians are 18 percent higher than for White Americans.[35] 28.9% of all Asian Americans smoked at one point in their lives. Current rates of smoking stand at 14.8%. Smokers are more likely males (22.6%) than females (7.3%).[36] However, high smoking prevalence is concentrated around certain areas. For example, Vietnamese men in Franklin County, Ohio, were found to have a smoking rate of 43.4%.[37]

Asian Americans, between all racial/ethnic groups in the United States are the only group with the leading cause of death being cancer.[31]

Another contributor to the high rates of cancer in the Asian American community are disparities stemming from cultural differences and the health care system. Language barriers can prevent individuals from thoroughly understanding medical information like risks, screening, and possible solutions.[31][38] There also continues to be a lack of access to medical interpreters[38] and lack of extended help to individuals whose first language is not English.[39] Many Asian American cultures have negative stigmas associated with diagnosis and medical care. These stigmas and emotions include feelings of alienation if diagnosed, negative stigmas about Western medicine, poor experiences with American health care, and possible medical practices that go against cultural or religious beliefs.[40][41] Additionally, it is commonly believed that cancer screening and treatment only occurs with the onset of symptoms.[42] Alongside these cultural barriers, Asian Americans also face disparities in the health care system. Many are faced with lack of insurance, primary care, resources for non-English speaking individuals, minimal outreach to their communities, and lack of accessibility to quality health care.[43] With being faced with both cultural and systematic barriers, individuals often are faced with experiences that deter them from future medical care.[43]

Mental health

Main article: Mental health of Asian Americans

The number of epidemiological and population-based studies focused on Asian American mental health is limited. Mental health problems can be measured using symptom scales rather than

DSM-III and DSM-IIIR mental disorders among Asian Americans and found that there was a low prevalence in psychiatric disorders compared to European Americans.[47][48] However, these studies only sampled English-speaking Asian Americans and did not have large sample sizes, so they are not necessarily representative of the Asian American population. The Chinese American Psychiatric Epidemiological Study (CAPES) was the first large-scale study to examine the incidence of DSM-IIIR psychiatric disorders among primarily Chinese American immigrants. It found that 6.9% of the participants reported having major depression during their lifetime,[49] compared with the 17.1% prevalence in Americans in the NCS study[47] and 4.9% in the ECA study.[48] The lack of accurate data on the mental health of Asians contributes to unjust health policy. Lawmakers need to expand the collection and publication of disaggregated health data on various Asian communities to provide systematic changes to mental health access.[50]

The statistics on mental disorders in Asian American populations may be lower than the actual incidence. Mental illness is highly stigmatized in many Asian cultures, so symptoms are likely underreported.

psychosomatic symptoms including headache, anxiety, insomnia, heat sensation, and indigestion that arises from familial stressors like infidelity, in-law conflict, and oppressive patriarchal family structure.[52] An inability to express frustrations due to cultural expectations of family harmony leads to a buildup of emotions and the resulting psychosomatic symptoms.[52] Because of this kind of cultural variation in mental disorders and expression of symptoms, lack of health care access, and an underutilization of mental health resources, researchers have difficulty obtaining accurate statistics about Asian American mental health.[53] Various organizations are providing more visibility and encouragement of utilizing mental health resources. One entity, called the Asian Mental Health Collective, aims to normalize and de-stigmatize mental health within the Asian community. They provide resources and a directory of Asian therapists in the U.S., of which 220 out of a total of 587 speak an Asian language.[54]
With over dozens of Asian languages, there needs to be more access to non-English speaking mental health providers. Asians and Asian American are not a monolith.

Some of the key factors that affect mental health in Asian Americans include acculturation, language barriers among parents and children, and intergenerational conflict.[49] Acculturation describes the physical and psychological changes that occur when two cultures meet and encompasses the changes that occur when immigrants and refugees assimilate into a new culture.[55] Immigration to a country with a vastly different culture can be considered a stressful life event that leads to culture shock, migration shock, and acculturative stress.[49] Frequently diagnosed disorders in recent immigrants include depression, PTSD, anxiety, and schizophrenia, though the rate of incidence of mental health problems decreases with increased assimilation and time in a new country.[56] Refugees from Southeast Asian countries like Cambodia and Laos also experience high rates of PTSD from war traumas and resettlement stressors.[57] Varying English proficiency among immigrant Asian parents can be a source of conflict between parents and children. One study shows that in immigrant Chinese families, the level of English proficiency in the parental generation correlates with indicators of child and adolescent psychological well-being.[58] Another factor that contributes to intergenerational conflict is differing cultural values between the host society and the parents. This serves as a source of stress and psychological duress for American adolescents, as they are socialized into the host culture while still expected to maintain their parents' heritage.[59]

Among older adult Asian Americans

In 2003, the Asian American Federation of New York presented a research study in which demonstrated that there are health disparities in mental health problems among older Asian Americans.[60] The study found that the suicide rate among Asian Americans 65 years and older is double that of other older ethnic groups. Additionally, the estimated rate among older Asian Americans in the US in 2018 is 4.5% of 65 years and over.[60] Asian Americans are experiencing higher rates of depression compared with the general elderly population in the US, and one of the leading causes of death in the US for older Asian Americans is suicide.[60] The study also found that having depressive symptoms among older Asian Americans (or their mental health) is significantly associated with their general physical health, physical and social functioning and vitality. The study recommends meeting older Asian Americans' needs of culturally and linguistically proper social services and mental health agencies.

Drug use

Asian Americans generally have low rates of substance use, but contain disparities when disaggregated into ethnic groups, gender, and the type of drug used. Compared to other ethnic groups, research finds that Japanese and mixed-race Asian Americans have increased likelihoods of drug consumption while prescription drug abuse risk is high for Filipino Americans.[61] Gender provides a variation in risk as well. Chinese and Vietnamese females, compared to their male counterparts, have higher probability of alcohol addiction.[61] Asian American college-aged women who have depression are found to have positive correlation with drug and alcohol consumption.[61] Although Asian American youth substance abuse rates have increased over the years,[62] there has not been much research conducted on this.

Self-esteem

Self-esteem, consisting of self-evaluations and judgments of one's value or self-worth,[63] plays a significant part in Asian Americans' psychological well-being. A number of studies have revealed that Asian Americans are suffering from lower self-esteem and higher levels of depression relative to other racial/ethnic groups. The problem of low self-esteem is more prevalent among first generation immigrants and the U.S.-born Asian Americans with immigrant parents.[64]

Low self-esteem can lead to a number of negative outcomes. For example, Zhou and Bankston's (2002) research on the connection between the academic performance and self-esteem of Asian American students indicates that self-esteem is negatively linked with level of stress and angst, such that the lower their self-esteem, the higher their reported levels of stress and angst. This study also found that Asian American students are more prone to depression, insecurity, and fear of failure.[64]

Many factors contribute to the low self-esteem of Asian Americans. One such factor is the collective cultural identity derived from fundamental Asian cultures such as Confucianism.[65] The collective culture in Asian society underscores one's membership in social groups, in contrast to the individualist culture commonly found in the United States which stresses person's uniqueness and independence.[66] Asian Americans tend to build their self-esteem based on other people's evaluations and attitudes of themselves instead of their personal achievements and self-evaluations.[67] Another influencing factor comes from family. Compared with white parents, Asian American parents have more control and authority over their children, while offering children less encouragements, which plays a role in the low self-esteem of many Asian American students.[68] The influence of authoritative parenting is more notable in immigrant Asian American families. For example, many immigrant parents have high expectation for their children, trying to build their place and identity in a new environment through the achievement of their children. This parental pressure results in not only higher academic performance but greater stress and lower self-esteem.[64]

Additionally, apart from the historical racial incidents including anti-Asian movements and anti-immigration legislation, Asian Americans are also victims of racism in the United States. According to the Annual Audit of Violence Against Asian Pacific Americans conducted by the NAPALC in 2003, Asian Americans are one of the targeted groups of "racially motivated harassment, vandalism, theft, physical assault, and in some cases, homicide".[69] Moreover, the discrimination in daily life are significantly injuring Asian Americans' well-being, both physically and mentally. In the face of racially motivated incidents, students are reported to have "feelings of helplessness, depression, psychosomatic symptoms, and a loss of face".[69] However, it is reported that Asian Americans' own perception of racism against them is limited and the problem and needs caused by racism are often neglected by society, masked by stereotypes such as "model minority" and "honorary whites". It has been reported that self-esteem is positively related to people's ethnic identity and the extent to which they explore their ethnic identity. Research conducted by Umaña-Taylor and Fine in 2002[70] shows that self-cognition from effective self-exploring and the attempt to build racial perception and ethnic identity is conductive to enhancing the self-esteem of minority population including Asian Americans.

Other

Asian Americans have a higher prevalence of tuberculosis compared with all other ethnic groups, at 22.4 per 100,000 individuals.

Pacific Islanders stand at 20.8 cases per 100,000 individuals. According to the Centers for Disease Control and Prevention, the average tuberculosis rate is 3.9 cases per 100,000 individuals. The rate for foreign-born persons was around 11 times higher than among U.S.-born persons.[71]
While these statistics have been falling, it is important to note that tuberculosis is still a major health discrepancy issue among Asian Americans.

Asian Americans also have a greater vulnerability to certain refractive errors, like myopia.

Asian American women are at higher risk for getting

lactose intolerant, or have trouble digesting dairy products.[72] Furthermore, less time spent outdoors means less vitamin D production, which translates to less calcium absorption. In many Asian cultures, people feel that women with lighter skin tones are more attractive. These factors are further compounded by inadequate knowledge about osteoporosis and calcium consumption among Asian women.[73]

Barriers to health care access

At first glance, Asian Americans are far from being classified as a vulnerable population. This error has been perpetuated by many reports that classified Asian Americans as a single body, rather than as differentiated groups. As immigrants, Asian Americans are subject to barriers to accessing health care. Out of all barriers, financial, cultural, communication, and physical were the most often reported.[74] Financial barriers exist through the lack of health insurance. Most Asian Americans receive their health insurance through work. Koreans are most likely to be uninsured, given their self-employment status.[75] Because of the lack of health insurance, many of the most vulnerable individuals do not go for regular checkups, and do not have a regular primary care provider. Furthermore, out-of-pocket payments for care are relatively high compared with immigrant's homeland, leading to a reluctance to pay.

Asian Americans tend to avoid visiting the hospital unless absolutely necessary, so many infections remain unnoticed until they develop serious symptoms, and by then the infection may have led to cancer. Of all the racial/ ethnic groups, Asian Americans are the least likely to have visited a physician within the past 12 months.[76] Without routine checkups and the prompting of their physicians, Asian Americans are unlikely to receive their regular round of vaccinations, mammograms, and screenings. Asian American women over the age of 40 are the least likely racial/ethnic group to receive mammograms, and those who are diagnosed have more advanced stages of cancer compared to Caucasian women diagnosed.[77] Many of these cancer burdens on the Asian American population are unnecessary and preventable with increased screening and vaccinations, especially because many cancers associated with this category are of infectious origin.

Many Asian Americans also face physical barriers to health care access. Lack of transportation prevents many individuals from seeking out health care that may be further away from their residence.

Furthermore, there appears to be an additional language barrier, with those that have limited English proficiency reporting even fewer mammograms than Asian Americans who are proficient at English.

culturally sensitive physicians. Over two-thirds of Asian Americans are immigrants,[82] with one-third of the total population possessing limited English proficiency.[83] Immigrants and non-English speakers are especially vulnerable for low health literacy. Many Asian Americans are uncomfortable with communicating with their physician, leading to a gap in healthcare access and reporting. Even persons comfortable with using English may have trouble identifying or describing different symptoms, medications, or diseases.[84]
Cultural barriers also prevent proper health care access. Many Asian Americans only visit the doctor if there are visible symptoms. In other words,
preventive care is not a cultural norm. Also, Asian Americans were more likely than white respondents to say that their doctor did not understand their background and values. White respondents were more likely to agree that doctors listened to everything they had to say, compared with Asian American patients.[85] Lastly, many beliefs bar access to proper medical care. For example, many believe that blood is not replenished, and are therefore reluctant to have their blood drawn.[86]

Substance abuse treatment

There is a rather low representation of Asian Americans as clients in the mental health system, particularly in substance abuse treatment. Many Asian Americans are first-time clients at substance abuse treatment facilities.[87] More Asian Americans are presenting treatment for the first time than they have since the last 10 years. This has led to an increase in the number of Asian Americans seeking enrollment for treatment. The AAPIs that do enroll are contributing to a larger healthcare disparity between those that say they need the treatment versus those who are present at the treatment.[88] According to American Psychological Association, Asian Americans regard familial and social circles as their main support for life problems and view institutions as the last option for support.[88] As a result, treatment facilities may be accustomed to needs of the majority of non-Asian clients that take part in the programs. Considering the abundance of ethnic groups under Asian American population, lack of exposure to Asian American clients can be problematic as the system may not be culturally aware of or empathetic towards this diverse population's needs.

Relationship with drugs

Exploring the relationship Asian Americans have with drugs may help with understanding how to prevent and potentially redefine warning signs for drug abuse in this community. In more recent years, there has been attempts to explore the Asian American perceptions on drugs. Reasons for why people use substances vary depending on the ethnic subgroup and many other factors. Although research on this topic is limited, a study was done at music festival scenes where Asian Americans reported using drugs as means to express their identities or lifestyle tastes.[89] In terms of alcohol misuse, cultural identity struggles, language barriers, and acculturation may correlate with likelihood of alcohol misuse as a means of coping.[61] Each ethnic subgroup has unique life circumstances that impact how Asian Americans make decisions relating to drug use.[90]

Improving health and healthcare delivery

Policy approaches

Up to the 1990s, there was very little research into Asian American health.[

federal grants were directed towards Asian American health and research.[citation needed
]

With warnings coming in from researchers, the Asian American and Pacific Islander community worked to establish institutions for Asian American and Pacific Islander health research.

the Office of Minority Health
.

The federal government has also begun reporting Asian American census data in separate ethnic groups. The

US Census Bureau collects data on 25 Asian and 23 Pacific Islander subgroups. However, many of the NIH's surveys are erratic in their labeling of ethnic groups of Asian Americans, with some having different number of ethnic groups.[92]
Both Presidents
executive orders to establish the President's Advisory Commission on Asian American Pacific Islanders. The committee, in 2003, advised the creation of a national plan for the improvement of health in Asian and Pacific Islander communities.[93]
Policy measures that specifically target Asian Americans, however, are yet to be seen on the federal level. Uehara et al. (1994), as well as others, argues that treating Asian Americans as a single category can lead to inaccurate conclusions, but others argue that this homogenization is necessary in this neoliberal state, and it is just not feasible to evaluate data and provide specific healthcare to every single Asian minority.[94]

Grassroots movements

With the lack of policy initiatives from the government, Asian Americans have increasingly taken to grassroots movements to improve their health status.

Because of insurance, costs, and a variety of other reasons, the types of services needed to meet the needs of Asian minority communities are not usually offered at private hospitals. Federally qualified health centers (FQHCs) are legally mandated to provide primary care for medically underserved communities, and thus are ideal settings to implement and provide culturally and linguistically inclusive services to Asian immigrant communities. Asian activists and organizations were influenced by the Black Panther Party's work, especially surrounding community healthcare services and advocacy for underserved populations in Oakland and within the area during times of civil unrest and movements such as Civil Rights, Yellow Power, United Farm Workers Movement, Third World Liberation Front, etc. Movements such as these, as well as "the War on Poverty programs …  incentivized non-black minority community organizers to form panethnic [community service organizations] to gain access to state resources and serve the economically disadvantaged in their communities."[95] These civil rights movements were an inspiration for subsequent social justice movements. In response to an increasingly neoliberal and multicultural state that saw race as a neutral cultural concept, with the government lumping all Asian identities together in official censuses and data, "in the late 1960s, Asian American college and community activists of diverse racial backgrounds rallied around a deliberately political and strategic panethnic "Asian American" identity that was grounded in a radical political consciousness."[94] Asian Americans included Koreans, Chinese, Japanese, Pacific Islander, etc. The "state concessions (funding) to minority demands offered eager second- and third-generation Asian American activists new opportunities to establish community-based organizations to serve the people", and inspired by the civil rights movements and resulting ethnic power movements, these activists "sought to channel these new state funds into social service programs for child care, youth, affordable senior citizen housing, and health care."[94]

Some of these activists founded Asian Health Services, a Community Health Center that strives to provide affordable, accessible healthcare to immigrant (mostly Asian) communities in the Oakland area. Asian Health Services focuses its work largely on serving those who are historically marginalized (communities of color, non-English speaking, immigrants/refugees, etc.).

Photographer Corky Lee created a healthcare fair in New York's Chinatown in 1971 that provided free services for conditions like tuberculosis testing, sexually transmitted infections, and lead poisoning. He was inspired by social service programs created by the Black Panthers.[96]

The Asian & Pacific Islander American Health Forum (APIAHF), established in 1986, has worked to influence policy and mobilize individuals to improve Asian and Pacific Islander health. Among its many activities, APIAHF has a history of filing briefs of

Florida v. United States Department of Health and Human Services. On behalf of 39 organizations dedicated to improving the health of Asian and Pacific Islander communities, the APIAHF brief details the needs of the Asian American community.[97]

Community-based participatory research

To address the deficiencies in Asian American healthcare delivery, national organizations such as the Asian and Pacific Islander American Health Forum (APIAHF) and the Association of Asian Pacific Community Health Organizations (AAPCHO) have taken on community-based participatory research initiatives by connecting with local community partners to increase research and knowledge about historically underrepresented populations.[98] Both of these organizations were originally formed to address the lack of Asian American voices on issues that affect the health of their communities.[98] AAPCHO and APIAHF work with community health centers in the United States to research and develop data on their patients.[98] By working with organizations within the Asian American community, larger organizations have more data on the communities they aim to serve and are therefore better equipped to created informed policy and provide knowledgeable care.[98]

To better support Asian American health, studies have been done to establish best practices for community-based participatory research. One organization engaging in this research is the Center for the Study of Asian American Health (CSAAH) which follows three principles: "(1) creating and sustaining multiple partnerships; (2) promoting equity in partnerships; and (3) commitment to action as well as research".[99] Some strategies that CSAAH deployed included working with both health and non-health organizations to address the fact that many Asian Americans seek medical information from non-health centers.[99] They have also worked with organizations that represented specific Asian ethnic groups, making an effort to better understand the diversity within a historically homogenized group.[99]

Peer-to-peer education

Peer-to-peer education for the spread of information

Peer education is effective in sharing information with its target population since people are more likely to listen to and engage with information when it comes from people with similar backgrounds.[100] Youth who are often conflicting with the adults in their life find peer education to be especially useful.[100] Peer health education trains students to educate other students on sexual health topics, and since youth often rely on their peers for information, training students is a tactic that organizations, such as Asian Health Services (AHS) in Oakland, CA, use to increase the spread of reliable information.[100][101]

Major factors as to why Asian American youth have poor sexual health communication with their providers are confidentiality concerns, lack of knowledge about sexual health, and hesitancy and discomfort with discussions of these topics.[102] By utilizing peer-led workshops and project teams, organizations, such as Asian Health Service Youth Program (AHSYP), engage in approaches that can improve knowledge and attitudes about sexual health topics for Asian American adolescents.[103] Additionally, by using social media and technology to educate teens about reproductive and sexual health, Asian American youth have greater privacy to learn about and engage in these conversations, helping address disparities that arise due to cultural stigma.[104]

References

  1. ^
    S2CID 202274680
    .
  2. S2CID 22775032
    .
  3. ^ "Table 1: race and Hispanic or Latino origin for the United States: 2000 to 2003" (PDF). United States Census Bureau. Retrieved 20 February 2016.
  4. S2CID 70479878
    .
  5. ^ Uba, Laura (1994). Asian Americans: Personality Patterns, Identity, and Mental Health. New York, NY: The Guilford Press.
  6. ISBN 978-0-8147-9691-7
    .
  7. ^ "Preterm birth by Filipino women linked to genetic mutational change". 14 January 2014.
  8. ^ Hayes D, Shor R, Pieron P, Roberson E, Fuddy L (November 2010). "Premature Birth Fact Sheet" (PDF). Honolulu, HI: Hawai'i Department of Health, Family Health Services Division.
  9. PMID 22406228
    .
  10. ^
    S2CID 22096756
    .
  11. ^
    doi:10.1037/e376252004-001. {{cite journal}}: Cite journal requires |journal= (help
    )
  12. ^
    doi:10.1163/2210-7975_hrd-1296-2015001. {{cite journal}}: Cite journal requires |journal= (help
    )
  13. ^
    OCLC 1086378731.{{cite book}}: CS1 maint: multiple names: authors list (link
    )
  14. ^ Statistical Fact Sheet 2012 Update: Asians & Cardiovascular Diseases (PDF). American Heart Association. 2012. Retrieved 28 May 2012.
  15. ^ ". Office of Minority Health. (n.d.)".
  16. ^ "NIMHD Grantee Talks Asian Health Disparity Research" (Press release). National Institute on Minority Health and Health Disparities. 17 August 2022.
  17. S2CID 36538373
    .
  18. ^ "Asian American – the Office of Minority Health".
  19. ^
    PMID 26348752
    .
  20. PMID 24974975
    .
  21. PMID 14574337
    .
  22. S2CID 15637224
    .
  23. ^
    PMID 29736755
    .
  24. ^
    PMID 25905853
    .
  25. PMID 25538311
    .
  26. ^ "Screen at 23". The National Council of Asian Pacific Islander Physicians (NCAPIP). Retrieved 26 January 2019.
  27. PMID 17654490
    .
  28. ^ "Liver Cancer Risk Factors". cancer.org. Retrieved 2018-04-26.
  29. ^ "Chronic Liver Disease – The Office of Minority Health". minorityhealth.hhs.gov. Retrieved 2018-04-26.
  30. PMID 11567423
    .
  31. ^
    S2CID 27078800
    .
  32. PMID 2066247
    .
  33. PMID 8230262
    .
  34. ^ "How Many Cancers Are Linked with HPV Each Year? | CDC". 14 December 2021.
  35. ^ The Asian American/Pacific Islander Population-Health Status (PDF). Colorado Department of Public Health and Environment. Retrieved 25 May 2012.
  36. PMID 17278411
    .
  37. PMID 11720415
    .
  38. ^
    PMID 21687826
    .
  39. S2CID 254379247
    .
  40. S2CID 25871534
    .
  41. PMID 22537294
    .
  42. S2CID 33239504
    .
  43. ^
    S2CID 31976476
    .
  44. ^ Office of the Surgeon General (1999). "Mental health: Culture, race, ethnicity – supplement". Substance Abuse and Mental Health Services Administration.
  45. PMID 887955
    .
  46. PMID 8406223
    .
  47. ^
    PMID 8279933
    .
  48. ^ a b Robins, LN; Regier, DA (1991). Psychiatric Disorders in America: The Epidemiological Catchment Area Study. New York: Free Press.
  49. ^ a b c Rhee, Siyon (2009). Handbook of Mental Health and Acculturation in Asian American Families. Berkeley: Humana Press. pp. 81–94.
  50. ^ "4 Ways to Improve Access to Mental Health Services in Asian American Communities". Center for American Progress. Retrieved 2022-10-31.
  51. ISSN 1932-6270. Archived from the original
    (PDF) on 2012-08-13.
  52. ^
    S2CID 7042836
    .
  53. S2CID 144267796
    .
  54. ^ "US Therapist Directory". Asian Mental Health Collective. Retrieved 2022-10-31.
  55. S2CID 220262608
    .
  56. S2CID 144473450
    .
  57. PMID 10689600
    .
  58. OCLC 53127002
    .
  59. doi:10.1300/j285v04n01_04
    .
  60. ^ a b c The Asian American Federation of New York. "Asian American Elders in NYC: A Study of Health, Social Needs, Quality of Life and Quality of Care" (PDF).
  61. ^
    PMID 28673532
    .
  62. ^ Wong and Paul, 2005[full citation needed]
  63. PMID 12484642
    .
  64. ^
    S2CID 144337958
    .
  65. S2CID 2368634
    .
  66. S2CID 2390437
    .
  67. S2CID 144903681
    .
  68. PMID 2221563
    .
  69. ^
    PMID 16881751
    .
  70. ^ Toomey, R.; Umana-Taylor, A. (2012). "The role of ethnic identity on self-esteem for ethnic minority youth: A brief review". Prevention Researcher.
  71. ^ Trends in Tuberculosis, 2010. Centers for Disease Control. Retrieved 28 May 2012.
  72. ^ "Osteoporosis and Asian American Women". National Institute of Arthritis and Musculoskeletal and Skin Diseases. National Institutes of Health. June 2010. Retrieved 27 May 2012.
  73. S2CID 72647847
    .
  74. PMID 19663748
    .
  75. ^ Health Coverage and Access to Care Among Asian Americans, Native Hawaiians and Pacific Islanders (PDF). The Henry J Kaiser Family Foundation. 2008. Retrieved 28 May 2012.
  76. OCLC 920463469.[page needed
    ]
  77. PMID 10931471
    .
  78. ^ a b Ponce, N; Gatchel, M; Brown, ER (2003). "Cancer screening rates among Asian ethnic groups". UCLA Center for Health Policy Research.
  79. ^ California Department of Health Services, Immunization Branch (2002). "Fall 2001 seventh grade assessment results". Sacramento: California Department of Health Services.
  80. doi:10.1002/(sici)1520-6629(199703)25:2<141::aid-jcop3>3.0.co;2-0
    .
  81. PMID 889163
    .
  82. ^ Roberts, Sam (22 January 2010). "Census Figures Challenge Views of Race and Ethnicity". The New York Times. p. 13.
  83. ^ Health Inequities in the Asian American Community (PDF). Asian American Justice Center. Retrieved 29 May 2012.
  84. S2CID 205942726
    .
  85. PMID 15009790
    .
  86. OCLC 918478366.[page needed
    ]
  87. PMID 20297752
    .
  88. ^
    PMID 20428303
    .
  89. PMID 21822339
    .
  90. PMID 14667425
    .
  91. ^ "History of CSAAH". NYU Langone Medical Center. Retrieved 27 May 2012.
  92. PMID 20858884
    .
  93. ^ President's Advisory Commission on Asian Americans and Pacific Islanders (2003). Asian Americans and Pacific Islanders Addressing Health Disparities: Opportunities for Building a Healthier America. The White House.
  94. ^
    ProQuest 1440828002
    .
  95. S2CID 234399063
    .
  96. ^ Wang, Claire (3 March 2021). "Losing generation of activists who fought racism proves need for Asian American studies". NBC News.
  97. ^ Brief for the APIAHF, et al. as Amicus Curiae, Florida v. United States Department of Health and Human Services. Here, the Asian & Pacific Islander American Health Forum filed the amicus curiae brief, which appears in the case abbreviated "Florida v. U.S. Dept. of Health and Human Svcs." (PDF). 2012. Retrieved 30 May 2012.
  98. ^
    PMID 22643786. Project MUSE 468608
    .
  99. ^
    PMID 19081761. Project MUSE 215484
    .
  100. ^
    PMID 8514955
    .
  101. ^ "Asian Health Services".
  102. S2CID 146893649
    .
  103. S2CID 20761689
    .
  104. PMID 30153129
    .
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