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Health Promotion:
Asian Americans
Kevin Tao, Calvin Brasor, and Rhianna Mendez
Demographics of Asian
Americans
Who are Asian Americans?
● Asian Americans (AAs) are a diverse ethnic
group originating from nearly 50 different
countries...
Highest State Populations
● California - 4,155,685
● New York - 1,169,200
● Hawaii - 703,232
● Texas - 644,193
● New Jerse...
Health Disparities Facing
Asian Americans
Health Disparities
1. The two leading causes of death for Asian Americans in
the U.S. are cancer and cardiovascular diseas...
Cancer
● AAs are the only racial/ethnic group in the U.S. who
experiences cancer as the leading cause of death
● Asian sub...
Contributing Factors for
Disparities
Barriers to Care
● Low socioeconomic status
○ Two million Asian Americans do not have insurance
in the U.S.
● Language
○ l...
Model Minority
● Myth: AAs are healthy, wealthy, and wise.
○ AAs are a small and exceptionally healthy because of
socio-ec...
Generalizations About Asian
American Cultural Norms
World Views
● Naturalistic: harmony with environment
● Time is an unlimited continuum
○ birth and death are not absolute o...
Explanatory Model of Illness
Holistic
● Chinese: balance of hot & cold
○ use of herbs, massage, thermal treatments,
acupun...
● Most Asian cultures are collectivist
○ People view themselves as a member of a group
● What is best for the group
○ Depe...
Religion & Spirituality
● Buddhism
○ one with nature
● Confucianism
○ Focus: world & family (instead of god & afterlife)
●...
Traditional Belief
● Beliefs:
○ Fatalism
○ Karma
○ Harmony with nature
○ Cooperation
○ Spiritualism
**Herbalist doctors ar...
Health Habits/Preferences
● Social Orientation: Family
● Family Makeup: Extended
● Primary Relationship: Parent-child
● Fa...
Protective Factors
● "There is little information provided about
the Protective factors among the Asian
American groups." ...
Health Literacy
● 2000 census:
○ 4 million AA had Limited English
Proficiency
○ 73% of AA do not speak English in their
ho...
Discrimination
● Strained history with United States
○ Chinese Communism
○ Vietnam War
○ Korean War
○ World War II- Japane...
Colorectal Cancer
Colorectal Cancer (CRC)
● 2nd
most diagnosed cancer among AA
● Cancer that begins in the colon or rectum
○ begins as a pol...
Rates
Source: Data Evaluation and Publication Committee of the North
American Association of Central Cancer Registries (19...
Colorectal Cancer Prevention
● Colonoscopy
● Lifestyle
○ Avoid excess red meat, alcohol, and tobacco
○ Maintain good BMI &...
Health Promotion Program #1
Asian American Health
Initiative
● Formed in January 2005 to increase
awareness about cancers by:
○ Providing culturally c...
Outreach and Education
● Health Fairs and Health Education Seminars
provide:
○ Educational materials in many different asi...
Media Campaign
● Many Asian Americans use
ethnic media sources
● Asian American Health
Initiative regular launches
health ...
Screening Services
● Free screening for colorectal cancer are
provided for eligible Asian Americans
residing in Montgomery...
Effectiveness
● Breaks down language barriers
● Provides tailored care for individuals
● Plentiful network of providers fo...
Improvements
● Enhance research efforts
○ A lack of health data on Asian Americans contributes
to certain health dispariti...
Health Promotion Program #2
The Asian American Network for Cancer
Awareness, Research and Training
● Founded in 1999 and launched in 2000
● Designated...
Outreach
● Locations:
○ Sacramento, San Francisco, Los Angeles, Seattle, and Honolulu.
● Members:
○ Chinese Community Heal...
Education
● Focus:
○ Cambodian, Chinese, Filipino, Hmong, Korean, and
Vietnamese ancestry
● Education is tailored to each ...
Media Campaign
● Presentations & publications on studies and
research have been provided to AA
communities.
● Holds public...
Effectiveness
● 1,051 outreach activities
● produced 166 peer-reviewed publications
● secured $64.2 million in total grants
Improvements
● Expansion to other regions of the U.S.
● Expansion to other Asian-American
subpopulations
Health Promotion Program #3
Effective Colorectal Cancer Education for Asian
Americans: A Michigan Program
Health Asian American Project
● In 2005- 200...
Outreach
● Subgroups
○ Asian Indian, Chinese, Filipino, Hmong, Japanese,
Korean, Vietnamese
● Recruitment
○ Association of...
Education
● Fairs that promote health education
○ Presentation on early detection with on sight
translation
● Educational ...
Media Campaign
● Newspaper advertisements
● Flyers in grocery stores
● Coverage in asian language media
● Used sub-group's...
Effectiveness
● Effective
● Evidence-based education evaluation
○ showed a "significant increased knowledge and
attitudes ...
Improvements
● For public policy purposes:
○ program would need to include more AA without
health insurance
● Could improv...
Suggestions for the Future
Steps to Take in Improving
Quality and Access
● Need to absolve model minority
○ acknowledge AA population growth rate
○ u...
References
● Ritter, Lois & Hoffman, Nancy, (2010). Multicultural Health. ISBN-978-0-
7637-5742-7
● Kline, Michael and Huf...
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Health promotion: Asian american health disparities

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Health Promotion: The Burden of Disease in Asian American Populations; An analysis of Cancer Prevention and Treatment Programs for Asian Americans

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Health promotion: Asian american health disparities

  1. 1. Health Promotion: Asian Americans Kevin Tao, Calvin Brasor, and Rhianna Mendez
  2. 2. Demographics of Asian Americans
  3. 3. Who are Asian Americans? ● Asian Americans (AAs) are a diverse ethnic group originating from nearly 50 different countries ● There are over 800 languages and dialects spoken among Asian American groups. ● Wide range of socioeconomic characteristics, religious practices, and cultural practices. ● One of the fastest growing populations in the U.S. - 43% increase between 2000 & 2010.
  4. 4. Highest State Populations ● California - 4,155,685 ● New York - 1,169,200 ● Hawaii - 703,232 ● Texas - 644,193 ● New Jersey - 524,356
  5. 5. Health Disparities Facing Asian Americans
  6. 6. Health Disparities 1. The two leading causes of death for Asian Americans in the U.S. are cancer and cardiovascular disease 2. Asian American women have the lowest screening rates, and are usually diagnosed with cancer at a later stage than other minority groups 3. Asian Americans account for over half of deaths caused by hepatitis B 4. High prevalence of mental health problems 5. Asian Americans have a higher prevalence of tuberculosis than all other racial and ethnic groups 6. Asian American youth in grades 7 through 12 have the highest increase in smoking rates of any racial and ethnic group.
  7. 7. Cancer ● AAs are the only racial/ethnic group in the U.S. who experiences cancer as the leading cause of death ● Asian subgroups: ○ Chinese: highest mortality rates for lung & bronchial cancer ○ Filipinos: highest incidence & mortality rates for prostate & thyroid cancer ○ Japanese: highest incidence & mortality rates for colorectal & uterine cancer ○ Koreans: highest incidence & mortality rates for stomach cancer ○ Vietnamese: highest incidence & mortality rates for
  8. 8. Contributing Factors for Disparities
  9. 9. Barriers to Care ● Low socioeconomic status ○ Two million Asian Americans do not have insurance in the U.S. ● Language ○ limited english proficiency may discourage or prevent them from accessing health care services available to them ● Perception of Health ○ Asian Americans may not perceive the value or identify the purpose or necessity in obtaining care because of traditional approaches to health care.
  10. 10. Model Minority ● Myth: AAs are healthy, wealthy, and wise. ○ AAs are a small and exceptionally healthy because of socio-economic security and high education ○ "The Asian Pacific Islander minority in aggregate is healthier than all racial ethnic groups in the US including whites" - Department of Health & Human Services ● Reality: ○ AAs are the fastest growing population in the US ○ They suffer from several health disparities including cancer and cardiovascular disease. ● Effect:
  11. 11. Generalizations About Asian American Cultural Norms
  12. 12. World Views ● Naturalistic: harmony with environment ● Time is an unlimited continuum ○ birth and death are not absolute of ends ● Fatalistic
  13. 13. Explanatory Model of Illness Holistic ● Chinese: balance of hot & cold ○ use of herbs, massage, thermal treatments, acupuncture ○ qi ● Filipino: ○ Mystical - wandering souls ○ Personalistic - social or supernatural punishment ○ Naturalistic - natural events and stress ● Differing local beliefs ○ i.e. Hmong and the curses/wrath of gods
  14. 14. ● Most Asian cultures are collectivist ○ People view themselves as a member of a group ● What is best for the group ○ Dependence & Needs ● Societal orientation: family Collectivist Society
  15. 15. Religion & Spirituality ● Buddhism ○ one with nature ● Confucianism ○ Focus: world & family (instead of god & afterlife) ● Taoism ○ "yin" and "yang" ■ i.e. balance of hot and cold ● Islam ● Judaism ● Hinduism ● Christianity ● Jainism ● Sikhism ● Zoroastranism ● Sanamahism
  16. 16. Traditional Belief ● Beliefs: ○ Fatalism ○ Karma ○ Harmony with nature ○ Cooperation ○ Spiritualism **Herbalist doctors are the standard for cancer
  17. 17. Health Habits/Preferences ● Social Orientation: Family ● Family Makeup: Extended ● Primary Relationship: Parent-child ● Family Values: Well defined ● Relationship Emphasis: Interpersonal & Harmony ● Gender Roles: Male Dominant ● Control: Authoritative ● Emotional Expression: Suppressive
  18. 18. Protective Factors ● "There is little information provided about the Protective factors among the Asian American groups." (Harrison, 2005) ● Strong mentalities in: ○ Conformity ○ Immersion-emersion
  19. 19. Health Literacy ● 2000 census: ○ 4 million AA had Limited English Proficiency ○ 73% of AA do not speak English in their homes ■ national average = 18%
  20. 20. Discrimination ● Strained history with United States ○ Chinese Communism ○ Vietnam War ○ Korean War ○ World War II- Japanese Americans ● Workplace discrimination ○ can be written off as being intelligent and not having problems (model minority) ● Cultural discrimination (language, practices)
  21. 21. Colorectal Cancer
  22. 22. Colorectal Cancer (CRC) ● 2nd most diagnosed cancer among AA ● Cancer that begins in the colon or rectum ○ begins as a polyp ■ slow to develop ○ screenable & preventative ● Japanese are the subculture with the largest problem of Colorectal Cancer
  23. 23. Rates Source: Data Evaluation and Publication Committee of the North American Association of Central Cancer Registries (1999)
  24. 24. Colorectal Cancer Prevention ● Colonoscopy ● Lifestyle ○ Avoid excess red meat, alcohol, and tobacco ○ Maintain good BMI & body composition with exercise ○ Sufficient Calcium & Vitamin D ● Know family history
  25. 25. Health Promotion Program #1
  26. 26. Asian American Health Initiative ● Formed in January 2005 to increase awareness about cancers by: ○ Providing culturally competent cancer education ○ Screening services ● First health program in Montgomery County to specifically target the Asian American community
  27. 27. Outreach and Education ● Health Fairs and Health Education Seminars provide: ○ Educational materials in many different asian languages ○ Bilingual Asian Health promoters ○ Information targeted to specific Asian American Subgroups
  28. 28. Media Campaign ● Many Asian Americans use ethnic media sources ● Asian American Health Initiative regular launches health awareness campaigns in Chinese, Cambodian, Vietnamese, and Korean
  29. 29. Screening Services ● Free screening for colorectal cancer are provided for eligible Asian Americans residing in Montgomery County ● Those who are eligible have the opportunity to seek care from a provider who speak their native language.
  30. 30. Effectiveness ● Breaks down language barriers ● Provides tailored care for individuals ● Plentiful network of providers for clients to use
  31. 31. Improvements ● Enhance research efforts ○ A lack of health data on Asian Americans contributes to certain health disparities ● Rethink referrals ● Provider training
  32. 32. Health Promotion Program #2
  33. 33. The Asian American Network for Cancer Awareness, Research and Training ● Founded in 1999 and launched in 2000 ● Designated: The National Cancer Institute as The National Center for Reducing Asian American Cancer Health Disparities ● Mission Statement: ○ "to reduce cancer health disparities by conduc community-based participatory education, tra and research by, for, and with Asian Americans."
  34. 34. Outreach ● Locations: ○ Sacramento, San Francisco, Los Angeles, Seattle, and Honolulu. ● Members: ○ Chinese Community Health Resource Center ○ Hmong Women's Heritage Association ○ University of Hawaii Office of Student Equity, Excellence and Diversity ○ UC Davis Cancer Center ○ UC Los Angeles: UC San Francisco ○ University of Washington
  35. 35. Education ● Focus: ○ Cambodian, Chinese, Filipino, Hmong, Korean, and Vietnamese ancestry ● Education is tailored to each culture ○ "ethnically-specific, linguistically diverse, culturally appropriate, and cognitively empowering" ● Community relationships and trust are established before testing begins ○ The idea of blood biospecimen collection is introduced very slowly and in a delicate manner ○ Subjects must understand that testing benefits both the subjects and the researchers
  36. 36. Media Campaign ● Presentations & publications on studies and research have been provided to AA communities. ● Holds public events which are advertised through their website and regular flyer/calendar postings ● Holds Several Conferences and Symposiums
  37. 37. Effectiveness ● 1,051 outreach activities ● produced 166 peer-reviewed publications ● secured $64.2 million in total grants
  38. 38. Improvements ● Expansion to other regions of the U.S. ● Expansion to other Asian-American subpopulations
  39. 39. Health Promotion Program #3
  40. 40. Effective Colorectal Cancer Education for Asian Americans: A Michigan Program Health Asian American Project ● In 2005- 2006 HAAP began to include community based CRC education ● Goal: ○ Improve knowledge & attitude towards screening ○ increase screening rates ● Coordinated with community organizations
  41. 41. Outreach ● Subgroups ○ Asian Indian, Chinese, Filipino, Hmong, Japanese, Korean, Vietnamese ● Recruitment ○ Association of Chinese Americans & Korean Cultural Center of Michigan ● Used community gathering places ○ Churches, temples, community centers, & group picnics.
  42. 42. Education ● Fairs that promote health education ○ Presentation on early detection with on sight translation ● Educational brochures from the American Cancer Society are distributed in different asian languages ● Stressed importance of screening when no symptoms are presents ○ especially for older populations
  43. 43. Media Campaign ● Newspaper advertisements ● Flyers in grocery stores ● Coverage in asian language media ● Used sub-group's preferred language
  44. 44. Effectiveness ● Effective ● Evidence-based education evaluation ○ showed a "significant increased knowledge and attitudes about the importance of screening" ● Program follow up ○ 78% screening participation within the last 12 months ○ compared to 37% participation prior to study
  45. 45. Improvements ● For public policy purposes: ○ program would need to include more AA without health insurance ● Could improve accuracy by tracking screening rates through means other than self reports
  46. 46. Suggestions for the Future
  47. 47. Steps to Take in Improving Quality and Access ● Need to absolve model minority ○ acknowledge AA population growth rate ○ understand that AA suffer from significant health disparities (i.e. cancer) ● More research is needed, overall. ○ especially on AA without health insurance to justify larger changes in public policy ○ essential to creating national visibility of health disparities ● Find middle-ground between cultures ○ Inclusion of Holistic Medicine in Western practice ○ Methods to remove language barriers
  48. 48. References ● Ritter, Lois & Hoffman, Nancy, (2010). Multicultural Health. ISBN-978-0- 7637-5742-7 ● Kline, Michael and Huff, Robert, (2007). Health Promotion in Multicultural Populations: A Handbook for Practitioners and Students. ● Wu, T., Kao, J.Y., Hsieh, H., Tang, Y.Y., Chen, J., Lee, J., & Oakley, D. Effective Colorectal Cancer Education for Asian Americans: A Michigan Program. J Canc Educ (2010) 25:146–152 DOI 10.1007/s13187-009-0009- x ● Asian American Health Initiative (n.d.). Retrieved from http://aahiinfo. org/ ● Chen, M., Chow, E., & Nguyen, T. The Asian American Network for Cancer Awareness, Research and Training. (n.d.). Retrieved from http://www. aancart.org/

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