Overcoming Barriers to Asian American Health

By Mary Tablante

First, the good news. Asian American women have the highest life expectancy of any ethnic group in the U.S., living an average 85.8 years, according to the U.S. Department of Health and Human Services. Life expectancy among Asian subgroups ranges from Filipinos at 81.5 years, to Japanese at 84.5 years, and topping out with Chinese women at 86.1 years.

Now, the bad news. HHS says Asian Americans face various issues jeopardizing their health, many of which may be preventable as they are related to lower rates of preventive medical checkups and insurance coverage, and are exacerbated by cultural issues.

Cancer and cardiovascular disease are the two leading causes of death for AAPIs in the United States. AAPIs suffer a high rate of diabetes, hepatitis B, liver disease and problems associated with smoking. In 2010, tuberculosis was 11 times more common among Asians than Caucasians. Asian women have a high risk of osteoporosis, possibly because their average calcium intake is half that of Western population groups.

There are startling inconsistencies within the AAPI population. For instance, Asian-born women in the United States die from breast cancer up to four times as often as Asian Americans born here. In general, Asian Americans are 50 percent less likely to die from heart disease than non-Hispanic White adults, but native Hawaiians and Pacific Islanders are about 40 percent more likely to develop heart disease than Caucasians.

One problem is the proportion of non-Hispanic Asians without health insurance is 1.7 times higher than for whites, according to the Maryland Office of Minority Health and Health Disparities. 12.6 percent of Asian Americans in Frederick, Montgomery and Prince George’s counties are uninsured. The Kaiser Commission on Medicaid and the Uninsured says Asian Americans are less likely than non-Hispanic whites to receive health insurance through their jobs, and only 9 percent of those who do not receive employer-sponsored coverage arrange for it themselves.

Mariza Alignay, a registered nurse for almost 40 years, works at the Veterans Affairs Medical Center in Washington, D.C. She believes a significant portion of the AAPI community is not focused on the preventive aspects of healthcare, and is not properly informed. She said many AAPIs tend to not get proper screenings until they develop symptoms and find out they are already in a late stage of a problem.

“If you are educated, you would reach out for more information, but those who haven’t had the opportunity to do so depend on hearsay or look for cheap resources,” Alignay said. “When they talk about cheaper resources, they limit the amount of care they get. Most of the time they may not be able to follow through because they don’t have enough money to go through expensive testing or diagnosis to get their problems addressed.”

A persistent problem is language. In Frederick, Montgomery and Prince George’s counties, 18.6 percent of residents are “linguistically isolated,” according to the Center on Health Disparities at Adventist Healthcare. Most hospitals have translators, especially for Spanish, but Asians are less likely to have that support.

Merla Castillo, a healthcare professional in Silver Spring, Md., said she encounters patients with difficulty expressing themselves in English. A typical problem, she noted, occurred when she saw a Cambodian patient recently, and had to deal with the woman’s health issues indirectly by communicating through the patient’s daughter. Her workplace has a phone system for translators she says offers help.

Nurse Alignay believes younger AAPIs may be better educated about leading a healthy lifestyle. But she said for health care services to improve, there should be equal efforts from both minority patients and medical professionals.

“If the minority population has better understanding on how to access healthcare, there probably needs to be a compromise. Both sides should be educated,” Alignay said.

State and county governments are recognizing the disparities and are moving to ease them. Maryland established the Office of Minority Health and Health Disparities to organize, fund and communicate efforts to reduce racial health gaps. The Montgomery County Asian American Health Initiative works with community-based partners to provide AAPIs with services including preventative screenings and education on health issues which disproportionately affect them.

What You Can Do

The Montgomery County AAHI has culturally tailored health education materials for the Asian American community available in English, Chinese, Korean, Vietnamese and Hindi. Download for free at www.AAHIinfo.org.

Visit the Asian & Pacific Islander Health Forum, which works for policy and systems changes at the federal, state, and local level at www.apiahf.org.