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Asian Americans & Hepatitis B
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HBV affects 1.25 million Americans, half of whom are Asian-Americans
New York Ð Two of the biggest health problems Asian Americans face today are tuberculosis and chronic hepatitis B.
Dr. Francisco Sy, a Filipino American who is the health scientist administrator and chief of the Office of Community Based Participatory Research and Outreach at the National Institutes of Health's (NIH) National Center on Minority Health and Health Disparities, made this declaration at this year's second annual Asian American Health Conference.
The conference was sponsored by New York University's Center for Asian American Health (CSAAH), the first institution of its kind in the country to focus on addressing the growing health concerns of the Asian American community.
Asian Americans comprise the highest rates for tuberculosis, possibly due to the significant numbers of foreign born in their populations. Filipinos make up the second largest group infected by TB in the U.S. population, with 11% infected or 264,000 cases. They are followed by 8% of Vietnamese and 7% of Indians.
Because TB is regarded by many as highly contagious, those infected suffer from social stigma and isolation, leading many to deny or hide their illness or avoid seeking health attention. Poor health screenings and large numbers of undocumented migrants who do not get checked also contribute to the increase in the disease.
Chronic Hepatitis B, a highly contagious virus that infects the liver, affects 1.25 million Americans, half of whom are Asian Americans. Every year, 4,000-5,000 people die due to cirrhosis and liver cancer.
Hepatitis B is found in the blood and body fluids of infected people and can be spread through sexual contact, the sharing of needles or razors, from mother to infant during birth, and by living in a household with a chronically infected person. The virus, which can be treated by vaccines if discovered early enough, is hardy and can live outside the body for several days.
Those most at risk include sexually active adults with multiple partners and people whose jobs potentially expose them to human blood or body fluids, including most healthcare and some public safety workers, as well as some athletes, coaches and teachers.
The specific impact of these diseases on the Asian American community, said Dr. Sy, just stress the importance of community based participatory research projects Ð projects which would assess and address the needs and ailments of Asian Americans from the grassroots.
Decrying that too many health academics do too much "helicopter" research in minority communities -- i.e., go in and out to study the population in the short term without really getting to know them -- Dr. Sy argued that "community is so important and we need to be treated as partners [in health studies] and not guinea pigs."
Dr. Sy also contended that the stereotype which characterizes Asian Americans as the "model minority" has contributed to the dearth on health data for the group, a detriment for the community because data is what gets institutions like the NIH to give money to do further studies or finance programs.
"If there is no data," said Dr. Sy, "there is no funding and communities sufferÉ[and] because Asian Americans are considered Ômodel minorities' then people think they don't have any [health] problems."
The reality indeed is far from such assumptions. According to Dr. Sy, 21% of Asian Americans are uninsured and 12.5% live below the poverty line. Many also have language barriers which, along with the lack of financial resources, keep them form navigating America's convoluted healthcare system.
Dr. Sy also mentioned that the group's social and cultural practices -- like putting the family over the self, holding a fatalistic view of illness or subscribing to more "traditional" types of healing (for Filipinos this include prayer and religious healing) and keeping topics like domestic violence and sexual orientation taboo Ð have acted as barriers for a healthier Asian American community.
Indeed, it is with the idea to address challenges that specifically face Filipino Americans which led Noilyn Abesamis and Rhodora Ursua to form with other community organizations and leaders the Kalusugan Coalition (Kalusugan means "health" in Tagalog) in 2004.
The coalition acts as a health outreach program to improve the health of the Filipino American community in the New York Metropolitan Area Ð the first of its kind in the East Coast.
According to Ursua, the NIH recently agreed to fund the group's three-year planning grant to study the cardiovascular health of NY/NJ Filipino American community.
Heart disease is the leading cause of death for Filipino Americans, whose rates top all other Asian subgroups. Some studies have shown that hypertension rates among FilAms might even surpass those of African Americans. The rate of diabetes and stroke are also high for the group, with the latter being the third cause of death.
Dr. Sy himself suffered from the disease. Nine months ago he weighed three hundred pounds, suffering from diabetes and hypertension. Today he is a hundred pounds lighter due to a gastro bypass surgery which shrunk his stomach and a strict diet which exclude that Filipino food staple: white rice.
"I was at risk," said Dr. Sy, "so I decide to do something about it."
Meanwhile, cancer, being the second cause of death among the group, is also a big health issue for Filipino Americans. As studies have shown, the prevalence of various forms of cancer varies according to nativity. For instance, liver and thyroid cancer are higher in those foreign born Filipinos than in US natives. Also, Filipinos have the second poorest five-year survival rates for colon and rectal cancers of all US ethnic groups (highest is American Indians). Filipina women have a higher rate of dying of breast cancer within five years than any other ethnic group.
Filipinos in the U.S. also comprise the largest number of reported AIDS/HIV cases among all Asian and Pacific Islanders. 59% of AIDS cases in the Asian American community are among the foreign born.
Smoking is also a growing concern since studies have demonstrated that the risk of early smoking initiation is higher among Filipinos than other Asian groups.
However, community leaders Alma Trinidad and Stella Gran-O'Donell, both of whom are earning their PhD's in Social Work at the University of Washington in Seattle and who were presenters at the conference, pointed out less recognized Ð and discussed -- health concerns in the FilAm community.
Trinidad, president of Hawaii's 26-year old non-profit "Sariling Gawa" Youth Council, Inc., discussed how gang related violence and drug use (particularly crystal meth) affected FilAm youth. In Hawaii, Filipinos make up the second largest population in the states' juvenile detention system and is also second in number in terms of being victims and perpetrators of domestic violence.
Gran-O'Donell on the other hand spoke about her concern with suicide prevention among Filipinos. According to her, young Filipinas have the highest rates of suicide attempts in the West Coast. Indeed, young Asian American females have higher rates of suicide compared to the rest of the country.
Both agreed with Dr. Sy's call for more data specifically tailored to the Filipino American community to gain funding at the policy level. Indeed, this is what Trinidad hopes to accomplish in her role as academic and grassroots organizer, "we have to show them that our work is worth it," she said.
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