Asian American Health

Introduction
Cancer
Diabetes
Cardiovascular Disease and Associated Risk Factors
Screening and Diagnosis
Treatment

Asian American" refers to persons whose familial roots originate from many countries, ethnic groups and cultures of the Asian continent, including Asian Indian, Bangladeshi, Bhutanese, Burmese, Cambodian, Chinese, Filipino, Hmong, Indonesian, Japanese, Korean, Laotian, Malayan, Mien, Nepalese, Pakistani, Sikh, Sri Lankan, Thai and Vietnamese.

Asian Americans represent a large and rapidly growing segment of the U.S. population. A recent U.S. Census estimate puts their combined numbers at over 11 million people and predicts a better than tripling in population by 2050. They are exceedingly diverse, coming from nearly fifty countries and ethnic groups, each with distinct cultures, traditions, and histories, and they speak over 100 languages and dialects. Asian American diversity extends to socioeconomic indicators, with members found throughout the spectra of poverty to wealth, and illiteracy to advanced education.

Although Asian Americans in the United States suffer from the same health problems as the population at large, certain illnesses predominate. There is a particularly high rate of liver cancer among Asian Americans, while lung cancer is their leading cause of cancer death. Vietnamese women's cervical cancer rate is five times that of Caucasian women. Asian Americans have among the highest rates of tuberculosis and hepatitis B in the United States. Asian Indians have an unusually high rate of coronary artery disease, and parasitic infections are particularly widespread among Southeast Asian refugees.

Historically, breast cancer rates have been low in Asia but rates have increased substantially in Asian-Americans for reasons that are not well understood. The increased risk associated with high body weight was observed irrespective of HT use. Use of HT and high body size might have contributed to the rapid increase of breast cancer in Asian-Americans.

Diabetes is one of the leading causes of death and disability in the United States, costing more than $98 billion each year. It was the seventh leading cause of death listed on U.S. death certificates in 1995. It is the fifth leading cause of death in Asian Americans and Pacific Islanders between the ages of 45 and 64.

Although data on the number of Asian and Pacific Islander Americans who have diabetes are limited, studies show that type 2 diabetes is a growing problem among some groups within this population. For example, the prevalence of type 2 diabetes is 2 to 3 times higher among Japanese Americans living in Seattle compared with non-Hispanic whites. The prevalence is 2.5 times higher among Native Hawaiians compared to white residents of Hawaii.

People whose family members have diabetes are at increased risk for the disease. Also, people who are obese, who eat a high fat diet, and who are physically inactive are more likely to develop type 2 diabetes. Contrary to what many people believe, diabetes is not caused by eating too many sweets or sugary foods. The food choices of some Asian Americans and Pacific Islanders have changed due to their migration to the United States and to modern times. Instead of their traditional plant- and fish-based diets, they are choosing foods with more animal protein, animal fats, and processed carbohydrates. In addition, they have become less physically active. As a result, their chances of developing diabetes have increased.

Major research studies have shown that people who keep their blood sugar levels in the normal range can significantly delay the onset and the progression of eye disease, kidney disease, and nerve disease. In fact, research shows that any sustained lowering of blood sugar levels helps prevent these diabetes complications.

Heart disease is responsible for 40 percent of all deaths in the United States. About 57 million Americans are diagnosed with some form of CVD, which includes heart disease and stroke. Native Hawaiians disproportionately suffer the burden of heart disease, compared to other ethnic groups in the State of Hawai`i. Most Native Hawaiians are unaware of the extent of their health problems. When compared to all races in the United States, there is evidence that Native Hawaiians suffer higher overall mortality rates for major ailments.

Risk factors influence or increase an individual’s likelihood of developing heart disease. While some risk factors cannot be changed, many are modifiable. The key risk factors for heart disease are high blood cholesterol, high blood pressure, cigarette smoking, obesity, physical inactivity, and diabetes. The following section discusses the most common modifiable CVD risk factors and their effect on the AAPI population where data are available.

Hepatitis B is a liver disease caused by infection with hepatitis B virus (HBV). HBV infection can cause lifelong liver damage and even death. HBV infection is common in many places throughout the world, including Asia, the Pacific Islands, Alaska, Eastern Europe, the Middle East, Africa, and areas of South America.

Babies and young children who are infected are likely to develop lifelong infection. This lifelong infection is called chronic HBV infection and can lead to cirrhosis (scarring of the liver), liver failure, and liver cancer later in life. Chronic HBV infection develops in as many as 9 of 10 infected infants and young children and approximately 2-6 of 100 infected adults. Though people with chronic HBV infection might not feel sick, they carry the virus in their blood and can pass it to others.

All foreign-born people (including immigrants, refugees, asylum seekers, and internationally adopted children) born in Asia, the Pacific Islands, Africa, and other regions in the world with high rates of HBV infection should be tested for HBV infection, even if they've been vaccinated.

In recent years, large numbers of Asian immigrants and refugees in various Asian communities across the United States have been tested. These are the results.

• About 1 of 7 people tested is infected and can infect others.
• About 1 of 2 people tested had been infected at one time but have cleared the infection from their bodies and won't get infected again. They cannot spread HBV infection to others.
• About one 1 of 3 people had never been infected and need hepatitis B vaccine to be protected.

All the people you live with and your sex partner(s) should get tested for HBV infection and vaccinated if they have not already been infected. (Hepatitis B vaccination will not harm a person who has already been HBV-infected.) People with HBV infection might feel healthy, but they can still infect others. It is also important to protect others from contact with your infected blood and other infectious body fluids, including semen and vaginal fluids. Sweat, tears, urine, and mucus or saliva from sneezing, coughing, or drooling do not contain HBV. Human bites from infected persons have transmitted HBV.