OBJECTIVES: Several Asian-American groups are at a higher risk of dying of liver diseases attributable to hepatitis-B infection. This culturally diverse community should be well informed of and protected against liver diseases. The present study assesses the knowledge of hepatitis B before and after a hepatitis-B educational program and determines the infection status of an Asian community. METHODS: Nine Asian communities of Montgomery County, MD, enrolled in the hepatitis-B prevention program between 2005 and 2006. They attended culturally tailored lectures on prevention, completed self-administered pre- and posttests, and received blood screening for the disease. RESULTS: More than 800 Asian Americans participated in the study. Knowledge of prevention was improved after educational delivery. The average infection rate was 4.5%, with Cambodian, Thai, Vietnamese, Chinese and Korean groups having higher infection rates. The age group of 36-45 had the highest percentage of carriers (9.1%). CONCLUSION: Many Asian groups, particularly those of a southeast Asian decent, were subject to a higher probability of hepatitis-B infection. At an increased risk are first-generation Asian immigrants, groups with low immunization rates and those aged 36-45. The findings provide potential directions for focusing preventive interventions on at-risk Asian communities to reduce liver cancer disparities.
Asian Americans represent a mix of cultures and immigration experiences, which may put them differentially at risk for mental health problems. Yet, little is known about the mental health needs of older adults from various Asian subgroups compared to non-Hispanic whites.
To compare the prevalence rates of mental distress of Chinese, Filipino, South Asian, Japanese, Korean, and Vietnamese older adults (aged 55 and older) to that of non-Hispanic whites; and to examine subgroup differences in utilization of mental health services.
A cross-sectional analysis of a population-based sample of California adults responding to the 2007 California Health Interview Survey. Multivariable logistic regression analysis was used to examine subgroup differences in mental health status and use of mental health services among the six different Asian subgroups and non-Hispanic whites, adjusting for respondents’ demographic and health characteristics, socioeconomic status, and English-language proficiency.
A total of 20,712 respondents were included. Filipino [aOR=2.25; 95% CI=1.14-4.47] and Korean Americans [aOR=2.10; 95% CI=1.06-4.17] were more likely to report symptoms indicative of mental distress compared to non-Hispanic whites, yet were less likely to have seen a primary care provider [Filipino: aOR=0.41; 95% CI=0.18-0.90; Korean: aOR=0.24; 95% CI = 0.08-0.69] or have taken a prescription medication [Filipino: aOR=0.20; 95% CI=0.10-0.40; Korean: aOR=0.15; 95% CI=0.05-0.40], even after adjusting for indicators of respondents’ demographic and health characteristics, socioeconomic status, and English-language proficiency. In contrast, Japanese Americans were less likely to report symptoms indicative of mental distress [aOR=0.43; 95% CI=0.21-0.90], and were less likely to make use of mental health services compared to non-Hispanic whites.
The findings from this study not only highlight the unmet mental health needs among older Asian Americans, but also illustrate significant variations among the various Asian subgroups. Clinicians who work closely with these patients should regularly screen and assess older Asian adults for symptoms related to their mental health needs.
Asian Americans; mental health; aging; distress; California Health Interview Survey (CHIS)
To obtain information about newborn health outcomes among nine subgroups of the Asian population in the United States.
Cross-sectional comparison of outcomes for births to Cambodian-, Chinese-, Filipino-, Indian-, Japanese-, Korean-, Laotian-, Thai-, and Vietnamese-origin mothers, and births to non-Hispanic white mothers. Regression models are used to compare neonatal mortality rates across groups, before and after controlling for a range of risk factors.
All California births between 1991 and 2001
Racial and ethnic groups
Neonatal mortality (death within 28 days of birth)
Unadjusted mortality rates in some Asian-American subgroups are significantly different from rates for non-Hispanic whites (non-Hispanic white rate=2.0 per 1,000 births; Chinese=1.2, Japanese=1.2, Korean=2.7; all p<0.05). For infants of Chinese mothers, observed risk factors explain the differences observed in unadjusted data. For Cambodian, Japanese, Korean, and Thai newborns, differences persist or even widen after risk factors are taken into account. After risk adjustment, infants of Cambodian, Japanese, and Korean mothers have significantly lower neonatal mortality rates than those born to non-Hispanic whites (adjusted OR=0.58 for Cambodian, 0.67 for Japanese, 0.69 for Korean, all p<0.05), and infants of Thai mothers have higher rates (adjusted OR 1.89, p<0.05).
There are significant variations in neonatal mortality between subgroups of the Asian-American population that are not entirely explained by differences in observable risk factors. Efforts to improve clinical care that treat Asian-Americans as a homogeneous group may miss important opportunities for improving infant health in specific sub-groups.
The use of physicians is more common than of behavioral specialists, especially in underserved Asian American communities. Despite a rapidly aging Asian American population, research has overlooked older people. This study examines the way mental health need affects the number of physician contacts by older Asian Americans.
This study uses data on self-identified Asian Americans aged over age 50 years derived from the 2001 California Health Interview Survey. A total of 1191 Asian Americans from Chinese, Filipino, Korean, and Vietnamese backgrounds were studied. Replicate weights were applied to account for the survey’s complex sampling methods. Linear regression was used to identify the number of physician contacts.
Overall, respondents had seen a doctor an average of five times in the previous 12 months; 7% perceived that they had a mental health need. Perceiving a mental health need was associated with a decreased number of physician contacts for Filipino and Korean Americans.
This study revealed interethnic differences among older Asian Americans’ contact with physicians. As older Filipino and Korean Americans who perceive a mental health need have fewer contacts with their physician, correctly identifying mental health needs in the health care system for these groups is crucial. Health and mental health professionals can work toward reducing mental health disparities by accounting for older Asian Americans’ help-seeking patterns when designing evidence-based interventions.
minority groups; Asians; health service use
Asian American women's health has been understudied while the Asian American population is increasing. The purpose of this study was to examine the physical, behavioral, and mental health of Asian American women.
Using a nationally representative sample (n=1097) from the National Latino Asian American Study (NLAAS), the first comprehensive epidemiologic survey in the United States, we examined the annual rates of behavioral, physical, and mental healthcare service use, including general medical, specialty mental health, and any medical services, in three major subgroups of Asian American women.
Health problems varied with three major subgroups of Asian American women. In physical health, Chinese American women reported the highest rates of headache, other pain, hypertension, heart diseases, heart attacks, chronic lung diseases, and asthma. Vietnamese American women reported the highest rates of ulcer, stroke, and diabetes. Filipino American women had the highest rates of cancers and epilepsy. In behavioral health, Filipino women ranked highest on all types of drug use and cigarette smoking, compared with their counterparts. In mental health, Filipino American women reported significantly better mental health self-rating compared with their Chinese and Vietnamese American counterparts. Asian American women from each ethnic group sought health services at distinct rates. However, the help-seeking patterns of health services are similar.
Asian American women encountered various physical, behavioral, and mental health problems, yet they had low rates of seeking healthcare services. Hence, it is critical to further examine factors associated with the underestimation of physical and mental health problems and underuse of health services by Asian American women.
The U.S. Office of Management and Budget (OMB) guidelines for collecting and reporting race and ethnicity information recently divided the “Asian or Pacific Islander” category into “Asian” and “Native Hawaiian or Other Pacific Islander”. The OMB’s decision to disaggregate the “Asian or Pacific Islander” category was the first step toward providing these communities with information to better serve their needs. However, whether individuals who formerly made up the combined group categorize themselves as the new guidelines intend is a question analyzed in this report.
A subset of adults participating in the Hemochromatosis and Iron Overload Screening Study completed both the OMB-minimum and the expanded race and ethnicity measure used in the National Health Interview Survey. We compared responses on the expanded measure contained within the OMB “Asian” definition (Filipino, Korean, Vietnamese, Japanese, Asian Indian, Chinese, and/or Other Asian) to “Asian” responses on the OMB-minimum measure.
Mixed heritage Asians less often marked “Asian”. Among mixed heritage Japanese, Chinese, and Filipinos, 27%, 49%, and 52% did not mark “Asian” on the OMB measure, respectively. Eleven percent of single-heritage Filipinos did not mark “Asian.”
Many individuals formerly making up the combined “Asian or Pacific Islander” group do not categorize themselves as the revised OMB guidelines intend. This is particularly evident among Filipinos and among Asians of mixed heritage. This research illuminates the reliability and utility of the broad “Asian” category and points to possible consequences of collapsing groups into a single category, i.e., missed information and/or erroneous generalization.
The authors documented California's tobacco control initiatives for Asian Americans and the current tobacco use status among Asian subgroups and provide a discussion of the challenges ahead. The California Tobacco Control Program has employed a comprehensive approach to decrease tobacco use in Asian Americans, including ethnic-specific media campaigns, culturally competent interventions, and technical assistance and training networks. Surveillance of tobacco use among Asian Americans and the interpretation of the results have always been a challenge. Data from the 2001 The California Health Interview Survey (CHIS) were analyzed to provide smoking prevalence estimates for all Asian Americans and Asian-American subgroups, including Korean, Filipino, Japanese, South Asian, Chinese, and Vietnamese. Current smoking prevalence was analyzed by gender and by English proficiency level. Cigarette smoking prevalence among Asian males in general was almost three times of that among Asian females. Korean and Vietnamese males had higher cigarette smoking prevalence rates than males in other subgroups. Although Asian females in general had low smoking prevalence rates, significant differences were found among Asian subgroups, from 1.1% (Vietnamese) to 12.7% (Japanese). Asian men who had high English proficiency were less likely to be smokers than men with lower English proficiency. Asian women with high English proficiency were more likely to be smokers than women with lower English proficiency. Smoking prevalence rates among Asian Americans in California differed significantly on the basis of ethnicity, gender, and English proficiency. English proficiency seemed to have the effect of reducing smoking prevalence rates among Asian males but had just the opposite effect among Asian females.
public health; epidemiology; cancer; statistics
Background Asian patients preferentially seek mental health care from their primary care providers but are unlikely to receive it. Primary care providers need culturally-informed strategies for addressing stigmatizing illnesses. Methods 11 Vietnamese American community members participated in semi-structured interviews. Interviews were audio-taped and transcribed. The grounded theory approach was used for qualitative coding and thematic analysis. Results Vietnamese community members describe experiences with depression under four themes: (1) Stigma and face; (2) Social functioning and the role of the family; (3) Traditional healing and beliefs about medications; and (4) Language and culture. Based on this data, we offer suggestions for improving culturally-informed care for Vietnamese Americans. Disucssion Our study adds to the research aimed at improving communication and health care relationships between physicians and Vietnamese American patients. Physicians should learn to tailor their interviewing style to the increasingly diverse patient population.
Communication; Depression; Primary care; Vietnamese American
Prior literature emphasizes that Asian Americans with dementia may be particularly vulnerable to the stigma of chronic mental illness. However, there is a dearth of empirical research to support this claim. This study examines the relationship of stigma and dementia in 32 qualitative interviews with Chinese and Vietnamese family caregivers. Stigma was a common theme in the interviews (91%). Further analysis of stigma revealed two sources: chronic mental illness stigma and stigma reflecting negative stereotypes of aging or the aged. Chinese and Vietnamese cultural views of normal aging are not a unitary category but accommodate different trajectories of aging, some more and some less desired. When applied to persons with dementia, a “normalized” but negative trajectory of aging carried with it significant stigma that was distinct from but in addition to the stigma of chronic and severe mental illness. Older Chinese and Vietnamese with dementia are thus at risk of experiencing multiple stigmas that include but go beyond the stigma associated with chronic and severe mental illness.
To examine the relationship between body mass index and metabolic syndrome for Asian Americans and non-Hispanic Whites, given that evidence shows racial/ethnic heterogeneity exists in how body mass index predicts metabolic syndrome.
Research Design and Methods
Electronic health records of 43 507 primary care patients aged 35 years and older with self-identified race/ethnicity of interest (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or non-Hispanic White) were analyzed in a mixed-payer, outpatient-focused healthcare organization in the San Francisco Bay Area.
Metabolic syndrome prevalence is significantly higher in Asians compared to non-Hispanic Whites for every body mass index category. For women at the mean age of 55 and body mass index of 25 kg/m2, the predicted prevalence of metabolic syndrome is 12% for non-Hispanic White women compared to 30% for Asians; similarly for men, the predicted prevalence of metabolic syndrome is 22% for non-Hispanic Whites compared to 43% of Asians. Compared to non-Hispanic White women and men with a body mass index of 25 kg/m2, comparable prevalence of metabolic syndrome was seen at body mass index of 19.6 kg/m2 for Asian women and 19.9 kg/m2 for Asian men. A similar pattern was seen in disaggregated Asian subgroups.
Despite lower body mass index values and lower prevalence of overweight/obesity than non-Hispanic Whites, Asian Americans have higher rates of metabolic syndrome over the range of body mass index. Our results indicate that body mass index ranges for defining overweight/obesity in Asian populations should be lower than for non-Hispanic Whites.
Obesity; Metabolic Syndrome; Racial Differences; Asian; Population Study
We describe how local community organizations partnered to conduct a survey in the Chinese, Cambodian, and Vietnamese populations of Chicago to compare health outcomes and assess progress toward Healthy People 2010 goals. Interviews were conducted with 380 randomly selected Chinese adults through door-to-door sampling, and with 250 Cambodian adults and 150 Vietnamese adults through respondent-driven sampling. Data on 14 key health outcomes are described for this analysis. The three surveyed communities were generally poorer, less educated, more often foreign-born, and had less English proficiency than Asians nationally. There were few significant variations among the three populations, but there were notable differences in the burden of tuberculosis, obesity, diabetes, and arthritis. Insurance coverage and cancer-screening utilization were also significantly lower than for US Asians. Health information about Chinese, Cambodian, and Vietnamese populations in Chicago are available for the first time and serve as baseline data for community interventions. Findings highlight important health concerns for these populations and have implications for funders and policy makers in allocating resources, setting health priorities, and addressing health disparities.
Asian American; Chinese; Cambodian; Vietnamese; Health disparities
Asian Americans and Pacific Islanders (AAPI) have the fastest growing rate of overweight and obese children. Aggressive programs are urgently needed to prevent unhealthy acculturation-related changes in diet and physical activity and to promote the healthier aspects of traditional lifestyle habits. We conducted focus groups and key informant interviews to explore knowledge, attitudes, dietary practices, and physical activity levels among three low-income Asian American ethnic groups, Chinese, Vietnamese, and Hmong, in California. Content analysis was used to identify similarities and differences among the groups. Several common health beliefs clearly emerged. Participants noted the importance of fresh (not frozen) fruit and vegetable consumption and physical activity for general health. The concept of good health included having a harmonious family, balance, and mental and emotional stability. All groups also expressed the general belief that specific foods have hot or cold properties and are part of the Yin/Yang belief system common to Asian cultures. The lure of fast food, children’s adoption of American eating habits, and long work hours were identified as barriers to a healthy, more traditional lifestyle. A California campaign for Asian Americans using multilevel strategies is recommended to counter the alarming rise of obesity among AAPI youth. Strategies directed to individual, community, and policy levels should emphasize maintenance of healthy traditional diets, informed selection of mainstream U.S. foods, and promotion of active lifestyles to prevent an impending burden from cancer and nutrition-related chronic diseases in AAPI populations.
Five A Day; Asian Americans; Chinese; health disparities; Hmong; nutrition; obesity; physical activity; Vietnamese
This study determined the national prevalence and profile of Asian Americans with Activities of Daily Living (ADL) limitations and identified factors associated with institutionalization. Data were obtained from 2006 American Community Survey, which replaced the long-form of the US Census. The data are nationally representative of both institutionalized and community-dwelling older adults. Respondents were Vietnamese (n = 203), Korean (n = 131), Japanese (n = 193), Filipino (n = 309), Asian Indian (n = 169), Chinese (n = 404), Hawaiian/Pacific Islander (n = 54), and non-Hispanic whites (n = 55,040) aged 55 and over who all had ADL limitations. The prevalence of institutionalized among those with ADL limitations varies substantially from 4.7% of Asian Indians to 18.8% of Korean Americans with ADL limitations. Every AAPI group had a lower prevalence of institutionalization than disabled Non-Hispanic whites older adults (23.8%) (p < 0.001). After adjustment for socio-demographic characteristics, Asian Indians, Vietnamese, Japanese, Filipino, and Chinese had significantly lower odds of institutionalization than non-Hispanic whites (OR = 0.29, 0.31, 0.58, 0.51, 0.70, respectively). When the sample was restricted to AAPIs, the odds of institutionalization were higher among those who were older, unmarried, cognitively impaired and those who spoke English at home. This variation suggests that aggregating data across the AAPI groups obscures meaningful differences among these subpopulations and substantial inter-group differences may have important implications in the long-term care setting.
older adults; Asian Americans; long-term care; immigration; activities of daily living; socio cultural factors; treatment barriers
Southeast Asians living in the United States are a unique Asian immigrant population. They are considered one of the “newer” Asian immigrant groups, tend to be less affluent compared with their East and South Asian counterparts, and are steadily growing in number (U.S. Bureau of the Census, 2000). Unfortunately, few studies exist specifically about Southeast Asian immigrants. The lack of studies, coupled with the community's growing mental health issues, suggests the need for increased research on this population. This study contributes to the literature by examining the extent to which identification with Vietnamese or Cambodian culture, peer relationships, and coping behaviors affect substance use among Cambodian and Vietnamese immigrant youth. A sample of 102 participants, age 12–18 years, completed self-report measures regarding these variables. Overall, results indicate that identification with one's culture of origin and coping behaviors moderate the relationship between deviant peer association and substance use. Results are discussed within a contextual model of problem behavior among Southeast Asian youth.
This article presents a review of the prevalence and manifestation of depression among Asian Americans and discusses some of the existing issues in the assessment and diagnosis of depression among Asian Americans. The authors point out the diversity and increasing numbers of Asian Americans and the need to provide better mental health services for this population. While the prevalence of depression among Asian Americans is lower than that among other ethnic/racial groups, Asian Americans receive treatment for depression less often and its quality is less adequate. In addition, the previous belief that Asians somatize depression may become obsolete as more evidence appears to support that Westerners may “psychologize” depression. The cultural validity of the current DSM-IV conceptualization of depression is questioned. In the course of the review, the theme of complexity emerges: the heterogeneity of ethnic Asian American groups, the multidimensionality of depression, and the intersectionality of multiple factors among depressed Asian Americans.
To compare the prevalence of coronary heart disease (CHD), stroke, and peripheral vascular disease (PVD) across Asian-American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) and non-Hispanic white (NHW) subjects in a mixed-payer, outpatient health care organization in California.
Electronic health records from 2007 to 2010 were examined for 94,423 Asian and NHW patients. Age-adjusted prevalence rates of CHD, stroke, and PVD, defined by physician International Classification of Diseases, Version 9, codes, were directly standardized to the NHW population. Age-adjusted odds ratios were calculated by the use of logistic regression for each Asian subgroup, by sex, compared with NHWs.
The range of age-adjusted prevalence rates were: CHD (1.7%–5.2%), stroke (0.3%–1.8%), and PVD (0.9%–3.4%). The adjusted odds ratios of CHD were significantly higher for Filipino women (1.66; 95% confidence interval; 1.13–2.43) and men (1.47, 1.05–2.06) and Asian Indian men (1.77, 1.43–2.21), and significantly lower for Chinese women (0.72, 0.55–0.94) and men (0.78, 0.65–0.93), compared with NHWs. The odds of stroke were significantly greater for Filipino women (2.02, 1.22–3.34). The odds of PVD were generally lower for all Asian subgroups.
There is considerable heterogeneity across Asian subgroups for prevalent CHD, stroke, and PVD. Future research should disaggregate Asian subgroups and cardiovascular outcomes to inform targeted prevention and treatment efforts.
Asian; Cardiovascular Diseases; Coronary Heart Disease; Peripheral Vascular Disease; Stroke
We compared the prevalence and treatment of type 2 diabetes across Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) and Non-Hispanic Whites (NHWs) in a Northern California healthcare system.
A three-year, cross-sectional sample of patient electronic health records was accessed to compare diabetes prevalence in 21,816 Asian and 73,728 NHWs aged 35+ years. Diabetes was classified through ICD-9 codes, abnormal laboratory values, or use of oral anti-diabetic medication. Multivariate adjusted prevalence rates for each Asian subgroup, and adjusted odds ratios (OR) relative to NHWs, were compared.
Age-adjusted prevalence ranged from 5.8%-18.2% (women) and 8.1%-25.3% (men). Age-adjusted ORs of Asian subgroups ranged 1.11-3.94 (women) and 1.14-4.56 (men). The odds of diabetes were significantly higher in Asian Indians (women OR 3.44, men OR 3.54) and Filipinos (women OR 3.94, men OR 4.56), compared to NHWs. Results for Asian Indians and Filipinos were similar with age-and-BMI adjustment. Treatment rates across subgroups were 59.7-82.0% (women) and 62.9-79.4% (men).
Heterogeneity exists in the prevalence of diabetes across Asian subgroups, independent of obesity prevalence. Asian Indian and Filipino subgroups had particularly high prevalence of diabetes when compared to NHWs. Future studies should explore these clinically important differences among Asian subgroups.
diabetes; prevalence; Asian American; racial/ethnic subgroup
To establish baseline data for lymphoid neoplasm incidence by subtype for six Asian-American ethnic groups.
Incident rates were estimated by age and sex for six Asian ethnic groups—Asian Indian/Pakistani, Chinese, Filipino, Japanese, Korean, Vietnamese— in five United States cancer registry areas during 1996–2004. For comparison, rates for non-Hispanic Whites were also estimated.
During 1996–2004, Filipinos had the highest (24.0) and Koreans had the lowest incidence (12.7) of total lymphoid neoplasms. By subtype, Vietnamese and Filipinos had the highest incidence for diffuse large B-cell lymphoma (DLBCL) (8.0 and 7.2); Japanese had the highest incidence of follicular lymphoma (2.3). Although a general male predominance of lymphoid neoplasms was observed, this pattern varied by lymphoid neoplasm subtype. Whites generally had higher rates than all Asian ethnic groups for all lymphoid neoplasms and most lymphoma subtypes, although the magnitude of the difference varied by both ethnicity and lymphoma subtype.
The observed variations in incidence patterns among Asian ethnic groups in the United States suggest that it may be fruitful to pursue studies that compare Asian populations for postulated environmental and genetic risk factors.
Lymphoid neoplasms; Asians
To compare diabetes prevalence among Asian Americans by World Health Organization and U.S. BMI classifications.
RESEARCH DESIGN AND METHODS
Data on Asian American adults (n = 7,414) from the National Health Interview Survey for 1997–2005 were analyzed. Diabetes prevalence was estimated across weight and ethnic group strata.
Regardless of BMI classification, Asian Indians and Filipinos had the highest prevalence of overweight (34–47 and 35–47%, respectively, compared with 20–38% in Chinese; P < 0.05). Asian Indians also had the highest ethnic-specific diabetes prevalence (ranging from 6–7% among the normal weight to 19–33% among the obese) compared with non-Hispanic whites: odds ratio (95% CI) for Asian Indians 2.0 (1.5–2.6), adjusted for age and sex, and 3.1 (2.4–4.0) with additional adjustment for BMI.
Asian Indian ethnicity, but not other Asian ethnicities, was strongly associated with diabetes. Weight classification as a marker of diabetes risk may need to accommodate differences across Asian subgroups.
Accounting for population genetic substructure is important in reducing type 1 errors in genetic studies of complex disease. As efforts to understand complex genetic disease are expanded to different continental populations the understanding of genetic substructure within these continents will be useful in design and execution of association tests. In this study, population differentiation (Fst) and Principal Components Analyses (PCA) are examined using >200 K genotypes from multiple populations of East Asian ancestry. The population groups included those from the Human Genome Diversity Panel [Cambodian, Yi, Daur, Mongolian, Lahu, Dai, Hezhen, Miaozu, Naxi, Oroqen, She, Tu, Tujia, Naxi, Xibo, and Yakut], HapMap [ Han Chinese (CHB) and Japanese (JPT)], and East Asian or East Asian American subjects of Vietnamese, Korean, Filipino and Chinese ancestry. Paired Fst (Wei and Cockerham) showed close relationships between CHB and several large East Asian population groups (CHB/Korean, 0.0019; CHB/JPT, 00651; CHB/Vietnamese, 0.0065) with larger separation with Filipino (CHB/Filipino, 0.014). Low levels of differentiation were also observed between Dai and Vietnamese (0.0045) and between Vietnamese and Cambodian (0.0062). Similarly, small Fst's were observed among different presumed Han Chinese populations originating in different regions of mainland of China and Taiwan (Fst's <0.0025 with CHB). For PCA, the first two PC's showed a pattern of relationships that closely followed the geographic distribution of the different East Asian populations. PCA showed substructure both between different East Asian groups and within the Han Chinese population. These studies have also identified a subset of East Asian substructure ancestry informative markers (EASTASAIMS) that may be useful for future complex genetic disease association studies in reducing type 1 errors and in identifying homogeneous groups that may increase the power of such studies.
Among Asian Americans, colorectal cancer (CRC) is the second most commonly diagnosed cancer, and it is the third highest cause of cancer-related mortality. The 2001 California Health Interview Survey (CHIS 2001) was used to examine 1) CRC screening rates between different Asian-American ethnic groups compared with non-Latino whites and 2) factors related to CRC screening. The CHIS 2001 was a population-based telephone survey that was conducted in California. Responses about CRC screening were analyzed from 1771 Asian Americans age 50 years and older (Chinese, Filipino, South Asian, Japanese, Korean, and Vietnamese). The authors examined two CRC screening outcomes: individuals who ever had CRC screening and individuals who were up to date for CRC screening. For CRC screening, fecal occult blood test (FOBT), sigmoidoscopy/colonoscopy, and any other form of screening were examined. CRC screening of any kind was low in all populations, and Koreans had the lowest rate (49%). Multivariate analysis revealed that, compared with non-Latino whites, Koreans were less likely to undergo FOBT (odds ratio [OR], 0.40; 95% confidence interval [95% CI], 0.25–0.62), and Filipinos were the least likely to undergo sigmoidoscopy/colonoscopy (OR, 0.62; 95% CI, 0.44–0.88) or to be up to date with screening (OR, 0.68; 95% CI, 0.48–0.97). Asian Americans were less likely to undergo screening if they were older, male, less educated, recent immigrants, living with ≥ 3 individuals, poor, or uninsured. Asian-American populations, especially Koreans and Filipinos, are under-screened for CRC. Outreach efforts could be more focused on helping Asian Americans to understand the importance of CRC screening, providing accurate information in different Asian languages. Other strategies for increasing CRC screening may include using a more family-centered approach and using qualified translators.
Asian American Network for Cancer Awareness, Research, and Training; cancer; Chinese; Vietnamese; Korean; Filipino; South Asian; Japanese; fecal occult blood test; sigmoidoscopy; colonoscopy
The purpose of this community-based participatory study was to identify factors associated with colorectal cancer (CRC) screening compliance and non-compliance among Cambodians, Vietnamese, Koreans and Chinese men and women 50 years and older living in the United States. A cross-sectional design was used in the study. The completed sample included 815 Asian Americans which included Cambodians (N=215), Vietnamese (N=195), Koreans (N=94) and Chinese (N=311). A 95-item questionnaire was developed and pilot tested for content validity and reliability. An in-person data collection approach was utilized and participants were given choice in responding in English or their native language. Of the 815 participants, 79.1% (N=645) reported never-screened, 7.9% (N=64), non-compliance, and 13.0% (N=106) compliance. Education was significantly associated with never-screened for CRC for Vietnamese and Chinese; employment status for Cambodians and Koreans; lack of health insurance for Cambodians, Korean and Chinese; English fluency and years lived in the U.S. for Vietnamese, Koreans, and Chinese. Less acculturated Asian Americans were more likely to be never screened, but differentially across ethnic subgroups. Barriers to screening included lack of knowledge, language, transportation, and time. Increased culturally-targeted public awareness and education programs are needed to improve CRC screening and compliance among high risk Asian American ethnic subgroups.
sigmoidoscopy or colonoscopy; fecal occult blood test; Vietnamese; Korean; Chinese; Cambodian; correlates of colorectal cancer screening
Recent evidence suggests increasing rates of alcohol use and related disorders among Asian-American young adults. Relatively little research has focused on this group, and few studies have examined heterogeneity in drinking prevalence and correlates across Asian subgroups. This study examined interactive effects of ethnicity, acculturation, and gender on drinking behavior among Asian-American undergraduates.
Participants were 112 Chinese Americans and 108 Korean Americans (mean age = 19.2 years, 61% female) who completed measures of alcohol use, acculturation, and demographic factors. Multivariate analyses examined drinking behavior (defined as quantity, frequency, and duration) as a function of ethnicity, gender, and acculturation.
Overall, Korean ethnicity predicted increased drinking, and acculturation predicted decreased drinking. However, acculturation interacted with ethnicity such that its influence was protective for Korean Americans and negligible for Chinese Americans.
Previous research implicates acculturation as a risk factor for drinking among Asian Americans, but the current findings suggest that protective effects may also exist. Results also indicate that Korean ethnicity is a risk factor particularly in the context of low acculturation. These findings illustrate the need to consider ethnic subgroup differences in drinking rates and in risk and protective factors for alcohol use among Asian Americans.
This study compares problem behaviors across a range of adolescent Asian Pacific Islander (API) subgroups using the Add Health data, and controlling for parental education or immigrant status. The study finds that Filipino, “other” API, and multiethnic API American youth are at higher risk for poorer outcomes than Chinese, Korean, and Vietnamese American counterparts. Many of these differences remained after adjusting for parental education. Controlling for immigrant status explained only some of the subgroup differences. The results suggest several shortcomings to the “model minority” stereotype that is often applied to API American youth. Research and practice should not overlook the higher risk for problem behaviors among certain API American subgroups. The findings highlight the need for more resources for API Americans, especially for the API subgroups facing higher risks.
The purpose of this study was to compare the relative effectiveness of several different strategies for recruiting elderly Asians, African Americans, and Caucasians to participate in mental health research.
A total of 35 African American, 24 Asian American, and 215 Caucasian participants were phone-screened for potential enrollment into a University of California, San Francisco Department of Psychiatry treatment outcome study for older adults (60+ years of age) with major depression and mild cognitive impairment.
The methods by which participants were recruited were recorded, coded into composite categories, and statistically analyzed to determine whether certain recruitment strategies were disproportionately effective for recruiting participants from the three racial groups.
Fisher's exact test analyses revealed that Asians and African Americans were significantly less likely than Caucasians to be recruited through mental health-based methods, and African Americans were significantly more likely than Caucasians and Asians to be recruited via referrals rather than solicitations. Logistic regression, which controlled for potential confounds, largely supported these findings.
Findings suggest that the recruitment of elderly African or Asian Americans into mental health treatment outcome research can be facilitated by a flexible consumer-oriented strategy that integrates multiple recruitment methods. Establishing study credibility through non-mental health media and professional referral sources may be especially effective in engaging the participation of elderly Asian Americans; and cultivating ongoing relationships with key gatekeepers, who can observe benefits to the community, may be particularly effective in recruiting elderly African Americans.
recruitment; Asian; African American; minority; late life depression; cognitive impairment; executive dysfunction