HEALTH: Mamogram followups often take longer for Asian women

Asian/American women, particularly Filipinas and Vietnamese, often take twice as long than white women to receive follow-up exams after an abnormal screening mammogram. 

Many population-based breast cancer studies do not include Asians, and those that do often report them as a single group. 

To study the relationship between breast cancer screening and outcomes in multiple Asian populations, a team led by Drs. Kim Hanh Nguyen and Leah Karliner, both of the University of California, San Francisco examined information from the San Francisco Mammography Registry. 

The investigators examined data on 50,970 San Francisco-area women with mammogram results from 2000-2010 that indicated the need for further diagnostic imaging. Among Asian/American women, Vietnamese and Filipinas had the longest—and Japanese the shortest—median time to follow-up imaging tests (32, 28, and 19 days, respectively) compared with non-Hispanic White women (15 days).

The proportion of women receiving follow-up tests at 30 days was lower for Asians than for non-Hispanic Whites (57 percent versus 77 percent), and these disparities persisted at 60 and 90 days for all Asian ethnic groups except Japanese women. Asian women also had a higher rate of no follow-up at one year than non-Hispanic Whites (15 percent versus 10 percent), with Filipinas having the highest percentage of no follow-up among Asian ethnic groups (18 percent).

“The reasons for these long delays may be due to linguistic, cultural and other barriers that affect patient-provider communication for disadvantaged Asian groups,” said Dr. Nguyen. “More research attention is needed to understand the specific reasons for these differences.”

By 2060 the projected number of US residents who will identify as Asian or Asian with another race will reach 48.6 million, or 11.7 percent of the total population.

“Rather than being a monolithic group, Asians are, in fact, very diverse in nationalities, language, immigration history, education, and economic background. Recognizing differences among Asians may help clinicians develop better rapport and communication with their Asian patients, which can improve adherence to screening recommendations,” said Dr. Nguyen.

“The misconception of the model minority suggesting Asians are doing better than other minorities is insensitive to disparities that exist for Asians and undermines the need to address such disparities.”

How the AAPI community will be impacted if Republicans eliminate the Affordable Care Act

ASAM NEWS

THE AFFORDABLE CARE ACT was pitched as a moonshot by President Obama in 2009. Since the official institution of the Patient Protection and Affordable Care Act (ACA) in 2010, many previously marginalized groups in healthcare have received access to health care insurance. Now, President-elect Donald Trump heads for office this January 20, after campaigning for a starkly opposite vision. 

The ACA - sometimes referred to as Obamacare - appears to be the first of several Democratic-instituted programs Trump will repeal. So what does this mean for Asian/Americans and Pacific Islanders?

A lot is at stake. According to the U.S. Census Bureau, between the years 2008 to 2014, Asians represented the highest rate of enrollment in health insurance purchases. The CDC National Health Survey shows comparable trends. Between 2013 and 2015, the percentage of Asian/Americans who were non-insured decreased from 16.1 percent to 8.8 percent; almost halving the percentage of uninsured. These drastic numerical changes coincide ACA’s enactment.

According to statistics provided by the White House in 2014, 1 in 4 Korean/Americans and 1 in 5 Vietnamese/Americans lacked insurance. The US Department of Healthcare and Human Services cites that Asian/Americans are an unlikely group to be screened for cancer. For example, in 2010, Asian/American women were the least likely population to have had a Pap smear. Furthermore, Asian/Americans and Pacific Islanders ranging from 19 to 24 in age were 1.6 times more likely to have Hepatitis B than non-Hispanic Whites.

When seeking healthcare, Asian Americans face issues comparable to many immigrants and lower-income patients. The lack of comprehension, fear of the system and the inaccessibility of hospitals are all barriers to entry for these populations. 

Asians, in particular, face another edge of the “model minority” sword: the population ranks among the fastest-growing populations in poverty since the Great Recession. Moreover, because Asian/Americans typically either work for or run small private businesses, health benefits are rare.

Theresa Lau, author of an opinion article on NBC news recalls 15-mile drives and waiting hours to see a community health specialist for her care. With non-English speaking parents who worked long hours for limited income, a doctor’s visit was atypical and difficult. Lau’s dismay at the potential repeal of the ACA reflects an opinion many may share. Since the ACA’s implementation in 2010, around 20 million new patients have been insured.

The outlook for continuation of the ACA looks to be grim. Trump has already nominated Seema Verma as the Administrator of the Centers for Medicare and Medicaid Services and Tom Price as Health and Human Services Secretary.

Verma is known as a staunch Republican. Her work with Indiana Governor Mitch Daniels advocated for low-income patients to compensate for their insurance by volunteering, and contributing to a health payment account. Price is known for drafting an alternate, GOP rendition of the ACA, the Empowering Patients First Act or EPFA. The alternative proposes offers tax credits so patients may purchase insurance through the private market. Together, the decisions of Trump, Verma, and Price will change the health landscape of millions of Americans, marginalized and not.

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Health: PSA addresses suicide in AAPI communitiy

REPRINTED FROM ASAM NEWS

A CATCHY new public service campaign has been released to give a lift to anyone feeling a little down or even depressed.

Launched by motivational speaker, songwriter and TV/Radio host Larissa Lam, "I Feel Alive" features a number of Asian/American celebrities.

The campaign is meant to coincide with Suicide Prevention Month.

Suicide is the second leading cause of death among Asian/Americans ages 15 to 34. Each year, 2,500 Asian Americans and Pacific Islanders die of suicide.

Despite its subject, the PSA features an upbeat tune written and performed by Lam.

It is worth both checking out and sharing.

Health: Boba may be bad for you

Those who love these boba drinks should cut back, say health advocates.

OH, NO! Boba drinks can lead to diabetes. The popular sweet drink, also known as Bubble Drinks, which has those tapioca balls floating around in them, can have up to 36 grams of sugar, or as much as a can of Coke.

Too much sugar in your diet can cause diabetes. Medical experts have already warned us about too much white rice can lead to Type 2 diabetes. Sugary drinks are the single biggest source of dietary calories and a major contributor to Type 2 diabetes.

“There’s a model minority myth for public health: If you’re skinny, you’re healthy,” says Scott Chan, program director of the Asian Pacific Islander Obesity Prevention Alliance, one of the groups behind a “Rethink Your Asian Drink” campaign.

RELATED: Study says white rice can lead to Type 2 diabetes 

While Asian Americans have a rate of diabetes at 10 percent (compared with 7 percent of whites) a recent study by the National Institute of Health (NIH) shared that more than half of Asian Americans with diabetes are undiagnosed.

According to the American Heart Association (AHA), the maximum amount of added sugars you should eat in a day are:

Men: 150 calories per day (37.5 grams or 9 teaspoons)Women: 100 calories per day (25 grams or 6 teaspoons)

Americans consume 200 to 300 more calories each day than we did 30 years ago, says the Alliance on its website. Nearly half of these extra calories come from sugar-sweetened drinks. More calories mean extra weight. One can of soda a day can add up to 10 pounds or more of weight gain in a year. But what happens when we look beyond just mainstream drinks like soda?

It's not just boba drinks. All those fruity drinks sold at many of the Asian groceries are just as bad. Many people know drinking soda everyday is not good for your health, but Asian drinks can be just as bad. For example, boba milk tea can have as many calories as a McDonalds double cheeseburger.

Health: Gene discovered in Asians that creates a craving for fast food

The craving for noodles may be beyond one's control.

STUDYING LATE at night and all of sudden, you get a craving for pizza, french fries or that good ol' college standby - a bowl of ramen noodles. A little voice in your brain keeps repeating, "Eat junk food, eat junk food."

A new UCLA study has found a gene that may be the culprit for Asian/Americans. The gene, DRD2 A1 is the gene that causes some Asian/Americans to crave unhealthy food like french fries or fast food.

Despite the popular myth of the existence of a skinny gene among Asians and the immense cultural pressure for Asian women to be skinny, Asians and Asian/Americans are just as likely to become obese as any other race.

RELATED: Asian/American women battle body image issues

However, the DRD2 A1 gene is also found among Asians who still live in Asia where the obesity epidemic has become a problem. As Asian countries become more urbanized, fast food outlets proliferate and traditional recipes are used only on special occasions.

The bad gene is a variation of DRD2 (dopamine receptor D2), a type associated with various forms of addiction.

Dr. Zhaoping Li, senior author of the study, believes that their findings are important in addressing addictive behavior among people with the genetic variation. While the research specifically involved Asian/Americans, its findings are reportedly applicable to anyone of Asian descent. It also proves promising in tackling obesity for the particular demographic.

Fast food is gaining popularity in Asia, too

RELATED: White rice leads to Type 2 diabetes

In a 2014 article, Gen Re reported the rise of obesity in Asian countries, a trend that was attributed to economic growth and cultural factors. At the time, Malaysia had the highest prevalence of obesity (14 percent), while Vietnam scored the lowest (1.7 percent).

The publication also cited other studies which pointed to the vulnerability of Asians. As it turns out, the group is said to: (1) have a higher percentage of body fat, (2) be more susceptible to developing central obesity and (3) do less physical activity than Euro/Americans.

The Diplomat sees the increasing rural-to-urban migration in the region as a catalyst for obesity. Migrants consume more processed food and lead more sedentary urban lifestyles. Asia is expected to be 64 percent urban by 2050, calling for more strategic interventions and policies.

RELATED: Calif. governor rejects bill to document disparities among Asians

One of the UCLA study’s important goals was to understand the genetic factors that contribute to obesity so that better treatment plans could be developed for obese people, and the researchers write that there is a specific need for more in-depth analysis of obesity in Asians and Asian/Americans. In the meantime, authors of the UCLA research propose further studies to investigate the possibility of reducing food cravings through dopamine-like drugs. Whether these medications help in weight reduction for those with the genetic variation is yet to be known.

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Health: Asian/Americans confront hepatitis B, the 'silent killer'

Journalist Alan Wang is featured in "Be About It."

ALAN WANG, former a television journalist in the San Francisco Bay Area and from outward appearances, is living the good life.

"I don't want for too much," he tells a reporter from the San Jose Mercury News. "There are only a few things you've got: your health and your family and the love around you. I've really learned to appreciate that." 

In a Sunday feature article about a documentary, "Be About It," he told the reporter that he suffers from Hepatitis B.

One in 10 Asian/Americans is chronically infected with Hepatitis B, and San Francisco has the highest rate of liver cancer in the world, according to figures from San Francisco Hep B Free.

There are several reasons hepatitis B is known as "the silent killer," the article states. "First, it often doesn't produce symptoms in people for decades, so people aren't aware they've got it until it has progressed significantly, says Huy Trinh, a San Jose hepatologist, or liver specialist. In the meantime, the disease progresses, and people transmit it unwittingly."

"The majority of patients are not aware they have the infection," Trinh says. "Their perception is that they must have significant symptoms to have the virus."

The film, which has been making the rounds of film festivals, including the CAAMFest film festival in San Francisco in March and will be shown later this month in the Los Angeles Asian Pacific Film Festival, aims "to break the silence" about a disease that disproportionately impacts people from East Asia and Asian/Americans. It is the story of two fathers who have contracted the disease. 

A.J. Jabanero competed in triathalons.

Besides Wang, the other father featured in the documentary is A.J. Jabonero, who died from the disease about a year ago. 

Up until late 2014, Jabonero seemed to be doing amazingly well. He began to devote himself to eating well and competing in triathlons, especially after he became the father of his first two children, now 7 and 3, says his wife Melissa. 

But he was inconsistent in taking his medication, she says.

Often stigmatized and misunderstood, Hep B is the most common cause of liver cancer among Asian Americans. 

Wang left the television station where he worked last March 31. According to his LinkIn bio, he is now a spokesperson for Weber Shandwick/Gilead Sciences, which is helping promote "Be About It."

The executive director of the documentary is Paul Kiely and it was directed by Christopher Wong, who was also a co-producer along with Zebediah Smith. "Be About It" will be shown in the Los Angeles Asian Pacific Film Festival, April 22 at the Downtown Independent theater. 

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For more news about Asian/Americans & Pacific Islanders, read AsAm News.

Bonta bill to address health and educational disparities among AAPI communities

California Assemblymember Rob Bonta speaks at a press conference on the AHEAD Act.

OAKLAND'S Assemblymember Rob Bonta (D), author of AB 1726, the Accounting for Health and Education in Asian Pacific Islander Demographics Act (with the clever acronym will henceforth be known as the AHEAD Act), issued the following statement last week after holding press conferences in Oakland and Sacramento to call for accurate data collection for all AAPI subgroups.

“Good data drives good policy,” Bonta explained. “One way to get good data is through disaggregation. Disaggregating data means breaking it down into smaller subgroups and assessing specific trends that were previously hidden.

“Certain subgroups within the API community are falling behind on public health and education benchmarks, but these facts are hidden within the broader group statistics. That’s why I’ve introduced the AHEAD Act, to help meet the needs of California’s diverse communities.” 

Gov. Jerry Brown refused to sign a similar bill last year, saying that the state was already collecting that data and the legislation would have created duplication.

RELATED: Health legislation vetoed by governor

Bonta, the only Filipino/American lawmaker in the California legislature, gave an example of how disaggregation drives good public policy decisions. “In 2011, Asian Americans for Community Involvement (AACI) in San Jose performed a county health assessment using disaggregated data. That data revealed that Chinese Americans have significantly higher rates of Hepatitis B, which allowed AACI to conduct targeted outreach to Chinese residents. If AB 1726 becomes law, we will have the opportunity to evaluate more accurate data on disease rates, health insurance coverage, and birth and death rates.”

Quyen Dinh, executive director of the South East Asian Resource Action Center, spoke in strong support of the bill at the Oakland press conference. "Diversity and race in America is not something to be afraid of, it’s something to be understood and embraced. Disaggregated data facilitates data-driven, targeted interventions that are a better use of our tax dollars to uplift all of our students, our brothers, our sisters, our cousins.” 

All of these shortcomings can be traced to “outdated data systems” that put all Asians in one category, when in fact there are 23 separate groups, each of them with unique needs.

“We don’t look the same and are not all the same,” said Phong La, former chair of the API Commission, API American Public Affairs Association. “We speak different languages and have different medical needs. We need to figure out who’s where.”

The AHEAD Act is also a top priority for the API Legislative Caucus. Assemblymember Das Williams (D-Carpinteria), Caucus chair, explained his support. “The API community has historically advocated for disaggregated data because we are uniquely diverse and each community has specific needs. Understanding how long certain students are spending in the community college system, figuring out what specific language needs are needed for certain regions, or identifying how specific communities are affected by certain health problems - all of this information is vital and relevant for our work as public servants.”

The Act is also supported by more than 50 API organizations, and is sponsored by the Southeast Asia Resource Action Center, Empowering Pacific Islander Communities, and the Asian Pacific Islander Health Forum.

“The AHEAD Act is a great example of what the API community can do when it stands together, united for the common good of the whole group. With accurate data, we will have a clearer picture of who requires assistance, be better positioned to provide needed support for community members who have been left behind, and, together, create a stronger California,” Bonta concluded.

The press conference is below:

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