New California study finds health care lacking among diverse AANHPI communities

The COVID-19 pandemic spotlighted the Asian American, Native Hawaiian and Pacific Islander community in many ways: some good, some bad, especially in regards to health, says a new study.

The attacks, which ranges from schoolyard bullying, public harassment to beatings and deadly shootings, are borne out of ignorance and the racism simmering under the veneer of civility that used to be expected in US society. The hateful assaults spurred the AANHPI -- the fastest growing ethnic group in California and the nation -- into a flurry of action shattering the stereotypes assigned to them by American society and revealed that the so-called "model minority" was not as successful as believed.

Some of actions on multiple fronts that manifested in a willingness by AANHPIs to break their traditional reticence of bringing attention to themselves. As a result of the  combined actions of declarations from public figures, demonstrations and increased political activities, AANHPIs were successful in grabbing the attention of media, educators, researchers, politicians, service providers and even the entertainment industry.

In the field of health, one study funded by a $10 million grant from the State of California to AAPI Data, in partnership with the UCLA Center for Health Policy Research, is a  groundbreaking study that highlights disparities in the access and utilization of health, mental health and social services by Asian American and Native Hawaiian and Pacific Islander communities, which totals about 6.5 million residents making up about 15.5% of the population, according to the 2020 Census.

Some highlights of the study:

• Asians, Native Hawaiians and Pacific Islanders were slightly less likely to be enrolled in public programs such as CalFresh, Medicare and Medi-Cal compared to other racial and ethnic groups. Enrollment among detailed Asian, Native Hawaiian and Pacific Islander groups showed wider variation, including much larger gaps among groups such as Indians, Japanese and Taiwanese.
• Asians, Native Hawaiians and Pacific Islanders were less likely than whites to have a usual source of care, have visited a doctor in the last 12 months, and be able to schedule a doctor’s appointment in a timely manner.
• While Asian American and Native Hawaiian and Pacific Islander communities reported the lowest rates of suicide ideation overall, disaggregated data reveal Japanese, Korean and U.S.-born Asians are more likely to have said they had ever thought of committing suicide.
•  Among those who reported needing help for emotional, mental or addiction problems in the past year, Asians, along with Blacks and Hispanics, were significantly less likely to receive needed mental, emotional or addiction treatment than whites. Disaggregated data for Asians show similar challenges in accessing mental health services, especially for Vietnamese.

“As you can see in this comprehensive report, the more we break down the data by subgroups, the more apparent the differences and vulnerabilities become. We hope this report can help inform better decision-making and policies,” said Ninez A. Ponce, PhD, MPP, director of the UCLA Center for Health Policy Research, principal investigator of CHIS, and senior researcher at AAPI Data. 

FYI: Read the entire report: "The Health, Mental Health, and Social Services Needs of Asian Americans and Pacific Islanders in California."

"High-quality data is the first step and the foundation to achieving health equity. We are proud to partner with AAPI Data on this report that highlights the unique health challenges and needs of Asian American and Native Hawaiian and Pacific Islander communities, who for so long have been grouped together,” Ponce added. 

Other findings of the study are:

● Asian, Black and Hispanic women were less likely than white women to use birth control. Asian teens were significantly less likely to have received counseling about birth control in the past year.

● While Asians, in general, were less likely to report non-consensual sex or sexual assault in the survey, Japanese and Koreans were more likely to report it than Asians in general, with Japanese reporting at the highest rate among the groups surveyed.

● With Universal Pre-K set as a goal for the 2025–2026 school year in California, a snapshot of ACS data shows which communities have existing gaps in preschool enrollment. Native Hawaiian or Pacific Islander children were among the least likely of all Californian children to be enrolled in Pre-K. Disaggregated Asian data also show that less than half of Laotian, Filipino, Pakistani, Cambodian and Hmong preschool-aged children were enrolled in a pre-K program.

● While Asians in general were less likely to provide care to family or friends with a disability or serious illness than members of other major racial and ethnic groups, Japanese, Filipinos and Vietnamese were much more likely to be caregivers.

● Native Hawaiian and Pacific Islander caregivers were more likely to cite financial stress from caregiving.

● While Asians in general reported relatively low levels of physical and mental health problems due to caregiving, Koreans and South Asians were significantly more likely to report those problems compared to all Asians.

Researchers also found that the shortage of physicians in the Inland Empire, where Filipino Americans made up the largest Asian group, shows up in the survey in the lower percentage of people who were able to get timely medical appointments. Asians have been disproportionately impacted by the shortage, compared to the same measures at the statewide level cited above. Asians in the Inland Empire also were much less likely to get a timely appointment than Blacks, Hispanics, and Whites in the Inland Empire.

The data showed that only 62% of Asians in the Inland Empire, defined as that area east of Los Angeles centering around the metro areas of Riverside and San Bernardino, were able to get an appointment in a timely way (defined as within two days). In the other five regions of California, 83% or more of Asians were able to get an appointment in a timely way. 

A side result of the survey, demographic findings revealed that Filipino Americans were the largest Asian group in the Inland Empire and Samoans and Chamorros were the two largest NHPI groups in the Inland Empire. Chinese and Filipino Americans were the largest share of the Asian child population in the Inland Empire.

Recommendations

The report also outlines several recommendations for action to address equity in health and social services for Asian American and Native Hawaiian and Pacific Islander communities in California. The recommendations include:

● Investing in centralized sharing of limited culturally competent mental health resources and expanding capacity.

● Supporting families and caregivers with in-language support to address financial, physical and mental hardships associated with caregiving.

● Improve awareness and access to public and government programs to address underutilization.

● Invest in increasing language access capacity by creating job opportunities for multilingual immigrants to become certified interpreters.

● Increase opportunities for government partnerships with community-based organizations to leverage their trusted voices to get the word out about new initiatives or public health information.

● Implement and expand data disaggregation efforts to create more timely and accurate data on Asian American and Native Hawaiian and Pacific Islander communities to better implement new policies and programs.

“This new report reveals many disparities in the delivery and allocation of social services and points to the need for the AA and NHPI communities to be an active part of the political decision-making process,” noted Alex Tom, executive director of Center for Empowered Politics. “This report gives civic engagement organizations vital disaggregated data that will strengthen our capacity to articulate the issues and challenges that the AA and NHPI electorates face."

AANHPIs are among the fastest growing racial groups in California and nationwide. In response to the wave of anti-Asian attacks, California passed the API Equity Budget in 2021 that included a three-year investment of over $166 million to better serve communities experiencing hate and barriers to various government services. The award to AAPI Data was part of the first year's expenditure of the Equity Budget.

“Good, disaggregated data is essential to ensure that state and local government agencies understand and address the needs of Asian American, Native Hawaiian, and Pacific Islander communities,” noted California State Senator Richard Pan, MD, Chair of the Asian Pacific Islander Legislative Caucus. “We look forward to more actionable reports from AAPI Data and the California Health Interview Survey, with fresh data collections that shed light on AANHPI mental health needs and experiences with discrimination in various forms.”

DITOR'S NOTE: For additional commentary, news and views from an AANHPI perspective, follow @DioknoEd on Twitter.

Correct count matters for AAPI health

By Andis Robezniek
American Medical Association

When grouped together, Asian Americans comprise the fastest-growing ethnic population in the U.S., going from 11.9 million in 2000 to 20.4 million in 2015—a rise of 71.4%.

The problem, however, is that grouping all Asian Americans together masks their diversity and tends to hide their particular challenges. This problem is exacerbated when data for Asian American and Pacific Islanders are aggregated under the “AAPI” banner, relegating many to become statistically invisible in the anonymous “other” data column.

Or, as it’s put in the AMA Center for Health Equity’s “AAPI Community Data Needed to Assess Better Health Outcomes” (PDF) report, “What is measured is what is valued; what is undercounted tends to be counted out.”

“The dearth of racially and ethnically disaggregated data reflecting the health of AAPI persons and families underlies the struggles of the physician community to fully attend to, and be attuned to, the unique needs of their AAPI patients,” the report states.

The need for this data is not just an academic debate—it leads to real-world deficits, said Ray Samoa, MD, assistant professor in the Department of Diabetes, Endocrinology and Metabolism at City of Hope Medical Center, in Duarte, California.“The public health cycle that I understand starts with data,” which then informs allocation of resources and programming, Dr. Samoa said. “Native Hawaiians, Pacific Islanders, Native Americans, Asian populations—we are invisible, so there is no data. So there's no way for us to even partake in any of the downstream benefits of that cycle.”

Dr. Samoa, who told Congress that, to his knowledge, he is “the only endocrinologist of Pacific Islander descent on the U.S. continent,” made his remarks during an episode of the AMA Prioritizing Equity video series, “COVID-19 and Asian American and Pacific Islander Voices.”

How disaggregation changes the picture

When all are assembled under the AAPI banner, differences in health issues are lost, said Anna Yap, MD, a fourth-year resident in University of California, Los Angeles-Ronald Reagan/Olive View emergency medicine program. She is also a delegate in the AMA Resident and Fellow Section.

With diabetes, for example, about 10% of the AAPI population has diabetes, compared with 8% of the overall U.S. population, Dr. Yap said.

“When you break that data down, it's actually 47% of American Samoans and 20% of native Hawaiians who have diabetes,” she said. “You wouldn't know this unless you disaggregated the data.”

Dr. Yap spoke during a recent episode of the "AMA Moving Medicine” podcast series on data disaggregation

Legacy of racist U.S. history

With the Chinese Exclusion Act (1882), the Immigration Act (1917), the National Origins Act (1924), and the internment of Japanese Americans during World War II, Dr. Yap said discrimination against Asian Americans and Pacific Islanders was codified into law and became “baked in policy” even after the laws were repealed.

Too little attention is paid to the U.S. history of racist, discriminatory actions against Asian Americans, leading to it getting “kind of erased,” Dr. Yap said.

Moreover, it’s too often assumed that all Asian Americans represent a so-called model minority, and that these historical wrongs don’t matter anymore.

But the impact is there. Dr. Yap’s family is from Malaysia and, as a child, she said other schoolchildren bullied her for speaking Chinese or for the lunch she brought to school.

“I was made fun of for having rice in a rice box that my dad so lovingly prepared,” she said.

Similarly, Dr. Yap spoke about hate directed at her and other Asians during the COVID-19 pandemic.

“I had a patient who initially was nice to me but, when he realized I was Chinese-appearing, started yelling at me about how my people were making everyone sick,” Dr. Yap said, adding that this man threw urine at her and a nurse.

“We've been working so hard to fight against this pandemic and it's really disheartening to be targeted and to be hated just for our race,” she added. “To carry that burden of being hated for what we look like while still trying to provide care has been particularly rough in the community.”

Filipinos, Native Hawaiians have more health risk factors than other AAPI groups

Kaiser findings suggest value in identifying AAPI patients’ 

ethnic backgrounds in medical records

By Jan Greene
Kaiser Permanente

Asian Americans from different parts of Asia have very different cardiovascular risk factors and chronic conditions such as diabetes, hypertension, and heart disease, research from the Kaiser Permanente Division of Research suggests.

The study released Sunday (Nov. 24) found that overall, Filipinos and Native Hawaiians/Pacific Islanders had significantly more risk factors and chronic disease prevalence than other Asian American ethnic groups. Prevalence among Filipinos and Native Hawaiians/Pacific Islanders was similar to that for blacks and Latinos, two groups that have been the focus of health disparities research.

“Based on a relatively small body of previous research, we suspected that we would see differences,“ said lead author Nancy Gordon, ScD, a research scientist with the Kaiser Permanente Division of Research. “But we didn’t expect them to be so large. For instance, Filipino Americans in the study were twice as likely to have diabetes than those of Chinese ethnicity.”

The study, published in BMC Public Health November 25, used electronic health record (EHR) data for 1.4 million adults aged 45 to 84 who were Kaiser Permanente Northern California members during 2016. The researchers identified 274,910 Asian Americans using race and ethnicity information from the EHR and patient surveys.

They assigned the patients to Asian subgroups, including Chinese, Filipino, Japanese, Korean, Southeast Asian and South Asian. They also studied Native Hawaiians and Pacific Islanders, who are grouped together separately in epidemiological research.

The study examined prevalence of smoking, obesity (using both standard and Asian-specific classifications), and diagnoses of diabetes, hypertension, and coronary artery disease.

Other findings of the research included:

• Diabetes prevalence ranged from a low of 15.6% for Chinese to 31.9% for Filipinos and 34.5% for Native Hawaiians and Pacific Islanders.

• Obesity using standard BMI measurement ranged from 7.6% among Koreans and Southeast Asians to 43.6% among Native Hawaiians and Pacific Islanders, 20.8% among Filipinos, 20% among South Asians, and 19.7% among Japanese.

• Using a separate BMI threshold recommended for Asians, obesity prevalence ranged from 19% among Southeast Asians, Koreans, and Chinese to 36% to 40% among Japanese, South Asians, and Filipinos; it was 60% among Native Hawaiian/Pacific Islanders. Prevalence was higher among men than women in most subgroups, except South Asian and Native Hawaiian/Pacific Islanders

• Smoking rates were 3% for South Asians, 4.8% for Chinese, 7.3% for Southeast Asian and Filipino, 7.7% for Korean, and 10.4% for Native Hawaiian/Pacific Islanders.

The research team didn’t attempt to explain the reasons for the differences. The authors plan to further study issues such as the role of obesity in varying diabetes prevalence and how social determinants of health and psychosocial risk factors relate to differences in chronic illness prevalence among Asian ethnicities.

The information could identify patients who are more likely to have cardiovascular risks and chronic conditions, allowing physicians to carry out earlier screening and more frequent monitoring, said coauthor Joan Lo, MD, a research scientist with the Division of Research. 

“This could become even more important as physicians increasingly see patients by video or phone visits that don’t involve collection of vital signs that can track small changes in health status,” she said.

The findings could also be of interest to health researchers and population health managers, Gordon said. Having more granular Asian ethnicity data in the EHR would allow health systems to track quality metrics specific to Asian ethnic groups.

Asian ethnicity information could also help organizations enhance delivery of equitable and culturally competent care by offering ethnicity-tailored dietary assessments and patient education resources, Gordon said. They could also use it to build a workforce whose ethnic diversity mirrors the patient population, she added.

The study was funded by the Kaiser Permanente Northern California Community Benefit Program.

Study: Asian American cardiovascular risks no different than other groups

ASAM NEWS & VIEWS FROM THE EDGE

Asian Americans fared better than their white counterparts and were considered 42% more likely to have "ideal" cardiovascular health, according to research published last week in the Journal of the American Heart Association. But that advantage disappeared when the data was tweaked to redefine what was considered overweight for Asian Americans.

Authors of the American Heart Association's recent study say their research is the first to assess the heart health of Asian Americans using a nationally representative sample.

Previous research has shown Asian populations are at higher risk for diabetes, high blood pressure and high cholesterol at lower BMI thresholds. Using standard BMI definitions for overweight and obesity among Asian Americans may fail to identify people at increased cardiovascular risk, according to the study.

Even when compared to white people of similar age, sex and body fat, Asian Americans tend to have consistently lower BMI because of their "different body build," said Dr. Jing Fang, the study's lead author and an epidemiologist in the heart disease and stroke prevention division of the Centers for Disease Control and Prevention.

Specifically, Asians are more likely to develop fat around the abdomen, which is linked to a higher risk for cardiovascular disease. It's partly why the World Health Organization proposed lowering the BMI cutoff for Asian populations to consider anything 23 or higher as overweight, Fang said.

A “normal” BMI is considered to be anything below 25. But previous research has suggested that Asian Americans are at higher risk for diabetes, high blood pressure, and high cholesterol at lower BMI thresholds. Failure to use population-specific metrics can put Asian Americans at a higher risk for going undiagnosed and untreated. More than half of Asians with diabetes go undiagnosed, for example, according to the American Heart Association.

Fang said that these findings “highlight the need for the application of population-specific and culturally appropriate metrics when assessing [cardiovascular health].” This is made all the more important by the fact that Asian Americans are one of the fastest-growing groups in the U.S. They currently make up 5.6% of the overall population, and are projected to double in population by 2060, according to the American Heart Association.

Anh Vu Sawyer is someone who is well aware of the fact that low BMI doesn’t equate to good heart health.

“I have a very low body mass index,” said Sawyer, “but I was surprised to learn that I’m already prediabetic and did have high blood pressure.” These conditions put her at higher risk for heart disease and stroke. Her diagnosis 8 years ago was a reminder to eat healthier, but also to educate others. 

Sawyer is the executive director of the Southeast Asian Coalition of Central Massachusetts in Worcester, MA, which serves around 10,000 people in the local Southeast Asian community. One of the many services they provide is a healthy eating group, and an urban gardening project.

Sawyer wants to open a commercial kitchen that uses the fresh produce from the garden. She envisions catering and cooking classes from the kitchen, and opportunities for community seniors to cook.

“The food the elders cook is just amazing,” Sawyer said. Still, she reminds herself to be mindful of her diet.

“I have to stay off the noodles,” she laughed. “Once a week, that’s it.”

Hopefully with this latest research publication, more people in the medical profession and the general population will know when someone is at risk, and should be watching their diet and taking other measures for better heart health.

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Heart disease varies among AAPI communities

South Asians, Filipinos and Vietnamese are more prone to die from heart disease and stroke than other Asian subgroups, suggests new research.

It is already a known fact that Asian Americans are more likely to die from stroke than whites, according to the study published online March 20 in the Journal of the American Heart Association.

But results from the study showed that the subgroups had varying results.

"Usually researchers combine Asian subgroups in studies, masking what might be important health differences," said study author Dr. Latha Palaniappan, a professor of medicine at Stanford University in California.

"Looking at overall death rates might not reveal that some groups are dying prematurely from heart disease and stroke," she said in a Journal news release.

"A striking finding was that years of life lost due to stroke in women were greater for all of the Asian subgroups than … whites. This tells us that stroke is a very important contributor to premature death, especially in Asian women," Palaniappan explained.

The researchers also found that among Asian Americans, the average age of death from heart disease was younger among the Asian Indian subgroup. They lost an average of 17 years of life to heart disease, according to HealthDay News.

The most years of life lost to stroke were among Vietnamese (17 years) and Filipinos (16 years), the findings showed.

"One of the benefits of the study is that we've identified these differences among Asian subgroups. Now we can create culturally tailored and personalized preventive programs and guidelines for each group based on its unique risks," Palaniappan said.

This is the value of having disaggregated data. Not all subgroups fit under one mass category. The differences -- at least in health results -- between Japanese, Filipinos, Vietnamese, South Asians and others, are real.

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TGIF Feature: Filipino artist urges the community to register as bone marrow donors an...

Filipino pop artist Guji Lorenzana links his original song “Be Alright” to his new campaign to register more Asian American bone marrow donors. 

Lorenzana's new release is dedicated to his late mother who battled cancer for nearly two years. The song was initially just for Lorenzana’s mother but after her passing last June, it became so much more.

“I decided to make it a lifelong advocacy and campaign to honor her, to spread cancer awareness, to spread cancer prevention and to do all I can just to help out in the community,” he said in Daly City, Calif.

The Asian American Donor Program said that despite the low numbers of Filipinos in the registry, matches have been made.

“When a patient or recipient meets the donor, it is absolutely amazing. Not only is the donor saving the patient and their family and really the community, that donor is very special. It will also change their life,” said Carol Gillespie, executive director of the Asian American Donor Program.

Lorenzana launched the Be Alright campaign and partnered with the Asian American Donor Program and Be the Match to create the PSA below:

Enjoy Lorenzana's entire song below:

To learn more about the Asian American Donor Program, link here.

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Study: Asian Americans prone to strokes

ASAM NEWS

A new study found that Asian Americans had more severe ischemic strokes, experienced greater hemorrhagic complications, and received less intravenous t-PA treatment than White patients, reports MedPageToday.
The main author of the study, Sarah Song with the Department of Neurological Sciences at Rush Medical College , compared clinical characteristics, outcomes and treatment patterns of 64,337 Asian Americans and 1,707,962 White patients with acute ischemic strokes.

After adjusting patient and hospital variables in the analysis, results showed that Asian Americans demonstrated greater stroke severity compared with White patients—experiencing higher in-hospital mortality, longer lengths in hospital stays, and less-likely independent ambulation following discharge, which researchers reported in JAMA Neurology. The data for the study came from the American Heart Association/American Stroke Association.

Dr. Song sees this as a necessary catalyst for additional research on clinical care and outcomes for Asian Americans.

“This is just one study, but it’s alarming,” Dr. Song told MedPage Today. “Asian Americans are the most rapidly growing ethnic group in the country. This study is a call to action that we need more research in this population.”

Last year, Dr. Song presented some of these findings in preliminary research at the American Stroke Association’s International Stroke Conference 2018. Song said in a statement about that earlier study, “This study highlights the need for more focused research, improved stroke prevention and possibly different treatment strategies for Asian Americans” reports NBC News.

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Study: South Asian Americans have high tisk of heart fisease

ASAM NEWS

A RECENT MEDICAL STUDY finds a high risk of heart disease among South Asians living in the U.S due to genetics, reports NBC News. The study also highlights the importance of living a healthier lifestyle.

Anabelle Santos Volgman, the lead author of the report and medical director of the Rush Heart Center for Woman at the Rush University Medical Center in Chicago, said that several factors had contributed to the increased risk of heart disease, including the fact that the South Asians are prone to bad cholesterol and diabetes.

“We don’t have an answer to why South Asians have a higher risk of diabetes, but there are many genetic theories that have not been substantiated,” she said, adding that the study published by the medical Journal Circulation of the American Heart Association was made to investigate the risk factors of heart disease.

South Asians in the states come from many countries including Bangladesh, Bhutan, India, Nepal, Pakistan, the Maldives and Sri Lanka. The study found they have a higher death and hospitalization rate due to heart disease than others in the U.S.

According to Jwatch.com, the Associate Editor of NEJM Journal Watch Cardiology, Karol E. Watson, reviewed the study and said that dietary factors may contribute to the increased risk as many South Asians consume a high percentage of carbohydrates and saturated fats.

The study provides recommendations for South Asians to eat traditional whole grains and to have more physical exercise to decrease the level of cholesterol, blood pressure and the risk of early diabetes.

“The lifestyle changes can make a big impact,” said Volgman. “What we need to emphasize is that they need to take heart disease seriously and seek help to determine if they are at high risk.”

South Asians immigrated to the United States in three waves beginning in the late 18th century. The first wave occurred from the 1890’s to the 1920’s. The second wave started after the establishment of the 1965 Immigration and Nationality Act sending a total of 20,000 skilled professionals and 25,000 physicians to the states.

A third wave of immigration in the mid 1980’s included extended family members and parents of thousands of professionals and physicians.

Data from the U.S Census Bureau shows that most of the South Asians in the states are originally from India followed by Bhutan and Nepal. Many reside in urban metropolitan areas in California, New York, New Jersey, Texas, and Illinois.

Sunday Read: Being always on guard because of one's race can tax workers emotionally and mentally

Illustrative Photo by Sodanie Chea Via Flickr Creative Commons

By Louis Chan
ASAM NEWS

JACKIE YOUNG felt highly valued by her company when she was first hired for a sales position, but that quickly changed.

Jackie connected with people she knew to market a company event designed to increase the corporation’s exposure in the public eye and also to bring in new vendors.

“This event had a great turn out, but when my boss stood at the doorway looking in she turned to me and said, “Why are there so many Chinese?” recalled Young to AsAmNews. “I was quite offended as to why she would think this would appear to be an issue with her, and standing before her (me), a Chinese/American. Less than a third of the public in the room were Chinese, so there really weren’t that many.”

Young explained she had used her “personal connections” as she was taught in training and described one of her friends as a Pied Piper” who invited other friends, some who happen to be Asian and others who were not.

“After I explained this to my boss as she stood at the entrance, shook her head and said “'No, no,' and walked away. That was the first sign to me that she has subconscious bias or should I just say she’s racist?”

Young’s experience mirrors that of other people of color, according to a new report released by Catalyst, a nonprofit dedicated to building “workplaces that work for women.”

The report entitled Day-to-Day Experiences of Emotional Tax Among Women and Men of Color in The Workplace found that Asian, Black, Latinx, and multiracial professionals pay an emotional tax at work when they feel they must be on guard to protect against racial and gender bias.

“Emotional Tax is the day-to-day experience of having to be on guard for experiences of bias and the impact of that on the ability to thrive at work and in life,” said Jennifer Thorpe-Moscon of Catalyst to AsAmNews. “We define it as “the combination of feeling different from peers at work because of gender, race, and/or ethnicity and the associated effects on health, well-being, and ability to thrive at work.”’

Out of the 1569 professionals surveyed, 24 percent of the respondents were Asian with the average age of all respondents 35. Women made up 51 percent. 

One respondent identified as Ying, a 27-year old Asian business woman, was among those who took part.

“Once I was given a writing assignment about defensive driving techniques,” said Ying. “Although I liked the subject, I felt very on guard when it was read aloud to me, as well as everyone else in our meeting. I braced myself for the inevitable Asian/woman jokes. When they did come, I coped with it by smiling and shrugging it off so as not to cause tension.”

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In addition to examining women of color, the report's data reveal the Emotional Tax experiences of men of color in US workplaces: over one-quarter of Asian, Black, Latinx and multiracial men who are on guard anticipate bias because of their gender, and, in general, far more experience Emotional Tax. 

According to the Catalyst findings, Asian men experience a sort of double jeopardy. When they act more assertively— contradicting the meek and passive stereotype—they may be penalized in the workplace while white men are commended and promoted for exhibiting the same behavioral traits.

Among the other findings of the survey are:

• Asian, Black, Latinx, and multiracial professionals pay an Emotional Tax at work when they feel they must be on guard to protect against racial and gender bias. 
• This experience was shared by nearly 60% of the women and men of color we surveyed. 
• Employees who feel on guard are most likely to want to leave their employers and face challenges to their well-being. 
• A majority of those who are on guard have a strong drive to contribute and succeed—suggesting that the loss of their talent would be detrimental to the organization. 
• To retain these valuable employees and address potential reasons for being on guard, leaders must cultivate inclusive workplaces.

"Women of color continue to deal with some of the workplace's most entrenched hurdles, such as pay inequities and near invisibility in top leadership roles, as well as daunting roadblocks that stifle the meaningful dialogue that would help make real progress," says Dnika J. Travis, PhD, Catalyst Vice President for Research. 

"Over time, these daily battles take a heavy toll on women of color, creating a damaging link between their health and the workplace. And because of consequences associated with Emotional Tax, companies must begin to take intentional action to avoid possible harm to their businesses and employees' health and well-being."

(Views From the Edge contributed to this report,)

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Health: Asian Americans are a higher risk for stroke, says new study

ASIAN/AMERICANS are at higher risk for stroke and hypertension compared to whites, according to a study examining U.S. death records from 2003–2010.

Although heart disease is the No. 1 killer of all Americans, certain races and ethnicities face higher cardiovascular risk than others. Asian Americans are the fastest growing racial/ethnic group in the United States, yet little is known about heart risks in distinct subgroups of the Asian American population. 

The study "highlights the need for more focused research, improved stroke prevention and possibly different treatment strategies for Asian-Americans," said study author Dr. Sarah Song, an assistant professor of cerebrovascular disease at Rush University Medical Center in Chicago.

"Among Asian-Americans, the various minority populations differ in so many ways," she noted. "Vietnamese people are not the same as Korean, who are not the same as Japanese or South Asian groups. Aside from differences in language, differences in stroke risk factors, diet and lifestyle, and other cultural factors, make compiling all Asian-American groups into one single group problematic."

Published in the Journal of the American College of Cardiology, a recent study analyzed death records for the six largest Asian-American subgroups: Asian Indian, Chinese, Filipino, Japanese, Korean and Vietnamese. Together, these subgroups make up 84% of the Asians in the United States. 

After comparing U.S. death rates from 2003–2010, researchers found that stroke and high blood pressure was more common among every Asian American subgroup compared to non-Hispanic whites. Compared to whites, Asian Indians and Filipino men also had greater mortality from coronary artery disease—a condition that occurs when the heart’s arteries narrow, often due to the plaque build-up on the arterial walls. 

Based on these findings, authors highlight the need to direct specific treatment and prevention efforts to reduce health disparities in the Asian/American population. If Asian/Americans face greater risk of hypertension and stroke, it’s important to address these risk factors to prevent complications and improve outcomes. 

With a current population of more than 18 million that is projected to reach 34 million by 2050, addressing cardiovascular risk factors in this rapidly growing population will have a meaningful impact on improving the heart health of the U.S. population.

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