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Asian Americans and Heart Disease
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Introduction
Asian Americans are
those who live in the U.S. and personally identify
themselves as having Asian or Pacific Islander
ancestry. This group includes people whose origins are
the Far East, Southeast Asia, the Indian Subcontinent
and the Pacific Islands. It was classified into 28 Asian
and 19 Pacific Islander ethnic groups for the 1990
Census providing a great diversity in language, culture
and beliefs.
Asian Americans make
up about 4.3% of the U.S.'s population (as of the 2000
census), two-thirds of them being foreign-born
immigrants, and is the fastest growing of all the major
racial/ethnic groups (in terms of percentage increase).
That translates to about 12 million people who identify
themselves as at least part Asian. Compared to the
United States a proportionately greater segment of the
Canadian population are from South Asia. 750,000
Canadians have their ethnic roots in South Asia. That
compares with one million in the United States, a
country with 10 times the population of Canada.
There is a great
diversity within the overall Asian American population
as represented in Table 1. This table includes Asian
ethnic groups whose total population is at least 50,000
in size. It breaks down each Asian ethnic group's total
population by single ethnicity, two or more Asian
ethnicities, and finally, Asian and at least one other
race (multiracial Asians).
Growth of Asian Americans in relation
to other groups in the country
In terms of
proportion to the total U.S. population,
Hispanics/Latinos and Asian Americans are experiencing
the highest growth whereas African American population
has stayed and will remain relatively stable.
Conversely, the proportion of the U.S. population who
are White is expected to decrease each decade and in
2050, no
racial/ethnic group
will have be a majority, including Whites for the first
time in U.S. history. Table 2 shows Asian Americans as
the fastest growing of all the major racial/ethnic
groups, both from 1980-1990 and 1990-2000.
Within the Asian
Americans (see Table 3), Chinese are the largest Asian
American ethnic group followed by Philipino and Asian
Indians. In terms of growth among the six major Asian
American ethnic groups, the Vietnamese were the fastest
growing from 1980 to 1990 while Asian Indians have
become the fastest growing group since 1990.
The Asian American
population as a whole may still seem relatively small at
the national level. . However Asian Americans are a
vital and integral part of the culture, economy, and to
some extent politics with over 90% of them residing in
major metropolitan areas of the country. The States with
the largest shares of Asian and Pacific Islander
Americans are California, Hawaii, and Washington with
55% of the total number while the remainder living in
New York, New Jersey, Illinois and Texas (see Table 4).
Asian Americans and healthcare
While all Asian Americans
share many issues in common, it's important to remember
that their genetic traits, propensity to acquire various
diseases, characteristics and experiences of various
Asian ethnic groups are quite different from one
another. The epidemiological data becomes irrelevant
unless such collection is directed at individual ethnic
populations within such a broad classification as APIA.
Population specific data becomes necessary for planning
and devising timely and cost-effective measures to
improve public health and could lead to prevention of
Inequalities in access to healthcare including
prevention, diagnosis
and treatment of diseases. According to a report
by Johns Hopkins University Institute of Medicine,
ethnic racial minority Americans (African, Latino, and
Asian) does not receive the same level of quality
healthcare as non-minority Americans. To most people,
this is probably not a surprise. Since minorities have
an average household income less than that of
non-minorities, they are less likely to be able to
afford the same level of healthcare or have it provided
for them by their employers.
What
is alarming however is the significant disparity that
exists even when comparing conditions when there is a
"level playing
field", i.e. the patient has the same insurance status
and income. Most people would believe that given the
same insurance status and income, minorities and
non-minorities should receive the same quality of
healthcare. The Hopkins study confirmed previous
studies that indicated that this is clearly not the
case.
Studies have shown that minorities are far less likely
to receive:
- Routine medical procedures,
- Appropriate cardiac
medication
- Coronary artery
by-pass surgery
- Kidney transplants or
hemodialysis
In recognition of this and such
other facts, The National Center for Minority Health and
Health Disparities (NCMHD) and The National Institute of
Nursing Research (NINR), both part of NIH and DHHS is
establishing a five year $15 million program to address
the health imbalances in the American society through
establishing eight new Centers, each with partnership
between two or three University Schools of nursing (NIH,
Nov. 2002).
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