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Asian Americans are one of the diverse ethnic groups in US. There are 20 million Asian Americans in United State which represent 6% of US population (Yi, S. S.,2020). They are the fastest growing minority in the US. Research shows that Asian Americans are at high risk for hepatitis B, Liver Cancer, Tuberculosis and lung cancer among other condition. Compared with the low-risk group, the odds of having an unmet healthcare need was 1.52 times greater in the moderate-risk group and 2.24 times greater in the high-risk group (Jang Y, Park NS, Yoon H, et al., 2017). Immigrant Asian after adaptation of American culture, they have increased risks of diabetes and other cardiovascular diseases as they started using American diets in their daily food consumptions as well as lifestyle change. Asian Americans have a higher prevalence of tuberculosis compared with others minority group.
Health Disparities
According American Heart Association in 2016, around 19.5% of Asian Americans have high blood pressure. In 2015, 18,819 deaths among Asian Americans were due to Cardiovascular Disease; 8,477 due to Chronic Heart Disease; and 2,616 due to Myocardial Infarction. According to National Institute on Minority Health and Health Disparities (NIMHD), Asian Americans face health disparities in cancer, chronic diseases, such as heart disease, hypertension, and diabetes, mental health, and among the elderly. In particular Asian Americans have the highest incidence and mortality rates of liver and stomach cancers – the most preventable cancers – largely due to high prevalence of related infections such as hepatitis B. In addition, Asian Americans have the lowest cancer screening rates and are typically diagnosed at a later stage. Heterogeneity in diseases and treatment is the result from cultural and socioeconomic differences and health care disparities. Lack of health insurance, limited access to healthcare, low treatment compliance rates, and lack of culturally sensitive disease prevention strategies causes this disparity. Within this group of population, theres an expectation to stand out for the good/best reasons which means good grades, a fancy job, high salary, good social standing and having husband or wife. Such family will have conservative mind and assume that any health related illness can prevent them from achieving those success. In this group of culture there is a misconception that any sort of illness whether it is mental or physical, will diminished their value among the community or family and also their ability to achieve the things that bring honor. All these factors differ their perception of illness and treatment in comparison with other Americans.
The manifestation of diseases process is affected by culture, generational and acculturation levels. A high percentage of Asian Americans have Limited English proficiency with 77% speaking different language than English at home (AAFP, 2015). Even when people have good command of conversational English their linguistic skills may not be adequate for clinical discussion. Major health care decision in this group are often made by a family and also individual problem reflect family problem. For example, in some Asian cultural groups, the experience of individual illness also reflects as entire family illness. Thus, shame, embarrassment can contribute to whether or not an individual seek treatment on other hand lack/absent of health insurance also hold the individual from seeking treatment. And hence, the patient typically seeks physicians only when they feel symptoms, and perhaps only when symptoms are severe. Regular physical check-up as well as follow up care is not seen among such group of Asian American. Cultural reliance on traditional eastern based practices to treat illness such as herbal medicine and spiritual healing also impact the perception of illness and treatment.
Nurses Responsibility
As a nurse we should always understand that Asian-American are immensely diverse in many ways and should not make assumptions about a patients experiences about any diseases and treatment. At first nurse should do assessment of language barrier like whether the patient speak English or not. Nurse should listen the patient actively by allowing sufficient time for the patient to share their feeling regarding the illness. This is because sometimes it may take time for some Asian patients to feel comfortable sharing their very personal information with outsiders. Apart from this nurse should also make inquiries about traditional beliefs to gather information on how these beliefs can influence patients perception of illness and preferred method of treatment. Some Asian American group may seek traditional healers like acupuncturist and herbalists to treat health, so when appropriate (culturally and individually) health care provider including nurse should always consider traditional practices as supplemental treatment. This not only include medication but also indicated diet and exercise.
Conclusion
Many Asian American patients will not schedule health maintenance visits unless its an emergency. For example, patients are often told, you dont need treatment now , but they only hear, you are fine . Cultural values such as stigma, language barrier and limited access to culturally competent service contribute to low treatment utilization rate. By proactively addressing the health literacy, linguistic needs and cultural nuances relevant to Asian American patients, nurse can take full advantage of every opportunity to promote the care of population that has often been underserved.
References
- Yi, S. S. (2020). Taking Action to Improve Asian American Health. American Journal of Public Health, 110(4), 435-437. https://doi-org.ezp.tccd.edu/10.2105/AJPH.2020.305596
- Ancheta, I. B., Carlson, J. M., Battie, C. A., Borja-Hart, N., Cobb, S., & Ancheta, C. V. (2015). One size does not fit all: cardiovascular health disparities as a function of ethnicity in Asian-American women. Applied Nursing Research, 28(2), 99105. https://doi-org.ezp.tccd.edu/10.1016/j.apnr.2014.06.001
- Jang Y, Park NS, Yoon H, et al., The risk typology of healthcare access and its association with unmet healthcare needs in Asian Americans. Health Soc Care Community. 2018;26:7279. https://doi.org/10.1111/hsc.12463.
- National Institute on minority health and health disparity. (n.d.). The Center for Asian Health Engages Communities in Research to Reduce Asian American Health Disparities. https://www.nimhd.nih.gov/news-events/features/training-workforce-dev/center-asian-health.html.
- American Academy of Family Physicians, (2015, October 1). Challenges and Opportunities in the Care of Asian American Patients. Retrieved October 8, 2020 from https://www.aafp.org/afp/2014/1001/p490.html.
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