Asian Americans and Cardiovascular Disease – Larger Implications for Asian Americans and Healthcare

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).

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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).

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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.

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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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