the impact of heart disease on asian americans and pacific islanders
TRANSCRIPT
The Impact of Heart Disease on Asian Americans and
Pacific Islanders
From “Addressing Cardiovascular Health in Asian Americans and Pacific Islanders: A Background Report”
NIH Publication No. 00-3647
“Asian American and Pacific Islander Workshops Summary Report on Cardiovascular Health”
NIH Publication No. 00-3793
For more information, contact:
The National Heart, Lung, and Blood Institute
Health Information Network
P.O. Box 30105, Bethesda, MD 20824-0105
Tel: (301) 592-8573
Fax: (301) 592-8563
www.nhlbi.nih.gov
Background Reports
Source: U.S. Bureau of Census, 1992.
Chinese22%
Filipino19%
Japanese12%
Korean11%
Other Asian11%
Vietnamese9%
Asian Indian11%
Pacific Islander5%
Ethnic Distribution of the Asian American and Pacific Islander Population, United States, 1990
Asian American Population for Selected Groups, 1990 (excludes Pacific Islanders)
Source: U.S. Bureau of Census, We the Americans: Asians, 1993.
OTHER 9%:
Cambodian 2%
Thai 1%
Hmong 1%
Other Asian 4%
Filipino20%
Japanese12%
Asian Indian12%
Vietnamese9%
Other9%
Laotian2%
Chinese24%
Korean12%
Pacific Islander Population, 1990 (Excludes Asian Americans)
Source: U.S. Bureau of Census, 1993.
Samoan17%
Guamanian14%
Tongan5%
Fijian2%
Hawaiian57%
Other 5%
Breaking the “Model Minority Myth”Asian American and Pacific Islander Poverty Rates, 1990
63.6
42.6
34.7
25.7
12.59.7
6.4
18.2
25.8
15.317.11414.113 14 13.7
7
23.1
14.3
0
10
20
30
40
50
60
70
Pe
rce
nt
Source: U.S. Census, 1992
Breaking the “Model Minority Myth”Asian American and Pacific Islander Per Capita Income, 1990
13,806
10,34213,63814,143
17,77719,373
6,1447,690
10,83411,446
11,000
2,6925,1205,5979,03211,177
11,97013,61614,876
0
5,000
10,000
15,000
20,000
25,000
U.S. T
otal
Total
AAPI
Total
Asia
n
Total
PI
Japa
nese
Asian
India
n
Chine
se
FilipinoTha
i
Korea
n
Vietna
mes
e
Laot
ian
Cambo
dian
Hmon
g
Other
Asia
n
Hawaii
an
Guam
anian
Samoa
n
Tonga
n
Do
llars
Source: U.S. Census, 1992.
*Heart disease is the leading cause of death
Source: National Vital Statistics System, CDC, NCHS, 1994.
34.6
33.9
33.7
31.7
30.4
29.4
27.1
21.8
19.5
0 10 20 30 40
Asian Indian*
Hawaiian*
Guamanian*
Filipino*
Samoan*
Japanese*
Chinese
Korean
Vietnamese
Percentage
Heart Disease asPercentage of All Deaths
26.7
107.9
181.8
25.8
62.6
109.7
0
20
40
60
80
100
120
140
160
180
200
CardiovascularDisease
Coronary HeartDisease
Stroke
Ra
tes
pe
r 1
00
,00
0
All RacesAAPI
Source: Anderson, 1998.
Selected 1995 Age-AdjustedDeath Rates
Age-Adjusted Heart DiseaseDeath Rates for Hawaiians
443.2
340.8375.9
190
273.8
125.8146.8
89.368.5
96.5
142.9
79.2
0
50
100
150
200
250
300
350
400
450
500
1970 1980 1990
Per
100
,000
Po
pu
lati
on
Full Hawaiian
Part Hawaiian
Non-Hawaiian
Hawaii: All Races
Source: Look MA & Braun KL, 1995.
AAPI CV Health Status: Risk Factors
• Low levels of awareness and control
• Very little awareness among Cambodian, Laotian, and Vietnamese immigrants
• Significantly higher levels among Filipino Americans
• Significantly lower blood pressure screening rates among AAPIs
High Blood Pressure
AAPI CV Health Status: Risk Factors
• Low blood cholesterol screening rates
• Highest in Japanese men and women vs. other AAPI ethnic groups
• Cholesterol levels are lower in Asian countries than in Western countries
High Blood Cholesterol
AAPI CV Health Status: Risk Factors
• Highest rates among Southeast Asians
• Southeast Asian males start smoking early in life
• High tobacco use among Korean men in California
Cigarette Smoking
AAPI CV Health Status: Risk Factors
• Overweight and obesity are prevalent among
Pacific Islanders
• Native Hawaiians and Samoans are among the
most obese people in the world
• Molokai Heart Study (Native Hawaiians): 64%
were obese
Obesity
AAPI CV Health Status: Risk Factors
• BMI levels for selected Samoan population
subgroups*
Men (BMI) Women (BMI)
Western Samoan 26 28
Hawaii 31 33
California 35 34
American Samoa 30 33* NOTE: BMI > 30 is obese; BMI of 25-29 is overweight
Obesity (cont.)
AAPI CV Health Status: Risk Factors
• AAPIs engage in less physical activity compared to the general population
• Korean Americans in California are less likely to exercise than the general Californian population
Physical Inactivity
AAPI CV Health Status: Risk FactorsDiabetes
• Highly prevalent among Pacific Islanders
• Higher risk for Native Hawaiians vs. other Hawaiian groups
• Guam’s death rate is 5 times higher than U.S. mainland
• One of the leading causes of death in American Samoa
Diet-Related Characteristics
• Migration patterns affect diet
• Eating habits change among Korean students
• Filipinos: food high in salt increased risk for hypertension
Diet-Related Characteristics (cont.)
• Some groups maintain strong ties to traditional diet
• Micronesia: deaths due to CVD and diabetes have been attributed to poor diet
Designing Culturally Appropriate Community-Based Programs
Strategies
• Establish trust with the community
• Integrate a health topic within a comfortable setting
• Address the community’s priority issues first
• Recognize cultural factors may affect improved
health outcomes
Designing Culturally Appropriate Community-Based Programs
Strategies
• Use compelling and accurate data
• Develop a cadre of knowledgeable lay counselors
• Establish alliances and coalitions
• Provide culturally sensitive and linguistically appropriate materials
Designing Culturally Appropriate Community-Based Programs
Strategies
• Use cultural themes and symbols • Determine the role of public policy • Be prepared to respond to changing needs of the
population (e.g., use consumer feedback)