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PubMed2001

Ethnic differences in anthropometric and lifestyle measures related to coronary heart disease risk between South Asian, Italian and general-population British women living in the west of Scotland.

AIMS: To compare anthropometric measurements and to define their behavioural associations in migrant and British-born South Asians (who have increased cardiovascular risk) or Italians (who have reduced cardiovascular risk), and in the general population of British women living in the west of Scotland. STUDY DESIGN: Cross-sectional survey of women aged 20-42 y, selected mainly from birth registration data, which included 63 migrant South Asians, 56 British-born South Asians, 39 migrant Italians, 51 British-born Italians, and 50 subjects representative of the general population of women, all resident in the west of Scotland. MEASUREMENTS: Height, weight, body mass index (BMI), and waist and hip circumferences. RESULTS: With age adjustment, migrant South Asians (0.88) had greater waist-to-hip ratio than British-born South Asians (0.84; P<0.05), while there was no difference between migrant (0.81) and British-born (0.79) Italian groups. Both migrant (P<0.001) and British-born South Asian (P<0.05) groups had higher waist-to-hip ratio and were about 3 cm shorter than Italian groups and the general population. Neither weight nor BMI were different between ethnic groups. Waist and hip circumferences were not different between migrant and British-born ethnic minority groups. Migrant South Asians (86.8 cm) had significantly (P<0.05) larger waist circumference than the general population (78.6 cm). British-born Italian women (103.0 cm) had larger hip circumference than the general population of women (96.4 cm), while other groups had similar hip circumferences. Additional adjustments for physical activity, smoking, alcohol consumption and parity reduced the differences in anthropometric measurements: only waist-to-hip ratio of migrant South Asians remained significantly (P<0.01) higher than that of the general population women. CONCLUSIONS: The adverse anthropometric indicators of cardiovascular risk in migrant South Asian women are substantially explained by their lifestyle factors and parity. British-born South Asian women are more similar to the general population women. Anthropometric differences between migrant or British-born Italians and the general population women are small.

Adult↗
PubMed1998

The role of complementary medicine in European and Asian patients with inflammatory bowel disease.

Three hundred and eighty-two patients with known inflammatory bowel disease (IBD) (190 European and 192 Asians) and 190 with coeliac disease were sent a previously validated questionnaire to investigate patients' use of alternative medicine and their views on its effectiveness. Details sought included whether they have ever consulted an alternative practitioner, whether they had followed a course of treatment and its clinical effects. Information about where patients had heard about such alternative practitioners and whether they were told to discontinue their current allopathic medication was sought. Results were analysed after three consecutive mailings, including one in Gujurati to Asian patients. A randomly selected group was re-interviewed four months later. To validate the study alternative medicine practitioners were also interviewed to investigate what percentage of their attendees have IBD and how many of those clients were Asians. One hundred and fifty-eight questionnaires were returned from European patients with IBD (response rate = 83%), 145 from patients with coeliac disease (response rate = 76%) but only 81 Asian patients with IBD (response rate = 42%). Forty-seven European and Asian patients with inflammatory bowel disease sought advice or treatment from an alternative practitioner, compared with only 11 with coeliac disease (chi(2) = 11.64, df = 12, P < 0.003). There was no significant difference in consultation rates between Asian and European patients with IBD (Yates corrected chi(2) = 0.78, ns). The most common practitioners consulted by all groups were homeopaths (n = 23) and herbalists (n = 27) but 20 patients consulted more than one practitioner at a time. Patients with coeliac disease and European patients with IBD had consulted osteopaths (n = 6) and reflexologists (n = 7). Ten patients with IBD had also attended a spiritualist and five Asian patients a hakim. Common sources of information about alternative remedies included friends and relatives (n = 13), the media (n = 11), word of mouth (n = 11) and family practitioners (n = 6). Most patients were advised to continue their current medications, although two had been told to stop and 10 advised to reduce the dose of their allopathic medications. Twenty alternative medicine practitioners stated that overall between 2-5% of their attendees have IBD with 10% of those clients being Asian. Asians preferred to consult Asian practitioners rather than European practitioners. There was no clear consensus as to whether complementary therapies were felt beneficial, although many patients with IBD believed them to be helpful.

Asia↗
PubMed2002

Prevalence, morbidity and service need among South Asian and white adults with intellectual disability in Leicestershire, UK.

BACKGROUND: Previous reports have suggested that South Asian and white UK populations have different prevalences of intellectual disability (ID), related psychological morbidity and service use. The aim of the present study was to compare these rates among South Asian and white adults in Leicestershire, UK. METHOD: This cross-sectional study is comprised of two parts. The analysis of prevalence is based on data from all South Asian and white adults known to the Leicestershire Learning Disabilities Register in 1991, with population denominators being drawn from the 1991 census. The other analyses use data collected from the most recent semi-structured home interviews, carried out between 1987 and 1998, with 206 South Asian and 2334 white adults. RESULTS: The prevalence of ID in adults in Leicestershire is 3.20 per 1000 in South Asians and 3.62 per 1000 in whites. Among adults with ID, South Asians have similar prevalences of disabilities to whites and significantly lower skill levels. South Asians show similar levels of psychological morbidity, but make significantly lower use than whites of psychiatric services, residential care and respite care. South Asians use community services as extensively as whites, but feel that they have a substantially greater unmet need, especially with regard to social services. CONCLUSION: South Asian and white populations have similar prevalences of ID and related psychological morbidity. Culturally appropriate services for South Asian adults may need to focus on skill development and community care.

Adult↗
PubMedDate not supplied

Higher levels of microproteinuria in Asian compared with European patients with diabetes mellitus and their relationship to dietary protein intake and diabetic complications.

Asian patients with diabetes have a higher prevalence of renal disease than their European counterparts. The aim of the study was to investigate the pattern of the renal excretion of proteins in 70 Asian and 70 European patients with diabetes and to relate it to dietary intake of protein and prevalence of diabetic complications. Compared with matched Europeans, Asian patients had an increased urinary excretion of albumin and transferrin (p < 0.02) with 14 Asians and 6 Europeans having significant microalbuminuria (> 30 micrograms min-1). In 12 Asians and all 6 Europeans this was associated with complications from diabetes, particularly vascular. Asian patients had significantly more ischaemic heart disease (p < 0.001) but less neuropathy (p < 0.001) and retinopathy (p < 0.05) than their matched European counterparts. Asian diets were lower in protein (median (range) Asian vs European: 12.5% (6-29%) vs 19% (11-27%); p < 0.01) and carbohydrate but higher in fat than European diets. There was no correlation between dietary protein intake and excretion of any of the urinary proteins measured. However, a significant correlation was found in Asians between protein intake and length of residence in the UK (p < 0.005). Unless ways to reduce complications can be found then future allocation of resources will need to take this into consideration in areas with large Asian communities.

Adult↗
PubMed2004

Hypoadiponectinaemia in South Asian women during pregnancy: evidence of ethnic variation in adiponectin concentration.

AIMS: People of South Asian descent face an increased risk of Type 2 diabetes mellitus (DM) and coronary artery disease (CAD) compared with other ethnic groups. One candidate factor underlying this risk may be adiponectin, as circulating levels of this adipocyte-derived protein are reduced in both Type 2 DM and CAD. In a recent study, we assessed the relationship between adiponectin and gestational diabetes (GDM), a potential model of early events in the natural history of Type 2 DM. Here, we report the impact of ethnicity on plasma adiponectin concentration in that study. METHODS: A cross-sectional study was performed in 180 women undergoing oral glucose tolerance testing in late second or early third trimester to investigate the relationship between adiponectin and glucose tolerance in pregnancy. Based on self-reported ethnicity, participants were stratified into three groups: (i) Caucasian (n = 116), (ii) South Asian (n = 31), and (iii) Asian (n = 28). RESULTS: Median adiponectin concentration was much lower in the South Asian group (9.7 micro g/ml) than in Caucasians (15.8 micro g/ml) or Asians (16.1 micro g/ml) (overall P < 0.0001). With adjustment for age, prepregnancy body mass index, weight gain in pregnancy, previous history of GDM, family history of DM, fasting insulin and glucose intolerance, mean adiponectin remained significantly lower among South Asians compared with either Caucasians (P < 0.0001) or Asians (P = 0.0034). CONCLUSIONS: Women of South Asian descent exhibit significantly reduced plasma concentrations of adiponectin in pregnancy compared with Caucasian and Asian counterparts. This observation raises the possibility of hypoadiponectinaemia as a potential factor contributing to the increased risk of diabetes and cardiovascular disease in South Asians.

Adiponectin↗
PubMed2005

Diabetes and cardiovascular disease among Asian Indians in the United States.

CONTEXT: Studies, mostly from outside the United States, have found high prevalence of diabetes, coronary heart disease (CHD), and hypertension among Asian Indians, despite low rates of associated risk factors. OBJECTIVE: To analyze the prevalence of obesity, diabetes, CHD, hypertension, and other associated risk factors among Asian Indians in the United States compared to non-Hispanic whites. DESIGN, SETTING, AND SUBJECTS: Cross-sectional study using data from the National Health Interview Survey (NHIS) for 1997, 1998, 1999, and 2000. We analyzed 87,846 non-Hispanic whites and 555 Asian Indians. MAIN OUTCOME MEASURES: Whether a subject reported having diabetes, CHD, or hypertension. RESULTS: Asian Indians had lower average body mass indices (BMIs) than non-Hispanic whites and lower rates of tobacco use, but were less physically active. In multivariate analysis controlling for age and BMI, Asian Indians had significantly higher odds of borderline or overt diabetes (adjusted OR [AOR], 2.70; 95% confidence interval [CI], 1.72 to 4.23). Multivariate analysis also showed that Asian Indians had nonsignificantly lower odds ratios for CHD (AOR, 0.58; 95% CI, 0.25 to 1.35) and significantly lower odds of reporting hypertension (AOR, 0.58; 95% CI, 0.42 to 0.82) compared to non-Hispanic whites. CONCLUSION: Asian Indians in the United States have higher odds of being diabetic despite lower rates of obesity. Unlike studies on Asian Indians in India and the United Kingdom, we found no evidence of an elevated risk of CHD or hypertension. We need more reliable national data on Asian Indians to understand their particular health behaviors and cardiovascular risks. Research and preventive efforts should focus on reducing diabetes among Asian Indians.

Adult↗
PubMed1991

High prevalence of systemic disease and mortality in Asian subjects with systemic lupus erythematosus.

All patients with systemic lupus erythematosus (SLE) (American Rheumatism Association criteria with positive antinuclear antibody titre) and who attended any of the three general hospitals in Leicester over a 10 year period were ascertained using several complementary sources. Eighty seven subjects (26 Asian, 61 white) were identified. The estimated prevalence of SLE in Leicester is 0.4/1000 for Asian and 0.2/1000 for white subjects. Mean age of onset of the disease was 24 years in Asian and 31 years in white subjects, with both groups showing a female preponderance. Proteinuria (greater than 1 g/24 h) was noted in 15 (58%) Asian and 21 (35%) white subjects; neuropsychiatric disease in 10 (38%) Asian and 8 (13%) white subjects; myalgic symptoms with raised muscle enzymes in 9 (35%) Asian and 3 (5%) white subjects. Nineteen (73%) Asian subjects were positive for extractable nuclear antigens as well, at some stage of their disease, compared with 6 (10%) white subjects. Immunosuppressive treatment was required in 12 (46%) Asian and 12 (20%) white subjects, and deaths of seven Asian and five white subjects were attributed to SLE. These findings show that Asian subjects have a higher prevalence of SLE with greater systemic disease and mortality.

Adult↗
PubMed2003

Prognosis for South Asian and white patients newly admitted to hospital with heart failure in the United Kingdom: historical cohort study.

OBJECTIVES: To compare patterns of admission to hospital and prognosis in white and South Asian patients newly admitted with heart failure, and to evaluate the effect of personal characteristics and comorbidity on outcome. DESIGN: Historical cohort study. SETTING: UK district health authority (population 960,000). PARTICIPANTS: 5789 consecutive patients newly admitted with heart failure. MAIN OUTCOME MEASURES: Population admission rates, incidence rates for first admission with heart failure, survival, and readmission rates. RESULTS: When compared with the white population, South Asian patients had significantly higher age adjusted admission rates (rate ratio 3.8 for men and 5.2 for women) and hospital incidence rates (2.2 and 2.9). Among 5789 incident cases of heart failure, South Asian patients were younger and more often male than white patients (70 (SD 0.6) v 78 (SD 0.1) years and 56.5% (190/336) v 49.3% (2494/5057)). South Asian patients were also more likely to have previous myocardial infarction (10.1% (n = 34) v 5.5% (n = 278)) or concomitant myocardial infarction (18.8% (n = 63) v 10.7% (n = 539)) or diabetes (45.8% (n = 154) v 16.2% (n = 817), all P < 0.001). A trend was shown to longer unadjusted survival for both sexes among South Asian patients. After adjustment for covariables, South Asian patients had a significantly lower risk of death (hazard ratio 0.82, 95% confidence interval 0.68 to 0.99) and a similar probability of death or readmission (0.96, 0.81 to 1.09) compared with white patients. CONCLUSIONS: Population admission rates for heart failure are higher among South Asian patients than white patients in Leicestershire. At first admission South Asian patients were younger and more often had concomitant diabetes or acute ischaemic heart disease than white patients. Despite major differences in personal characteristics and risk factors between white and South Asian patients, outcome was similar, if not better, in South Asian patients.

Asia↗
PubMed1995

Vegetarian diet as a risk factor for tuberculosis in immigrant south London Asians.

BACKGROUND: In a previous retrospective study of tuberculosis in south London among Asian immigrants from the Indian subcontinent Hindu Asians were found to have a significantly increased risk for tuberculosis compared with Muslims. This finding has been further investigated by examining the role of socioeconomic and lifestyle variables, including diet, as risk factors for tuberculosis in Asian immigrants from the Indian subcontinent resident in south London. METHODS: Using a case-control study technique Asian immigrants from the Indian subcontinent diagnosed with tuberculosis during the past 10 years and two Asian control groups (community and outpatient clinic controls) from the Indian subcontinent were investigated. Cases and community controls were approached by letter. A structured questionnaire concerning a range of demographic, migration, socioeconomic, dietary, and health topics was administered by a single trained interviewer to subjects (56 cases and 100 controls) who agreed to participate. RESULTS: The results confirmed earlier findings that Hindu Asians had an increased risk of tuberculosis compared with Muslims. However, further analysis revealed that religion had no independent influence after adjustment for vegetarianism (common among Hindu Asians). Unadjusted odds ratios for tuberculosis among vegetarians were 2.7 (95% CI 1.1 to 6.4) using community controls, and 4.3 (95% CI 1.8 to 10.4) using clinic controls. There was a trend of increasing risk of tuberculosis with decreasing frequency of meat or fish consumption. Lactovegetarians had an 8.5 fold risk (95% CI 1.6 to 45.4) compared with daily meat/fish eaters. Adjustment for a range of other socioeconomic, migration, and lifestyle variables made little difference to the relative risks derived using either community or clinic controls. CONCLUSIONS: These results indicate that a vegetarian diet is an independent risk factor for tuberculosis in immigrant Asians. The mechanism is unexplained. However, vitamin D deficiency, common among vegetarian Asians in south London, is known to affect immunological competence. Decreased immunocompetence associated with a vegetarian diet might result in increased mycobacterial reactivation among Asians from the Indian subcontinent.

Adult↗
PubMed2001

C-reactive protein, insulin resistance, central obesity, and coronary heart disease risk in Indian Asians from the United Kingdom compared with European whites.

BACKGROUND: Indian Asians in the United Kingdom have increased coronary heart disease (CHD) mortality compared with European whites, but the causes are not well understood. Increased circulating concentrations of C-reactive protein (CRP) are an independent risk factor for CHD. Therefore, we investigated this marker of inflammation in healthy UK Indian Asian and European white men. Methods and Results-- We measured serum CRP concentrations and conventional CHD risk factors in 1025 healthy male subjects (518 Indian Asians and 507 European whites) aged 35 to 60 years who were recruited at random from general practitioner lists. The geometric mean CRP concentration was 17% higher (95% confidence interval, 3% to 33%) in Indian Asians compared with European whites. CRP values were strongly associated with conventional CHD risk factors, measures of obesity, and metabolic disturbances associated with insulin resistance in both racial groups. The difference in CRP concentrations between Indian Asians and European whites remained after adjustment for conventional CHD risk factors but was eliminated by an adjustment for central obesity and insulin resistance score in Asians. On the basis of these results, we estimate that the processes underlying elevated CRP and/or increased CRP production itself are associated with an approximately 14% increase in population CHD risk among Indian Asians compared with European whites. CONCLUSIONS: CRP concentrations are higher in healthy Indian Asians than in European whites and are accounted for by greater central obesity and insulin resistance in Indian Asians. Our results suggest that inflammation or other mechanisms underlying elevated CRP values may contribute to the increased CHD risk among Indian Asians.

Adult↗
PubMed1993

Association of early-onset coronary heart disease in South Asian men with glucose intolerance and hyperinsulinemia.

BACKGROUND: Rates of coronary heart disease are higher in South Asians (Indians, Pakistanis, and Bangladeshis) settled overseas than in other ethnic groups. We tested the hypothesis that this excess risk results from metabolic disturbances associated with insulin resistance. METHODS AND RESULTS: There were 1,421 South Asian men and 1,515 European men aged 40-69 years in London examined in the Southall Study. Prevalence of ischemic ECG abnormalities was higher in South Asians than in Europeans (17% versus 12%, p < 0.001), with an excess of major Q waves (Minnesota codes 1-1 or 1-2) in younger South Asian men (p = 0.01 for the age-ethnicity interaction). Major Q waves were strongly associated with glucose intolerance and hyperinsulinemia in younger South Asians; these factors accounted statistically for 73% of major Q waves in those aged 40-54 years. Age-standardized prevalence of a positive history of coronary heart disease was similar in South Asians and Europeans (8.5% versus 8.2%, NS), and positive history without Q waves was not associated with glucose intolerance or hyperinsulinemia in South Asians. Smoking rates and average plasma cholesterol were lower in South Asians than in Europeans; in a logistic model controlling for smoking and cholesterol, the odds ratio for major Q waves in South Asians compared with Europeans was 2.4 (95% CI, 1.5-3.8). Adjusting for glucose intolerance and hyperinsulinemia reduced this ratio to 1.5 (95% CI, 0.9-2.5). CONCLUSIONS: These results are consistent with the hypothesis that insulin resistance underlies the high coronary risk in South Asian people and strengthen the evidence for a fundamental role of this metabolic pattern in the etiology of coronary heart disease.

Adult↗
PubMed2003

Hyperhomocysteinemia in Asian Indians living in the United States.

Hyperhomocysteinemia has been reported in Asian Indians (people from Indian subcontinent) to be related to relatively low plasma levels of folate and vitamin B-12. However, a true ethnic-related characteristic has not been excluded. This study was done to determine whether Asian Indians have high plasma homocysteine compared with Caucasians in the United States in the era of folate fortification, and whether low vitamin B-12 or insulin resistance may account for possible interethnic differences in plasma homocysteine. A total of 227 Asian Indians (131 males and 96 females) and 155 Caucasians (66 males and 89 females) completed a questionnaire for medical, family, and personal history. They had height, weight, and blood pressure measured and fasting blood drawn for routine chemistry, TSH, plasma homocysteine, vitamin B-12, and folate. Oral glucose tolerance test and vitamin B-6 was measured in a subgroup of 66 Asian Indians (47 males and 19 females) and 63 Caucasians (33 males and 30 females). Asian Indians were found to have significantly higher plasma homocysteine than Caucasians (median of 12.6 and 8.0 micro mol/liter, P < 0.0001, respectively) and lower plasma concentrations of B-6 (median 49 vs. 70 nmol/liter; P = 0.05, respectively). Plasma folate was relatively high and similar in both ethnic groups. Plasma vitamin B-12 was significantly lower in Asian Indians than Caucasians (median of 204 vs. 320 pmol/liter, P < 0.0001, respectively). Vitamin B-12 correlated significantly with plasma homocysteine. When vitamin B-12 was between 150 and 379 pmol/liter, the regression curve between vitamin B-12 and homocysteine had significantly different slope in the two ethnic groups (P value < 0.05) and Asian Indians had significantly higher homocysteine for any level of vitamin B-12. Although insulin resistance, measured as insulin area under the curve by oral glucose tolerance test was higher in Asian Indians and correlated significantly with homocysteine, it did not explain inter-ethnic differences in plasma homocysteine in a multivariate analysis. We conclude that Asian Indians living in the United States have significant elevation of plasma homocysteine concentrations despite normal plasma folate. Lower plasma concentrations of vitamin B-12 and lower insulin sensitivity may contribute to this finding but only partially explained the ethnic-related hyperhomocysteinemia of the Asian Indians.

Adult↗
PubMed2004

Can we apply the National Cholesterol Education Program Adult Treatment Panel definition of the metabolic syndrome to Asians?

OBJECTIVE: Limited information is available about the metabolic syndrome in Asians. Furthermore, the definition of central obesity using waist circumference may not be appropriate for Asians. The objectives of this study were to determine the optimal waist circumference for diagnosing central obesity in Asians and to estimate the prevalence of the metabolic syndrome in an Asian population. RESEARCH DESIGN AND METHODS: We used data from the 1998 Singapore National Health Survey, a cross-sectional survey involving 4,723 men and women of Chinese, Malay, and Asian-Indian ethnicity aged 18-69 years. Receiver operating characteristic analysis suggested that waist circumference >80 cm in women and >90 cm in men was a more appropriate definition of central obesity in this population. The prevalence of the metabolic syndrome was then determined using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria with and without the modified waist circumference criteria. RESULTS: In Asians, decreasing waist circumference increased the crude prevalence of the metabolic syndrome from 12.2 to 17.9%. Using the modified Asian criteria, the prevalence of the metabolic syndrome increased from 2.9% in those aged 18-30 years to 31.0% in those aged 60-69 years. It was more common in men (prevalence 20.9% in men versus 15.5% in women; P < 0.001) and Asian Indians (prevalence 28.8% in Asian-Indians, 24.2% in Malays, and 14.8% in Chinese; P < 0.001). CONCLUSIONS: NCEP ATP III criteria, applied to an Asian population, will underestimate the population at risk. With a lower waist circumference cutoff, the prevalence of the metabolic syndrome is comparable to that in Western populations. Ethnic differences are likely to exist between populations across Asia.

Adult↗
PubMed1992

Blunted seasonal variation in serum 25-hydroxy vitamin D and increased risk of osteomalacia in vegetarian London Asians.

Serum 25-hydroxy vitamin D levels were measured in 297 adult Asians and 68 white subjects at different times of year and seasonal variation compared between subjects grouped according to ethnic origin, religion and dietary habit. A sub-group of Asians with symptoms and biochemical changes suggestive of osteomalacia underwent bone biopsy, and static bone histomorphometry was performed. Histological osteomalacia was detected in 15 Asians and borderline changes in 13. The majority of these cases were among vegetarian Hindus. Significant seasonal variation in 25-hydroxy vitamin D was observed in all groups, but with lower peak and trough levels among Asians, and especially the Hindus and vegetarian Asians. Summer rises in 25-hydroxy vitamin D levels were blunted among Hindus and vegetarian Asians, compared to whites, Muslims and non-vegetarian Asians. Vegetarian Asians had significantly lower serum calcium and higher PTH levels than non-vegetarians, but multivariate analysis indicated that this was an effect of osteomalacia, not vegetarianism. We conclude that solar exposure has a significant effect on vitamin D status in Asians resident in London. Non-vegetarian Asians have similar rise and peak levels to whites, but those taking a vegetarian diet (in particular, Hindus) have an impaired seasonal rise in 25-hydroxy vitamin D levels, and are at particular risk of metabolic bone disease. This effect did not appear to be mediated through secondary hyperparathyroidism consequent on a vegetarian diet.

Adult↗
PubMed2006

Asian health in New Zealand--progress and challenges.

The recent increase in the population classed as 'Asian' in New Zealand (now 9.5%) has seen the establishment of an 'Asian health' platform with activities by academic institutions, service providers, and community organisations. However, Asian health remains outside the frames of reference for most health professionals. Three recent reports provide the first large-scale systematic data about the health of Asian peoples in New Zealand. These reports identify the problem of 'averaging' if the whole Asian category is used. Key health concerns include access to health services; cardiovascular disease, and diabetes for Indian peoples; levels of physical activity; and mental health, particularly in young people. Asian peoples born in New Zealand are less healthy than recent migrants classified as Asian. This 'healthy immigrant effect' abates with length of settlement in New Zealand. Despite these identified issues, there is a policy void for the health of Asian peoples in New Zealand, with no clear mandate to consider or monitor Asian peoples when undertaking research or formulating policy. Explicit engagement, policy, and service development for this significant and diverse part of the population should build on the agenda laid out by the recent advances in knowledge about Asian health in New Zealand.

Asia↗
PubMed2006

Communication between South Asian patients and GPs: comparative study using the Roter Interactional Analysis System.

BACKGROUND: The UK South Asian population has poorer health outcomes. Little is known about their process of care in general practice, or in particular the process of communication with GPs. AIM: To compare the ways in which white and South Asian patients communicate with white GPs. DESIGN OF STUDY: Observational study of video-recorded consultations using the Roter Interactional Analysis System (RIAS). SETTING: West Yorkshire, UK. METHOD: One hundred and eighty-three consultations with 11 GPs in West Yorkshire, UK were video-recorded and analysed. RESULTS: Main outcome measures were consultation length, verbal domination, 16 individual abridged RIAS categories, and three composite RIAS categories; with comparisons between white patients, South Asian patients fluent in English and South Asian patients nonfluent in English. South Asians fluent in English had the shortest consultations and South Asians non-fluent in English the longest consultations (one-way ANOVA F = 7.173, P = 0.001). There were no significant differences in verbal domination scores between the three groups. White patients had more affective (emotional) consultations than South Asian patients, and played a more active role in their consultations, as did their GPs. GPs spent less time giving information to South Asian patients who were not fluent in English and more time asking questions. GPs spent less time giving information to South Asian patients fluent in English compared with white patients. CONCLUSIONS: These findings were expected between patients fluent and non-fluent in English but do demonstrate their nature. The differences between white patients and South Asian patients fluent in English warrant further explanation. How much of this was due to systematic differences in behaviour by the GPs, or was in response to patients' differing needs and expectations is unknown. These differences may contribute to differences in health outcomes.

Adult↗
PubMedDate not supplied

Prenatal hemoglobinopathy screening: receptivity of Southeast Asian refugees.

Because of the availability of safe, accurate prenatal diagnosis for hemoglobinopathies, we wanted to know if pregnant women identified as carriers of a hemoglobinopathy by prenatal screening use this information to determine whether their fetus is at risk. Blood from all pregnant women served by a 40 percent sample of prenatal care providers in Rochester, New York, over 51 months underwent Hb electrophoresis and MCV +/- Hb A2 determination. The frequency of positive was 33/229 (14 percent) for Southeast Asians versus 567/15,824 (3.6 percent) for non-Southeast Asians. Of the positives, 29 (88 percent) Southeast Asians came for counseling versus 348 (61 percent) others. Of those counseled, 26 (90 percent) Southeast Asians had their partners tested, as did 211 (61 percent) others. Of the partners tested, 17 (65 percent) Southeast Asians were also positive compared to 44 (21 percent) others. Of couples offered prenatal diagnosis, 50 percent of each group (4/8 and 17/34) accepted. Of those accepting, all Southeast Asians actually underwent the procedure, while seven (41 percent) others miscarried or failed to keep their appointment. Thus, in our pregnant population, Southeast Asians are four times more likely to be hemoglobinopathy carries than non-Southeast Asians, and Southeast Asian carriers are four times more likely to warrant, want, and undergo prenatal diagnosis for a hemoglobinopathy than non-Southeast Asian carriers.

Adult↗
PubMed2026

Cancer statistics for Asian American, Native Hawaiian, and Pacific Islander people, 2026.

BACKGROUND: Cancer statistics for Asian American and Native Hawaiian and Pacific Islander (NHPI) people are usually aggregated, masking substantial variation within this heterogeneous population. Herein, the American Cancer Society reports cancer incidence and survival for 8 Asian American and 3 NHPI ethnic groups. METHODS: The authors used population-based cancer registry data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program, for Asian American and NHPI ethnic groups from 2000 through 2022. RESULTS: During 2018-2022, overall cancer incidence ranged from 218.3 per 100,000 Kampuchean people to 474.5 per 100,000 Native Hawaiian people, which was 1.5 times higher than the rate for the aggregated Asian American and NHPI population (307.3 per 100,000). High incidence among Native Hawaiian people is largely driven by the highest rates of female breast, colorectal, and prostate cancers, whereas infection-related cancers were highest among Asian American ethnic groups. For example, liver and stomach cancer incidence is highest among Vietnamese (22.2 per 100,000) and Korean people (17.8 per 100,000), respectively, both of which were nearly twice that in Native Hawaiian people (12.9 and 9.6 per 100,000, respectively). Native Hawaiian and Samoan women are twice and 3 times as likely, respectively, to be diagnosed with uterine corpus cancer as aggregated Asian American and NHPI women or White women. Five-year relative survival ranges from 42% in Laotians to 74% in Asian Indians/Pakistanis, with largest differences for colorectal (43% in Laotians to 72% in Asian Indians/Pakistanis) and prostate (63% in Kampucheans to 97% in Japanese) cancers. CONCLUSIONS: Wide variation in cancer risk within the Asian American and NHPI population highlights the critical need for disaggregated data to effectively target cancer prevention and control interventions.

Adolescent↗