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PubMed2006

Breast cancer among Asian Americans: is acculturation related to health-related quality of life?

PURPOSE/OBJECTIVES: To examine the association of acculturation with health-related quality of life (HRQOL) among Asian American breast cancer survivors. DESIGN: Cross-sectional. SETTING: Analysis of an Asian American subsample of breast cancer survivors from a larger multiethnic study. SAMPLE: 206 Asian Americans, including Chinese, Filipinos, Koreans, and Japanese. Most were diagnosed with early-stage breast cancer (stage 0-II) and were an average of 54 years old. METHODS: Participants completed a mailed questionnaire or answered a telephone survey in English, Mandarin, or Korean. HRQOL was measured using the Functional Assessment of Cancer Therapy Breast Version 4. Acculturation was measured using an eight-item scale adapted from Marin's Short Acculturation Scale. MAIN RESEARCH VARIABLES: HRQOL, acculturation, health insurance, life stress, and social support. FINDINGS: Acculturation was significantly associated with HRQOL when demographic, medical, socioecologic, and healthcare access factors were controlled. However, the significant association between acculturation and HRQOL disappeared when Asian subgroup membership was considered. Subgroup differences in HRQOL remained after controlling for covariates, with Korean Americans reporting lower HRQOL than the other Asian American subgroups. CONCLUSIONS: The absence of a significant association between acculturation and HRQOL in the final model is likely a result of the strong association between acculturation and Asian American subgroup membership. The results suggest that the correlation between acculturation and HRQOL is not an effect of having health insurance, life stress, and social support. IMPLICATIONS FOR NURSING: Closer attention is needed regarding acculturation level; Asian American subgroup differences, including language capacity; and socioecologic characteristics in nursing practice and research.

Acculturation↗
PubMed2000

Effects of acculturation on the MMPI-2 scores of Asian American students.

The use of the MMPI-2 (Butcher, Dahlstron, Graham, Tellegen, & Kaemmer, 1989) with minorities has been questioned due to potential misinterpretations related to cultural differences. This study examined acculturative differences among Asian American college students and their scores on the validity and clinical scales. A sample of Asian American students (n = 90) was assigned to groups based on acculturation level. Analysis of variance tests indicated that low-acculturated, bicultural, and high-acculturated Asian Americans yielded different profiles. Compared to a matched White student sample, low-acculturated Asian Americans scored significantly higher on 9 scales, and bicultural Asian Americans had 6 significantly different scores. These differences were clinically interpretable with a range from 6.46 to 21.65 T-score points. High-acculturated Asian Americans did not differ from Whites. Cultural variables to be considered when interpreting Asian American profiles are discussed.

Acculturation↗
PubMed2005

A comparison of twin birthweight data from Australia, the Netherlands, the United States, Japan, and South Korea: are genetic and environmental variations in birthweight similar in Caucasians and East Asians?

Birthweight has implications for physical and mental health in later life. Using data from Caucasian twins collected in Australia, the Netherlands and the United States, and from East Asian twins collected in Japan and South Korea, we compared the total phenotypic, genetic and environmental variances of birthweight between Caucasians and East Asians. Model-fitting analyses yielded four major findings. First, for both males and females, the total phenotypic variances of birthweight were about 45% larger in Caucasians than in East Asians. The larger phenotypic variances were mainly attributable to a greater shared environmental variance of birthweight in Caucasians (ranging from 62% to 67% of variance) than Asians (48% to 53%). Second, the genetic variance of birthweight was equal in Caucasians and East Asians for both males and females, explaining a maximum of 17% of variance. Third, small variations in total phenotypic variances of birthweight within Caucasians and within East Asians were mainly due to differences in nonshared environmental variances. We speculate that maternal effects (both genetic and environmental) explain the large shared environmental variance in birthweight and may account for the differences in phenotypic variance in birthweight between Caucasians and East Asians. Recent molecular findings and specific environmental factors that are subsumed by maternal effects are discussed.

Asian People↗
PubMed2004

Health status and health services utilization among US Chinese, Asian Indian, Filipino, and other Asian/Pacific Islander Children.

OBJECTIVE: This study examines the health status and health services access and utilization characteristics of US Chinese, Asian Indian, Filipino, other Asian/Pacific Islander (API), and non-Hispanic white children by using nationally representative data. METHODS: We analyzed the aggregated data file from the National Health Interview Survey from 1997 to 2000 including 334 Chinese, 287 Asian Indian, 292 Filipino, 696 "other API," and 29,016 non-Hispanic white children <18 years old. Bivariate and multivariate analyses were conducted to examine the relationship between Asian ethnicities and dependent variables including components of health status, health services access, and utilization. RESULTS: Logistic regression reveals that all Asian American children were less likely to miss school because of illness or injury or have learning disabilities compared with non-Hispanic whites. Other APIs were less likely to be taking prescription medication for at least 3 months, and Asian Indian children were half as likely to have chronic conditions. Chinese, Filipino, and other API children were more likely to be without contact with a health professional within the past 12 months. Citizenship/nativity status, maternal education attainment, and poverty status were all significant independent risk factors for health care access and utilization. CONCLUSIONS: Asian ethnicities and being foreign-born are generally associated with more favorable health status measures such as school absence, learning disability, use of prescription medications, and chronic conditions. However, these attributes are negatively associated with health care access and utilization, suggesting the need for outreach to Asian immigrant populations to educate them on accessing the US health care system.

Adolescent↗
PubMed2006

Asian oral-facial cleft birth prevalence.

OBJECTIVE: To determine the clefting birth prevalence among Asian populations, specifically Chinese and Japanese, using raw counts from nonoverlapping published studies of Asian populations, and to investigate whether Asian clefting rates have been interpreted accurately as being up to twice the Caucasian rate. DESIGN: A literature review of articles giving raw counts of clefting in Asian populations, primarily Japanese and Chinese. MAIN OUTCOME MEASURES: Where possible, clefts were identified by the patients' ethnicity, country of origin, cleft type, syndromic status, and birth status. RESULTS: Prevalence rates of cleft lip with or without cleft palate per 1000 live births are reported. Syndromic plus nonsyndromic cleft lip with or without cleft palate: Chinese, 1.30; Japanese, 1.34; Other Asian, 1.47; and total, 1.33. Nonsyndromic cleft lip with or without cleft palate: Chinese, 1.20; Japanese, 1.18; Other Asian, 1.22; and total, 1.19. CONCLUSIONS: Overall, Chinese and Japanese live birth prevalence rates for nonsyndromic cleft lip with or without cleft palate, based on the published reports of birth prevalence, are significantly lower than the oft-quoted rate of 2 per 1000 for Asians. The apparent reason for the discrepancy is that many published prevalence rates included all pregnancies (live births plus pregnancy losses) and do not distinguish between syndromic and nonsyndromic clefts or between cleft palate alone and cleft lip with or without cleft palate. These results demonstrate that it is extremely important for current population-based studies of clefts to include careful delineation of population groups, syndromes, cleft type, and birth status.

Asian People↗
PubMed2002

Cancer screening promotion among medically underserved Asian American women: integration of research and practice.

Mammography and Pap smear tests are known to be effective early detection measures for breast and cervical cancers, respectively, but Asian Americans are reluctant to make visits for routine preventive care. Quantitative and qualitative research conducted by the Healthy Asian Americans Project (HAAP) between 1996 and 1999 indicated that Asian residents in southeastern Michigan, like the general Asian population in the US, underutilized early cancer screening programs due to cultural, psychosocial, linguistic, and economic barriers. This article reports how the HAAP's research findings guided the Michigan Breast and Cervical Cancer Control Program (BCCCP) promotion (conducted from 2000 to 2001 among medically underserved Asian women residing in southeastern Michigan), and how evaluation of the HAAP's BCCCP promotion will direct future research and health promotion programs. The article presents strategies used to improve access to cancer screening programs for diverse Asian sub-groups as well as outcomes of the 2-year HAAP's BCCCP promotion among the target population. Discussion regarding lessons and experiences gained from integration of research and practice has implications on design and implementation of the cancer screening promotion for the rapidly increasing Asian American population as well as other medically underserved minority populations in the US.

Adult↗
PubMed1991

Cardiovascular risk factors among Asian Americans living in northern California.

BACKGROUND: Recent substantial immigration has created large population subsets of Asian Americans in the United States. Available data about cardiovascular risk factors in these persons are sparse. METHODS: This study examined data among 13,031 persons self-classified as 5951 Chinese, 4211 Filipinos, 1703 Japanese, and 1166 other Asians. Covariates in regression analyses were age, smoking, alcohol, education, and marital status. RESULTS: Chinese men and women had the lowest adjusted mean body mass index. Filipino men and women had the highest prevalence of hypertension. There were no major differences in blood glucose levels. Total cholesterol levels were highest in Japanese men and women. Comparisons of US-born persons and those born in respective countries of origin showed no major cholesterol or glucose differences; more hypertension only in Chinese and other Asian men; higher body mass index in men, but not in women of most ethnicities; and a lower smoking prevalence in men, but a substantially higher one in women. CONCLUSIONS: These data show important ethnic differences in risk factors among Asian Americans and indicate groups that should be targeted for public health efforts concerned with obesity (Asian-American men), hypertension (Filipino-American men and women), hypercholesteremia (all Asian Americans), and smoking cessation (Asian-American women).

Adult↗
PubMed1999

Ethnicity and birthplace in relation to tumor size and stage in Asian American women with breast cancer.

OBJECTIVES: This study examined whether Asian American women with breast cancer have tumor characteristics associated with delayed detection of their disease. METHODS: Breast cancer size and stage were examined in relation to subjects' ethnic group and birthplace, on the basis of Surveillance, Epidemiology, and End Results program data. RESULTS: Asian-born Asian American women with breast cancer had a greater proportion of tumors larger than 1 cm at diagnosis (79%) than did US White women (70%) (P < .001). In contrast, the proportion of tumors larger than 1 cm among Asian American women born in the United States (67%) did not differ significantly from that among US White women. CONCLUSIONS: Lower utilization of breast cancer screening by Asian-born Asian American women is probably responsible for their greater proportion of tumors larger than 1 cm relative to US White women in the study population. Interventional measures should be taken to increase the use of mammographic screening by first-generation Asian American women.

Adult↗
PubMed2005

Foot ulcer risk is lower in South-Asian and african-Caribbean compared with European diabetic patients in the U.K.: the North-West diabetes foot care study.

OBJECTIVE: To determine 1) foot ulcer rates for European, South-Asian, and African-Caribbean diabetic patients in the U.K and 2) the contribution of neuropathy and peripheral arterial disease (PAD) differences to altered ulcer risk between the groups. RESEARCH DESIGN AND METHODS: In this U.K. population-based study, we screened 15,692 type 1 and type 2 diabetic patients in the community health care setting for foot ulcers, foot deformities, neuropathy, and PAD plus other characteristics. In total, 13,409 were European (85.5%), 1,866 were South Asian (11.9%), and 371 were African Caribbean (2.4%). RESULTS: The age-adjusted prevalence of diabetic foot ulcers (past or present) for Europeans, South Asians, and African Caribbeans was 5.5, 1.8, and 2.7%, respectively (P < 0.0001). Asians and African Caribbeans had less neuropathy, PAD, and foot deformities than Europeans (P = 0.003). The unadjusted risk of ulcer (odds ratio [OR]) for Asians versus Europeans was 0.29 (95% CI 0.20-0.41) (P < 0.0001). PAD, neuropathy, foot deformities, and insulin use attenuated the age-adjusted OR from 0.32 to 0.52 (0.35-0.76) (P < 0.0001). African-Caribbean versus European ulcer risk in males was attenuated from 0.60 to 0.71 by vibration sensation. CONCLUSIONS: South Asians with diabetes in the U.K. have about one-third the risk of foot ulcers of Europeans. The lower levels of PAD, neuropathy, insulin usage, and foot deformities of the Asians account for approximately half of this reduced foot ulcer risk. Lower neuropathy is the main contributor to the reduced African-Caribbean ulcer rate, particularly in men. The reasons for these ethnic differences warrant further investigation.

Age Factors↗
PubMedDate not supplied

Cardiovascular health among Asian Americans/Pacific Islanders: an examination of health status and intervention approaches.

PURPOSE OF THE REVIEW. The purpose of this review is to examine the cardiovascular health status of Asian Americans/Pacific Islanders by primary risk factor and review current intervention approaches targeting this population. Asian Americans/Pacific Islanders in the United States have experienced triple digit percentage increases in population for every decade since 1970. Despite their rapidly increasing numbers, little is known about their cardiovascular health status. SEARCH METHODS USED. This article reviews the literature on the demographics, mortality, and prevalence of major cardiovascular risk factors among Asian Americans/Pacific Islanders. Selected intervention programs are also described. SUMMARY OF IMPORTANT FINDINGS. Data on cardiovascular disease mortality for Asian Americans/Pacific Islanders are relatively limited because few states collect ethnically specific mortality statistics. Data on cardiovascular risk factors, particularly smoking and hypertension, for certain Asian American/Pacific Islander groups portend excessive cardiovascular disease burdens. MAJOR CONCLUSIONS. Data specific to ethnic groups comprising Asian Americans and Pacific Islanders need to be called. Also, scientifically valid and linguistically appropriate interventions approved by ethnic community leaders are needed to address Asian Americans/Pacific Islanders.

Asian↗
PubMed1989

Practice patterns, attitudes and activities of Caucasian vs. Asian University of California-San Francisco PharmD graduates.

The results of a 1982 survey of graduates of the University of California at San Francisco (UCSF) doctor of pharmacy degree program were re-analyzed to explore whether cultural differences between Asian and Caucasian PharmD graduates affected professional practice patterns, attitudes and activities. Of the 732 respondents, 408 (56 percent) were Caucasians and 262 (36 percent) were Asians. Asian females had significantly fewer years of college education before entering pharmacy school and spend significantly fewer hours in the practice of pharmacy or related activities. Caucasians had a slightly higher grade point average than Asians. The mean score on the California State Board of Pharmacy Licensure Examination did not differ between the groups. For their first position following graduation, Asians predominated in operational positions, while Caucasians held clinical positions more frequently. Thirty-eight percent of Caucasians vs. 18 percent of Asians were taking or had completed postgraduate residency or fellowship training. An analysis of current jobs revealed that Asian males had the greatest increase in clinical positions when compared to the first position. Males of both ethnicities made the greatest gains in annual salary and in management positions compared to females.

Asian↗
PubMed1998

Health status of Asian Americans: United States, 1992-94.

OBJECTIVES: This report compares the health status of selected Asian national origin groups. METHODS: 1992-94 National Health Interview Survey (NHIS) data were analyzed for six Asian national origin groups (Chinese, Filipino, Asian Indian, Japanese, Vietnamese, and Korean), the Asian and Pacific Islander (API) population as a whole, and the non-Hispanic white population. Unadjusted and age-adjusted estimates and standard errors of health indicators and sociodemographic characteristics were generated. A broad range of health issues was studied including respondent-assessed health status, activity limitation, physician contacts, restricted activity days, hospital episodes, smoking status, and knowledge of acquired immunodeficiency syndrome (AIDS). RESULTS: A greater age-adjusted percent of Vietnamese (17.2 percent) and Korean (12.8 percent) persons had fair or poor respondent-assessed health status than persons of Chinese, Filipino, and Japanese descent (6.1-7.4 percent). A lower age-adjusted percent of Chinese persons (6.5 percent) experienced activity limitation compared with Filipino, Japanese, and Vietnamese persons (9.4-13.2 percent). Japanese persons (4.9 contacts) had a greater average annual number of physician contacts than Chinese persons (3.1 contacts) after age adjusting the data. When the data were age adjusted, a higher percent of Korean adults (22.5 percent) were current smokers than Chinese (10.0 percent) and Asian Indian adults (8.7 percent). A higher age-adjusted percent of Vietnamese (21.2 percent) and Asian Indian (18.0 percent) adults reported knowing nothing about AIDS compared with Japanese adults (5.1 percent). A greater proportion of Vietnamese adults (91.6 percent) had not been tested for the AIDS virus infection compared with Chinese, Filipino, Asian Indian, and Japanese adults (72.6-78.5 percent) after age adjusting the data. CONCLUSIONS: Differences in health emerge when data on the API population are analyzed by national origin group. Estimates of health presented for the API population as a whole mask differences among subgroups.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Lifestyle determinants of 5alpha-reductase metabolites in older African-American, white, and Asian-American men.

Men with higher endogenous 5alpha-reductase activity may have higher prostate cancer risk. This hypothesis raises two questions: (a) Could racial differences in 5alpha-reductase activity explain the observed racial differences in prostate cancer risk? and (b) Could a man reduce his activity level by modifying his lifestyle? To address these questions, we measured two hormonal indices of 5alpha-reductase activity [serum levels of androstane-3alpha-17beta-diol glucuronide (3alpha-diol G) and androsterone glucuronide (AG)] in healthy, older African-American, white, and Asian-American men, who are at high, intermediate, and low prostate cancer risk, respectively. We also examined associations between these metabolite levels and such lifestyle characteristics as body size and physical activity as well as select aspects of medical history and family history of prostate cancer. Men included in this cross-sectional analysis (n = 1054) had served as control subjects in a population-based case-control study of prostate cancer we conducted in California, Hawaii, and Vancouver, Canada and provided information on certain personal attributes and donated blood between March 1990 and March 1992. In this study, concentrations of 3alpha-diol G declined significantly with age and increased significantly with body mass index. Mean levels of 3alpha-diol G, adjusted for age and body mass index, were 6.1 ng/ml in African-Americans, 6.9 ng/ml in whites and 4.8 ng/ml in Asian-Americans. These differences were statistically significant (African-Americans versus whites: P < 0.01; whites versus Asian-Americans: P < 0.001). Concentrations of AG decreased significantly with age, but only in whites, and were unrelated to any of the reported personal attributes. Mean levels of AG, adjusted for age, were 44.1 ng/ml in African-Americans, 44.9 ng/ml in whites, and 37.5 ng/ml in Asian-Americans (Asian-Americans versus whites, P < 0.001). In conclusion, older African-American and white men have similar levels of these two indices of 5alpha-reductase activity, and these levels are higher than those of older Asian-American men. This difference may be related to the lower prostate cancer risk in Asian-Americans.

Age Distribution↗
PubMed2002

Consumer Health Information for Asians (CHIA): a collaborative project.

According to the 2000 United States Census, the Asian population in Houston, Texas, has increased more than 67% in the last ten years. To supplement an already active consumer health information program, the staff of the Houston Academy of Medicine-Texas Medical Center Library worked with community partners to bring health information to predominantly Asian neighborhoods. Brochures on health topics of concern to the Asian community were translated and placed in eight informational kiosks in Asian centers such as temples and an Asian grocery store. A press conference and a ribbon cutting ceremony were held to debut the kiosks and to introduce the Consumer Health Information for Asians (CHIA) program. Project goals for the future include digitizing the translated brochures, mounting them on the Houston HealthWays Website, and developing touch-screen kiosks. The CHIA group is investigating adding health resources in other Asian languages, as well as Spanish. Funding for this project has come from outside sources rather than from the regular library budget.

Academic Medical Centers↗
PubMed2005

What if your nursing student is from an Asian culture?

Nursing faculty are educating an increasing number of Asian and Asian American students. There is a paucity of literature on how to facilitate their growth into professional nurses given their unique cultural differences. In order to optimize their educational experience, nursing faculty need to have a working knowledge of the cultural underpinnings of Asian American students. Building on two real scenarios, this article provides footnotes for understanding the rationales of the behaviors of Asian and Asian American students. The Cultural Assessment Model by Giger and Davidhizar (2004) provides the framework for the analysis. Based on this cultural knowledge, strategies and tips for improving communication with Asian and Asian American students are presented.

Asian↗
PubMedDate not supplied

Morphology and properties of Asian and Caucasian hair.

Various aspects of Asian and Caucasian hairs were investigated and compared. We started by studying their cuticle structures--the number of cuticle layers, width of the cuticle cells, degree of their inclination, and the interval between surface cuticle edges. As a result of this study, on about two hundred subjects for each race, it was shown that there were statistically meaningful differences between all these attributes for the two hair types. Asian hair has more cuticle layers and wider cuticle cells than Caucasian hair, and the cuticular inclination of Asian hair is steeper and its cuticular interval is narrower than in Caucasian hair. In addition, it was also found that there are differences in how cuticle cells begin to fail. Under extension stress, Asian hair cuticles fail as large pieces while keeping their original shape. On the other hand, Caucasian hair cuticles tend to collapse to form small fragments. AFM measurements revealed that Caucasian cuticles are indeed more fragile than Asian cuticles. These results suggest that the strength of cuticular subcomponents is different between Asian and Caucasian hair and that the weakest point, where stress is first absorbed, differs between races. It was proven that the cuticles of Asian hair are more easily peeled off than Caucasian hair cuticles during daily grooming. This can be attributed to the difference in how stress is absorbed.

Adolescent↗
PubMed2006

Prevalence and correlates of cardiovascular risk factors in South Asians: population-based data from two California surveys.

OBJECTIVE: Few population-based studies report cardiovascular disease (CVD) risk factor prevalence for South Asians in the United States. We examined CVD risk for South Asians in California. DESIGN/SETTING/PARTICIPANTS: We used data from two population-based surveys with South Asian participants in California, the California Health Interview Survey (CHIS) and the Cardiovascular Health among Asian Indian (CHAI) survey. The CHIS 2001 was conducted in English; 769 South Asians aged 25-83 years participated as one of many ethnic groups. The CHAI survey was population-based but focused on ethnicity-specific characteristics in 304 South Asians aged 25-80 years in English and Punjabi in 2001-2002. MAIN OUTCOME MEASURES: A CVD risk score included smoking, hypertension, hypercholesterolemia, diabetes, myocardial infarction, and angina. Separate logistic regression models examined the association of sociodemographics, lifestyle, medical risk, acculturation, and "any CVD risk." RESULTS: In CHAI, hypertension (20%), hypercholesterolemia (24%), and diabetes (10%) were high; smoking was low (12%). In CHIS, prevalence of these conditions was lower, except smoking (21%). Approximately 35% of participants in each survey had any CVD risk. Male sex, age, higher body mass index, education less than a bachelor's degree, and alcohol use were associated with CVD risk in both studies. The CHAI subjects interviewed in English had higher odds of any CVD risk than those interviewed in Punjabi (odds ratio 10.3, 95% confidence interval 2.9-36.7). CONCLUSIONS: Data from multiple sources add crucial information about heterogeneity of risk within ethnic populations. South Asians in the CHIS had higher rates of smoking, but lower CVD risk scores than participants in the CHAI study. In CHAI, English language use was associated with increased CVD risk score. Additional research should examine if acculturation increases CVD risk.

Adult↗
PubMed2006

Low density lipoprotein subclasses in Asian and Caucasian adolescent boys.

South Asian adults are known to have very high rates of Coronary heart disease (CHD) and insulin resistance and, even as adolescents, may show higher risk factors for CHD. The aim of this study was to investigate the prevalence of small, dense low density lipoprotein (sdLDL) subclasses in a cohort of adolescent boys. The specific objective was to investigate the relationship between measures of fatness, ethnicity and LDL diameter in this cohort. Preformed native (non-denaturing) polyacrylamide 3-13% gradient gels and a multipurpose vertical electrophoresis system were used for the separation of LDL sub-fractions in a single school year cohort of boys aged 15-16 years (n=135). Latex beads and thyroglobulin standards were used to construct a calibration curve in order to calculate LDL particle diameters by regression (Total Lab Software v1.11). ANOVA was used to compare LDL size among different ethnic groups (SPSS and Stat View). The study sample was comprised of 45.2% Caucasians, 41.5% East Asians and 13.3% from the Indian subcontinent (South Asians). There was a non-significant trend for South Asians to have a lower LDL diameter than either Caucasians or East Asian boys which was independent of % total body fat (%TBF) and body mass index (BMI). This is the first adolescent cohort to examine sdLDL which included Caucasians, East and South Asians. It appears that the higher risk profile for CHD and diabetes noted in South Asian adults may be evident even during adolescence.

Adolescent↗