Health Promotion Among Asian Americans Robert Ramirez
Grand Canyon University: NRS-429V Family-Centered Health Promotion
February 22, 2015

Health Promotion Among Asian Americans The U.S. Public Health Service defines health promotion as “the process of advocating health in order to enhance the probability that personal, private, and public support of positive health practices will become a societal norm” (Edelman, Mandle, & Kudzma, 2014). Health is a basic human right; optimal health is a well-balanced structure of emotional, physical, spiritual, psychological, intellectual, and social well-being. The purpose of health promotion in nursing is to increase health knowledge that will in turn positively influence health behaviors of individuals and communities (Foster, 2012). Roughly 36% of the U.S. population is made up of various ethnic or racial minorities. Of that 36%, 4.8% were Asian Americans. According to the Office of Management and Budget, “Asians” consist of people that originate from the Far East, Southeast Asia, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan Thailand, Vietnam, or the Philippine Islands (CDC, 2014). These 14.7 million people are dispersed throughout the country, with Hawaii having the largest concentration (57%) of the total Asian population (CDC, 2014). The CDC (2014) states that minority groups “experience a disproportionate burden of preventable disease, death, and disability compared with non-minorities.” This paper will concentrate on health promotion among the Asian American population, compare and contrast the health status of this minority group to the national average, and describe suggested health promotion prevention techniques tailored to the specific needs presented in this paper.
Comparison of Asian Americans to the National Average According to the 2010 Census, the fastest growing population than any other race group in the United States were Asian Americans. The wide spectrum of variation within the Asian population results in significant differences that impact their health. For instance, research shows that Vietnamese women suffer from cervical cancer at a rate nearly 5 times more than White women; Cambodians have a stroke rate that is 4 times greater than Whites; Native Hawaiians are 5 times more likely to develop diabetes mellitus between the ages of 19 and 35 than non-Hawaiians (Samad, 2012).
Per the CDC (2014), the 3 leading causes of death in Asians are cancer, heart disease, and stroke. The top 3 causes of death on a national level are heart disease, cancer, and chronic respiratory diseases (CDC, 2014). In 2012, the average life expectancy at birth in the U.S. was 78.8 years. At 85.8 years, Asian Americans experience the longest life expectancy compared to all other ethnic groups (CDC, 2014).
In comparison to the total U.S. population, it is less likely for Asian Americans to live in poverty. Research also supports that Asians are more likely than the U.S. population to possess degrees or be college graduates, and they are more likely to be working in the fields of management, science, business, and arts occupation (Samad, 2012).
Barriers to Health Within any specific culture, there are factors that correlate with poor health. These include low education attainment, poverty, limited English proficiency, and other socioeconomic indicators (Samad, 2012). Acknowledgment of these barriers provides an opportunity to address them so that disparities can be eliminated and quality health care can be delivered.
Cultural Barriers
The biggest concern in regards to healthcare in the Asian population is communication. In the United States, English is the primary language. The ability to speak English greatly impacts communication between insurance companies, healthcare providers, and public services. According to the Census, over 4.0 million Asians have limited English proficiency (LEP) (Samad, 2012). Studies show that individuals with LEP are less likely to have insurance and receive critical preventive health measures (Samad, 2012).
Socioeconomic Barriers
One factor that has a strong correlation to health outcomes is financial resources. The Asian per capita income is $20,719; the national average in the United States is $21,587 (Samad, 2012). Considering this fact, socioeconomics is not a challenge to the health status of the Asian population.
Sociopolitical Barriers The Asian American population is not a politically inactive minority. Research shows that Asian Americans are realizing their potential to become a political force, thus there are more and more becoming activists, voters, candidates, political contributors, and participants in policy debates (Chang, 2001). With this realization of potential political strength, Asian Americans do not face any particular sociopolitical barriers to accessing healthcare.
Relation of Race, Ethnicity, Socioeconomic Status, and Education to Health In relation to their health, the Asian American community there both positive and negative influential factors. In some parts of the U.S., Asians are viewed as “perpetual foreigners” and become targets of racism and discrimination (Min, 2015). This leads to a fear of seeking healthcare. Asians are known to underutilize mental health services (Leong & Lau, 2011); barriers include “beliefs about causes of mental illness, stigma, unfamiliarity with mental health services, lack of awareness about available services, and inability to access services due to economic realities”(Leong & Lau, 2011). Barriers are present in the older generation of Asian immigrants because they are hesitant to adapt Western ideologies due to a lack of education, and simply because of native cultural values and beliefs (Who Are Asian Americans, 2012).
Current Health Status, Definition of Health Promotion, and Health Disparities As outlined in a report on Healthy People 2020, the following health indicators are current for the Asian American population. Tobacco use is at an all time low for both males and females, less than 10% (Louie, 2013). Asian women have the highest suicide rate for women 65 and older (Louie, 2013). Cancer related deaths are increasing faster in the Asian population than any other minority group (Louie, 2013). There is a high prevalence rate of Hepatitis B (Louie, 2013). Current reports note that Asians have the lowest AIDS/HIV prevalence rate (Louie, 2013). As mentioned, Asians are hesitant to adapt Western biomedical philosophy and health promotion practice. Rather their beliefs are focused more on the yin-yang theory and Ayuverdic principle, a belief that in two balanced energy forces brings about optimal health (Louie, 2013). There are several health disparities that affect Asian Americans. Cancer and cardiovascular disease are the main cause of death, and Asian women have the lowest cancer screening rates compared to other ethnic groups (Louie, 2013). The largest health threat to Asians is the Hepatitis B infection. Due to a decreased calcium intake in the average Asian diet, Asian women have a high risk for developing osteoporosis. Tuberculosis prevails the highest in Asian Americans. Mental health problems are disturbingly high in the Asian community (Who Are Asian Americans, 2012).
Health Promotion For a primary prevention approach, it would benefit the Asian community to provide “Asian educational sessions”, perhaps in a variety of Asian dialects to cater to the entire Asian community, on healthy living and health promotion. This will eliminate the lack of knowledge barrier. Increased funding for language interpretation in the healthcare system will also aid in better patient education. For a secondary prevention approach, cancer screenings and liver function tests should be encouraged to detect and diagnose the 2 main causes of death in the Asian population. Mental health services should also be encouraged and promoted to determine the need for treatment before the progression of any mental health diseases. For a tertiary prevention approach, palliative care should be emphasized for cancer patients and those with liver dysfunction to optimize quality of life and allow Asian patients to enjoy their latter years in comfort and peace. In conclusion, the Asian community is an exceedingly diverse ethnic minority in the United States. This specific community is faced with disproportionate burdens of health disparities and conditions that include Hepatitis B, mental health issues, cancer, cardiovascular diseases, and osteoporosis. Though many of these disparities are preventable, a lack of education contributes to the high prevalence within the Asian population. I believe that if a holistic approach, still sensitive to the Asian culture, is implemented and funded for this specific minority group, better health outcomes and health promotion will result.

References
CDC Minority Health: Asian American Populations. (2013, July 2). In Centers For Disease Control and Prevention. Retrieved from http://www.cdc.gov/minorityhealth/populations/REMP/asian.html
Chang, G. (2001). Asian Americans and Politics: Perspectives, Experiences, Prospects (pp. 5-10). Port Chester, NY: Stanford University Press. Retrieved February 21, 2015, from https://books.google.com/books?id=7sJpuzLHYw4C&pg=PA5&lpg=PA5&dq=political+barriers+to+asian+american+population&source=bl&ots=vp1JCvWa0w&sig=8vpfXtwCnCqduKlTx5zhth_szgI&hl=en&sa=X&ei=9kXpVLLyBoqUNrLD

Edelman, C., Mandle, C., & Kudzma, E. (2014). Health Promotion Throughout the Life Span (8th ed., p. 219). St. Louis, MO: Mosby.

Foster, D. (2012). What Is Health Promotion & Behavior?. In College of Public Health. Retrieved from https://www.publichealth.uga.edu/hpb/what-health-promotion-behavior

Leong, F. T. L., & Lau, A, S. L. (2011). Barriers to Providing Effective Mental Health Services to Asian Americans. Mental Health Services Research, 3(4), 201-214.

Louie, K. (2013). White Paper on the Health Status of Asian Americans and Pacific Islanders and Recommendations for Research. Nursing Outlook. Retrieved from http://www.aapcho.org/wp/wp-content/uploads/2012/02/HealthStatusofAAPIs.pdf

Min, G. (2015). Current Sociopolitical Barriers. In Counseling Asian Americans. Retrieved from https://counselingasianamericans.wordpress.com/current-sociopolitical-barriers/

Samad, B. (2012, February 8). Diverse Communities Diverse Experiences: The Status of Asian Americans & Pacific Islanders in the U.S. The Asian & Pacific Islander American Health Forum. Retrieved from http://www.aapcho.org/wp/wp-content/uploads/2012/02/APIAHF-DiverseCommunitiesDiverseExperiences.pdf
Who Are Asian Americans?. (2012). In Asian American Health Initiative. Retrieved from http://www.aahiinfo.org/english/asianAmericans.php