RESEARCH JOURNALS

Research to Identify Breast Cancer Disparities

Abstract

The San Diego-based branch of Susan G. Komen for the Cure conducted research regarding disparities among knowledge, diagnosis, and treatment of breast cancer in women throughout San Diego County. They found that San Diego has the highest rate of diagnosis throughout California, and that the diagnosis comes at an early stage, allowing for a 98% survival rate. The research found disparities among age and race. Younger women and women of minorities were less likely to be screened. Services varied throughout the county, accounting for some differences in diagnosis. Healthcare providers were generally unable to serve non-English speaking clients. Those who speak Spanish, Tagalog, Vietnamese, Farsi, Somali, Cantonese, or Korean were those with greatest need who were unable to receive treatment. Many perceived barriers factored into patients’ inability to access breast healthcare, such as language, culture, finances, and lack of awareness. The study hopes to increase “advocacy, education, provider training and funding for services, such as transportation and screening,” to improve breast health care throughout San Diego County.

Author: Susan G. Komen for the Cure San Diego

Year of Publication: 2010

Ethnic Group: Caucasian, African-Americans, Latinas, Asian Pacific Islanders, Native Americans

Age Group: Youth, Adult, Senior

Organization: Susan G. Komen for the Cure

Direct Link: http://www.news-medical.net/news/20090918/Research-to-identify-breast-cancer-disparities.aspx

Korean Use of Medical Services in Seoul, Korea and California

Abstract

This study assessed the types of health care services used by Korean immigrants, and differences in use between different countries, genders, health insurance status, acculturation status, and cardiovascular risk. Participant selection used probability sampling to represent the adult populations of California, United States, and Seoul, Republic of Korea. A telephone survey was administered to 2,830 adult Korean-Californians and 500 adult Koreans living in Seoul. Female gender was significantly associated with higher use of outpatient services, ER usage, and hospitalization. Californian residence was significantly associated with higher outpatient usage and lower hospitalization rates. Health insurance was associated with higher allopathic health care utilization, and lower traditional health care usage, and acculturation with lower traditional health care usage. Higher self-reported cardiac risk factors were associated with lower allopathic and higher traditional health care. This suggests barriers to allopathic health care, but not traditional health care, for Koreans living in California without health insurance.

Author: Hill L, Hofstetter CR, Hovell M, Lee J, Irvin V, Zakarian J

Year of Publication: 2006

Journal: Journal Of Immigrant And Minority Health, Volume: 8, Issue: 3, Page: 273-280

Ethnic Group: Korean

Age Group: Adult

University: San Diego State University, SDSU Graduate School of Public Health, Center for Behavioral Epidemiology and Community Health, Harvard University, HU School of Public Health, SDSU Dept of Political Science

Contact Information: Linda Hill, MD, MPH, 9245 Sky Park Court, Suite 230, San Diego, California 92123

Health of Cambodian Refugees

Abstract

Cambodian refugees have been entering the United States since 1975, with the largest numbers arriving in the early 1980s. While many adjusted satisfactorily to their new environment, many continue having severe difficulty with the resettlement. Studies show that Cambodians are suffering more physical and mental distress than Vietnamese, Hmong, and Laotians. They are experiencing more financial and social distress, as well. This paper describes a small neighborhood home visiting program established 13 years ago to provide follow-up care for Cambodian refugees seen in a University Medical Center and later serving as a community experience for fourth-year medical students. These close contacts with the Cambodian community indicate that for many, especially those who are aging, both health and adjustment appear to be deteriorating. Chronic illnesses and prolonged severe depression are taking the place of the infectious diseases and the personal health problems, like dental disease, that they brought with them when they resettled in America.

Author: Pickwell SM

Year of Publication: 1999

Journal: Journal of Immigrant Health, Volume: 1, Issue: 1, Pages: 49-52

Ethnic Group: Cambodian

Age Group: Adult, Senior

University: University of California San Diego, UCSD School of Medicine

Contact Information: Division of Graduate Nursing Education, School of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093-0807, USA

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Health Insurance Coverage for Vulnerable Populations: Contrasting Asian Americans and Latinos in the United States

Abstract

This paper examines the role that population vulnerabilities play in insurance coverage for a representative sample of Latinos and Asians in the U.S. Using data from the National Latino and Asian American Study (NLAAS), these analyses compare coverage differences among and within ethnic subgroups, across states and regions, among types of occupation and among those with or without English language proficiency. Extensive differences exist in coverage between Latinos and Asians, with Latinos more likely to be uninsured. Potential explanations include the type of occupations available to Latinos and Asians, reforms in immigration laws, length of time in the U.S., and regional differences in safety net coverage. Policy implications are discussed.

Recommendations

"Sorting out any mechanisms operating through health or mental health status at work is an important area for further research…Furthermore, particular Asian subgroups (such as Vietnamese Americans) are as likely as Latinos to be uninsured, and some Asian Americans may not receive the same quality of coverage as whites - an issue that cannot be addressed with the NLAAS, but one that is worth investigating(pg. 11).”.

Author(s): Alegria M, Cao Z, McGuire TG, Ojeda VD, Sribney B, Woo M, Takeuchi D

Year of Publication: 2006

Journal: Inquiry, Volume: 43, Issue: 3, Pages: 231-254

Ethnic Group(s): Puerto Rican, Cuban, Mexican, other Latino, Vietnamese, Filipino, Chinese, other Asian

University: Harvard Medical School Dept of Psychiatry, Cambridge Health Alliance Center for Multicultural Health Research, University of Washington

Contact Information: Dr. Alegria at the Center for Multicultural Mental Health Research, Cambridge Health Alliance, 120 Beacon St., 4th floor, Somerville, MA 02143. Email: E-mail: malegria@charesearch.org.

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Improving Health Coverage and Access for Asians/Pacific Islanders

Location: United States

Survey Population: General

Race: Asian Pacific Islanders

Age Group: N/A

Year of Publication: 2006

Abstract

Asian and Pacific Islander (API) communities across the U.S. continue to face inequalities in health coverage, provider access, and overall health status. Uninsured API adults are less likely to receive preventive care, screening services, and appropriate acute or chronic disease management, and they are more likely than insured individuals to have poorer overall health. In 1998, the federal government made eliminating racial and ethnic disparities in health a national priority. However, despite the increased attention that is now being paid to the problem of health disparities, many Asians and Pacific Islanders continue to lag substantially behind their white peers on measures ranging from provider access to health status.

For more information on Families USA's Minority Health Initiatives, contact Rea Paneres, Director of Minority Health Initiatives at minorityhealth@familiesusa.org or (202) 628-3030.

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High Fertility Among Indochinese Refugees

Location: San Diego and San Francisco, CA

Survey Population: Women

Race: Cambodian, Lao, Vietnamese, Khmer, Chinese-Vietnamese

Age Group: Young Adult, Adult

Year of Publication: 1988

Abstract

From 1975 to 1988, nearly 900,000 Indochinese refugees were resettled in the United States. This paper examines patterns of fertility among these refugees from Cambodia, Laos, and Vietnam who have exhibited high levels of reproduction since their arrival. Data are drawn from sample surveys in San Diego and San Francisco, CA. Fertility levels were found to exceed five children per ever-married woman, a level that is consistent with perceptions of ideal family size in the homeland. Fertility levels were significantly higher among rural second-wave refugees than in the more urban first-wave groups. One explanation for the high fertility is that couples have migrated from areas where fertility is high, and they have not yet adapted their reproductive behavior to the low fertility environment of the United States. This possibility is reinforced by a general gender preference for boys and exacerbated by the fact that, while a majority of women are aware of methods of fertility control, access is still limited by cultural and financial barriers, and the motivation to use family planning still appears to be relatively low. The data suggest that this refugee population will continue to put pressure on maternal and child health resources, and that continued residence in the United States could lead to desires to limit family size, thus increasing demand for methods of fertility control. Indochinese refugees in the United States represent a large, rapidly growing, ethno-culturally diverse population. Including their American born offspring, the Indochinese now number more than 1 million, surpassing Cuban-Americans as the largest refugee group in the United States (7) and representing the third largest Asian-origin population in this country, following people of Chinese and Filipino origin (2). The most obvious reason for the rapid increase of the Indochinese population is the large-scale migration of refugees from Vietnam, Laos, and Cambodia (table 1). These refugees, numbering nearly 900,000 admissions into the United States between 1975 and 1988, have come in two main waves. The first wave (1975-78) included fewer than 170,000 entrants; most of them were South Vietnamese evacuated when Saigon fell in April 1975. The more numerous and nationally heterogeneous second wave has included more than 600,000 refugees since 1979 (3). Migration is not the only source of growth of the Southeast Asian.

Weeks JR, Rumbaut RG, Brindis C, Korenbrot CC, Minkler D (1988). High Fertility Among Indochinese Refugees. Accessed July 2, 2012 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1580022/pdf/pubhealthrep00204-0041.pdf.

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Improving Cancer Awareness Among Asian Americans Using Targeted and Culturally Appropriate Media: A Case Study

Location: Philadelphia and surrounding counties

Survey Population: Men and women

Race: Chinese, Korean, Vietnamese, Cambodian

Age Group: N/A

Year of Publication: 2004

Abstract

Reaching Asian Americans with cancer awareness messages is critical to improving cancer detection and reducing risk. Two separate targeted media campaigns, sponsored by the Asian Tobacco Education, Cancer Awareness, and Research (ATECAR), were implemented to increase cancer awareness among Chinese, Koreans, Vietnamese, and Cambodians residing in Philadelphia and the surrounding counties. These campaigns, based on Rogers’s diffusion and innovation theoretical model, were culturally sensitive, multilingual, and implemented over an extended time frame using print articles and a radio series under the respective general headings ATECAR Link and Voice of ATECAR. The series covered a range of topics that included tobacco smoking and health, cervical and breast cancer, clinical trials, and cancer information. Despite a reputation for noninvolvement in mainstream cancerrelated media issues, results of the campaigns reflected an exceptional response from the targeted communities. The results suggest that wellplanned, community-based media campaigns can have positive impacts on cancer awareness in Asian communities.

Ma GX, Fleisher L, Gonzalez E, Edwards RL (2004). Improve cancer awareness among asian americans using culturally appropriate media. Home Health Care Management & Practice, 17(1), 39-44.

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