Asian Americans have historically been perceived as a "model minority", experiencing few health problems relative to other minority groups. Research within the past 20 years, however, has shown that Asian Americans are at high risk for hepatitis B, liver cancer, tuberculosis, and lung cancer, among other conditions. Asian American health disparities have gained focus only in the past 10 years, with policy initiatives geared towards promoting healthcare access to Asian Americans rising to prominence even later. Asian Americans are defined as Americans of Asian ancestry and constitute nearly 5% of American's population as of 2003, according to the U.S. Census Bureau. Yet, the Asian American population can hardly be described as homogenous. The term applies to members of over 25 groups that have been classified as a single group because of similar appearances, cultural values, and common ethnic backgrounds. The Asian Americans commonly studied have been limited primarily to individuals of Cambodian, Chinese, Filipino, Hmong, Japanese, Korean, Lao, Mien, or Vietnamese descent.
Health disparities Asian Americans are a heterogeneous group. The racial class is composed of many different ethnicities and cultures. In addition to country of origin, individuals can differ in socioeconomic status, education level, immigration status, level of acculturation, and English proficiency. In general, ethnic groups have their own health disparities. Vietnamese and Filipino Americans tend to have poorer health outcomes compared with Chinese, Japanese, and Korean Americans. Self-rated health was lowest in Vietnamese Americans, while Filipino Americans have the highest rates of chronic diseases, including asthma, high blood pressure, and heart disease. Filipinos are also an ethnic group that is a risk factor for premature births and amyotrophic lateral sclerosis (ALS or "Lou Gehrig's disease"). Koreans exhibit the highest psychological stress out of all ethnic groups. Thus, to classify and generalize health disparities to such a heterogeneous group may not be beneficial; however, a few health statistics can still be gleaned from general trends. Genetic inherited disorders and diseases (e.g. colorblindness, hemophilia) were reported to be uncommon in all Asian ethnic groups.
Cardiovascular disease Cardiovascular disease is one of the leading killers in all ethnic groups and a major contributor to disability among older adults. The incidence of heart disease is known to increase with age and the majority of deaths from coronary artery disease occur in people ages 65 years and older. While the rates of death from cardiovascular disease are lower for Asian Americans relative to other ethnic groups, they are still diagnosed with hypertension and heart disease. Cardiovascular disease and associated risk factors among Asian Americans and Pacific Islanders are high blood cholesterol, high blood pressure, cigarette smoking, obesity, and diabetes mellitus. According to American Heart Association in 2016, around 19.5% of Asian Americans have high blood pressure. In 2013, 18,819 deaths among Asians and Pacific Islanders were from cardiovascular disease, 8,477 from chronic heart disease, and 2,616 from myocardial infarction. Cancer, the second leading cause of death, contributed to 21.3% in 2017. The prevalence of coronary heart disease among Asian Americans is estimated to be around 4.9%.
Cardiovascular disease remains the leading cause of death for all Americans, and continues to disproportionally affect the Asian Americans who are disadvantageous in society because of various social determinants. The social determinants leading to health disparity include lack of language proficiency, health illiteracy from lower education attainment, racial discrimination, economic instability and poor community engagement. According to the National Institute on Minority Health and Health Disparity (NIMHD) sponsored lecture "Health Disparity Research in Diverse Asian American Populations in 2016", 70% of foreign-born Asian Americans were identified as having limited English proficiency, dissimilar cultural beliefs and behaviors, as well as unfamiliarity with the Western health care system and difficulty following instructions at the doctor's office. Addressing the health disparities requires significant awareness, comprehension, and consideration for the growing diversity of Asian population, especially for the foreign-born older Asian Americans. Understanding the impact of social determinants on health equity is crucial to health care professionals and policy makers to reduce health disparities and improve the health equality among Asian Americans and the underserved populations.
Diabetes With the adaptation of American culture, immigrant populations can be seen to have increased risks of diseases as Western diets are being introduced into their daily food consumption. However, there is a heightened risk of type 2 diabetes amongst Asian Americans as its presence makes up 21% of the Asian American population, twice as high as non-Hispanic whites. Various genetic and environmental factors cause Asian Americans to be more likely to develop type 2 diabetes than other racial and ethnic groups even though their body mass index (BMI) tends to be lower. Asian Americans have a higher percentage of body fat for their BMIs, which in turn elevates the risk of type 2 diabetes when BMIs are lowered; they in fact may have a higher percentage of body fat which contributes to a greater risk of developing diabetes and other health concerns that are commonly overseen. Because of their BMIs, which are usually lower than other racial and ethnic groups, there is a common misconception that they are not at much of a risk for developing type 2 diabetes. The World Health Organization, however, has suggested a lower BMI cutoff point in order to properly diagnose obesity for Asian Americans because of such low BMI levels.
Though it is expected that as there is a higher risk of type 2 diabetes within the Asian American population that much research is being done to screen for diabetes efficiently, the rate of not diagnosing type 2 diabetes for Asian Americans is three times as high as non-Hispanic whites. More than one in three people with diabetes are undiagnosed from improper screening, and that is particularly high for Asian Americans and Hispanics. A possible reason for why this may be the case is because Asian Americans are not aware of their elevated risk of developing type 2 diabetes and therefore refrain from screenings. Having no access to health insurance or lack of use of health care from language barriers as Asian immigrants may also contribute to the lack of screenings and increased likelihoods of undiagnosed type two diabetes. Research on language barriers showed differences in diagnoses of diabetes for Asian Americans and Hispanics particularly compared to whites in America as clinicians are lacking physician-patient communication. Another possibility is that the existence of the "model minority myth" prevents physicians from recognizing that such an elevated risk exists in Asian Americans, along with other common health issues. Based on these possibilities, Chinese and Korean Americans are also less likely than other Asian American subgroups to take part in self-management practices for their diabetes while Asian Americans as a whole are not given the physician-led management resources to treat diabetes like other racial groups.
In 2015, the American Diabetes Association (ADA) changed its guidelines for testing for diabetes for all Asian American adults who have a BMI of at least 23, instead of 25, which launched campaigns like "Screen at 23". Older Asian Americans have increased odds of diabetes or hypertension that still needs to be addressed.
Hepatitis B Hepatitis B is especially prevalent amongst Asian Americans. A study conducted between 2001 and 2006 that provided hepatitis B virus screenings to 3163 Asian Americans found that 8.9% of the population was chronically infected. Notably, 65.4% of those who were infected were unaware of their condition. Men were more likely to be infected than women, and hepatitis B infections were 19.4 times more likely in foreign born Asian Americans than in those born in the United States. Hepatitis B is one of the leading causes of the development of cirrhosis and hepatocellular carcinoma (HCC). Cirrhosis and liver cancer are often interconnected, and having cirrhosis may heighten the risk in development of liver cancer. Additionally, incidences of liver cancer amongst Asian Americans are 2 to 11 times higher than that of White Americans, depending on gender and ethnic group.
Cancer For Asian Americans, the leading cause of death is cancer, a factor unique to their racial/ethnic group. For every other racial/ethnic category, heart disease is the leading cause of death. Asian Americans exhibit the highest rates of cancers of the liver, cervix, and stomach. Additionally, Asian Americans have the highest rate of cancer for age categories 25–44 and 45–64, while it is just 45–64 for White people.
The cancer burden that affects Asian Americans is unusual because of the nature of the cancers. Those with higher rates in Asian American populations are of infectious origin, such as human papillomavirus leading to cervical cancer, hepatitis B virus leading to liver cancer, and Helicobacter pylori-induced stomach cancer. As more and more Asians immigrate to the United States, they adapt American customs, a phenomenon known as acculturation. The transition in lifestyles is associated with cancers attributed to dietary changes and sedentary living. There is an increase in colon and rectal cancer in Asian Americans from dietary changes. That may be attributed to the increase in consumption of red meat, which is consumed less in Asia than in America. That manifests itself in the Asian American population in the San Francisco Bay area, where colorectal cancer rates are higher than in mainland China.
Additionally, Asians born and raised in the United States experience a greater risk of getting breast cancer. Asian American women who reside in the United States for more than 10 years have an 80% greater risk for breast cancer compared with more recent immigrants from Asia. Breast cancer is not the only cancer where this can be seen.
Overall, Asian and Pacific Islander men and women had lower rates of HPV-associated cancers than White men and women.
High rates of smoking also contribute to high rates of lung cancer. Lung cancer rates for Southeast Asians are 18 percent higher than for White Americans. 28.9% of all Asian Americans smoked at one point in their lives. Current rates of smoking stand at 14.8%. Smokers are more likely males (22.6%) than females (7.3%). However, high smoking prevalence is concentrated around certain areas. For example, Vietnamese men in Franklin County, Ohio, were found to have a smoking rate of 43.4%.
Asian Americans, between all racial/ethnic groups in the United States are the only group with the leading cause of death being cancer.