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Nagata DK, Kim JHJ, Gone JP. Intergenerational Transmission of Ethnoracial Historical Trauma in the United States. Annu Rev Clin Psychol 2024; 20:175-200. [PMID: 38271636 DOI: 10.1146/annurev-clinpsy-080822-044522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Throughout time, ethnoracial groups have endured a range of traumatic experiences as historically marginalized members of the United States. The consequences of these experiences have been referred to as historical trauma (HT): a collective trauma, inflicted on a group of people who share a specific identity, that has psychological, physical, and social impacts on succeeding generations. In this review, we examine the literature on HT in relation to US ethnoracial groups by defining HT, providing a background for its development, and describing critiques of the concept. We then review the literature on HT in relation to Indigenous Americans, African Americans, and Asian Americans. For each group, we address the nature of HT, the transmission of HT and its impacts, and healing strategies. We conclude with a summary of the benefits, limitations, and complexities of HT research as well as recommendations for future work in this area.
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Affiliation(s)
- Donna K Nagata
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA;
| | - Jacqueline H J Kim
- Department of Medicine, University of California, Irvine, California, USA
| | - Joseph P Gone
- Department of Anthropology, Harvard University, Cambridge, Massachusetts, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Kim JHJ, Kagawa Singer M, Bang L, Ko A, Nguyen B, Chen Stokes S, Lu Q, Stanton AL. Supportive Care Needs in Chinese, Vietnamese, and Korean Americans With Metastatic Cancer: Mixed Methods Protocol for the DAWN Study. JMIR Res Protoc 2024; 13:e50032. [PMID: 38648633 PMCID: PMC11074895 DOI: 10.2196/50032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/06/2024] [Accepted: 03/11/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Asian Americans with metastatic cancer are an understudied population. The Describing Asian American Well-Being and Needs in Cancer (DAWN) Study was designed to understand the supportive care needs of Chinese-, Vietnamese-, and Korean-descent (CVK) patients with metastatic cancer. OBJECTIVE This study aims to present the DAWN Study protocol involving a primarily qualitative, convergent, mixed methods study from multiple perspectives (patients or survivors, caregivers, and health care professionals). METHODS CVK Americans diagnosed with solid-tumor metastatic cancer and their caregivers were recruited nationwide through various means (registries, community outreach newsletters, newspapers, radio advertisements, etc). Potentially eligible individuals were screened and consented on the web or through a phone interview. The study survey and interview for patients or survivors and caregivers were provided in English, traditional/simplified Chinese and Cantonese/Mandarin, Vietnamese, and Korean, and examined factors related to facing metastatic cancer, including quality of life, cultural values, coping, and cancer-related symptoms. Community-based organizations assisted in recruiting participants, developing and translating study materials, and connecting the team to individuals for conducting interviews in Asian languages. Health care professionals who have experience working with CVK patients or survivors with metastatic solid cancer were recruited through referrals from the DAWN Study community advisory board and were interviewed to understand unmet supportive care needs. RESULTS Recruitment began in November 2020; data collection was completed in October 2022. A total of 66 patients or survivors, 13 caregivers, and 15 health care professionals completed all portions of the study. We completed data management in December 2023 and will submit results for patients or survivors and caregivers to publication outlets in 2024. CONCLUSIONS Future findings related to this protocol will describe and understand the supportive care needs of CVK patients or survivors with metastatic cancer and will help develop culturally appropriate psychosocial interventions that target known predictors of unmet supportive care needs in Chinese, Vietnamese, and Korean Americans with metastatic cancer. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50032.
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Affiliation(s)
- Jacqueline H J Kim
- Department of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Marjorie Kagawa Singer
- Department of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Lisa Bang
- Department of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Amy Ko
- Department of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Becky Nguyen
- Vietnamese American Cancer Foundation, Fountain Valley, CA, United States
| | - Sandy Chen Stokes
- Chinese American Coalition for Compassionate Care, Cupertino, CA, United States
| | - Qian Lu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
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Zhu AL, Le AD, Li Y, Palaniappan LP, Srinivasan M, Shah NS, Wong SS, Valero‐Elizondo J, Elfassy T, Yang E. Social Determinants of Cardiovascular Risk Factors Among Asian American Subgroups. J Am Heart Assoc 2024; 13:e032509. [PMID: 38567660 PMCID: PMC11262505 DOI: 10.1161/jaha.123.032509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/30/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Social determinants of health (SDOH) play a significant role in the development of cardiovascular risk factors. We investigated SDOH associations with cardiovascular risk factors among Asian American subgroups. METHODS AND RESULTS We utilized the National Health Interview Survey, a nationally representative survey of US adults, years 2013 to 2018. SDOH variables were categorized into economic stability, neighborhood and social cohesion, food security, education, and health care utilization. SDOH score was created by categorizing 27 SDOH variables as 0 (favorable) or 1 (unfavorable). Self-reported cardiovascular risk factors included diabetes, high cholesterol, high blood pressure, obesity, insufficient physical activity, suboptimal sleep, and nicotine exposure. Among 6395 Asian adults aged ≥18 years, 22.1% self-identified as Filipino, 21.6% as Asian Indian, 21.0% as Chinese, and 35.3% as other Asian. From multivariable-adjusted logistic regression models, each SD increment of SDOH score was associated with higher odds of diabetes among Chinese (odds ratio [OR], 1.45; 95% CI, 1.04-2.03) and Filipino (OR, 1.24; 95% CI, 1.02-1.51) adults; high blood pressure among Filipino adults (OR, 1.28; 95% CI, 1.03-1.60); insufficient physical activity among Asian Indian (OR, 1.42; 95% CI, 1.22-1.65), Chinese (OR, 1.58; 95% CI, 1.33-1.88), and Filipino (OR, 1.24; 95% CI, 1.06-1.46) adults; suboptimal sleep among Asian Indian adults (OR, 1.20; 95% CI, 1.01-1.42); and nicotine exposure among Chinese (OR, 1.56; 95% CI, 1.15-2.11) and Filipino (OR, 1.50; 95% CI, 1.14-1.97) adults. CONCLUSIONS Unfavorable SDOH are associated with higher odds of cardiovascular risk factors in Asian American subgroups. Culturally specific interventions addressing SDOH may help improve cardiovascular health among Asian Americans.
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Affiliation(s)
- Alicia L. Zhu
- Stanford University Center for Asian Healthcare Research and EducationStanfordCA
- College of Arts and Sciences, School of Global Public HealthNew York UniversityNew YorkNY
| | - Austin D. Le
- Stanford University Center for Asian Healthcare Research and EducationStanfordCA
- Environmental Health Sciences DivisionUniversity of California, Berkeley, School of Public HealthBerkeleyCA
| | - Yuemeng Li
- Stanford University Center for Asian Healthcare Research and EducationStanfordCA
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGA
| | - Latha P. Palaniappan
- Stanford University Center for Asian Healthcare Research and EducationStanfordCA
- Division of Primary Care and Population HealthStanford University School of MedicineStanfordCA
| | - Malathi Srinivasan
- Stanford University Center for Asian Healthcare Research and EducationStanfordCA
- Division of Primary Care and Population HealthStanford University School of MedicineStanfordCA
| | - Nilay S. Shah
- Departments of Medicine (Cardiology) and Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - Sally S. Wong
- American Heart Association, Office of Science, Medicine, and HealthDallasTX
| | - Javier Valero‐Elizondo
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular CenterHoustonTX
| | - Tali Elfassy
- Stanford University Center for Asian Healthcare Research and EducationStanfordCA
- Department of Medicine, Division of Nephrology and HypertensionUniversity of Miami Miller School of MedicineMiamiFL
| | - Eugene Yang
- Stanford University Center for Asian Healthcare Research and EducationStanfordCA
- Division of CardiologyUniversity of Washington School of MedicineSeattleWA
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Morey BN, Shi Y, Ryu S, Redline S, Kawachi I, Park HW, Lee S. Risk of sleep apnea associated with higher blood pressure among Chinese and Korean Americans. ETHNICITY & HEALTH 2024; 29:295-308. [PMID: 38303653 PMCID: PMC10987275 DOI: 10.1080/13557858.2024.2311417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVE This study examines associations between sleep apnea risk and hypertension in a sample of immigrant Chinese and Korean Americans. DESIGN The dataset included Chinese and Korean patients ages 50-75 recruited from primary care physicians' offices from April 2018 to June 2020 in the Baltimore-Washington DC Metropolitan Area (n = 394). Hypertension risk was determined using a combination of blood pressure measurements, self-reported diagnosis of hypertension by a medical professional, and/or self-reported use of antihypertensive medications. Linear regression models examined the associations between sleep apnea risk and blood pressure (systolic blood pressure [SBP] and diastolic blood pressure [DBP]). Poisson regression models examined associations sleep apnea risk and hypertension. Models controlled for body mass index (BMI), demographic, and socioeconomic risk factors. We further examined models for potential effect modification by age, gender, Asian subgroup, and obesity, as well as effect modification of daytime sleepiness on the association between snoring and hypertension risk. RESULTS High risk of sleep apnea appeared to be associated positively with SBP (β = 6.77, 95% CI: 0.00-13.53), but not with DBP. The association was positive for hypertension, but it was not statistically significant (PR = 1.11, 95% CI: 0.87-1.41). We did not find effect modification of the associations between sleep apnea and hypertension risk, but we did find that daytime sleepiness moderated the effect of snoring on SBP. Snoring was associated with higher SBP, primarily in the presence of daytime sleepiness, such that predicted SBP was 133.27 mmHg (95% CI: 126.52, 140.02) for someone with both snoring and daytime sleepiness, compared to 123.37 mmHg (95% CI: 120.40, 126.34) for someone neither snoring nor daytime sleepiness. CONCLUSION Chinese and Korean immigrants living in the U.S. who are at high risk of sleep apnea have higher SBP on average, even after accounting for sociodemographic characteristics and BMI. CLINICAL TRAIL REGISTRATION : NCT03481296, date of registration: 3/29/2018.
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Affiliation(s)
- Brittany N. Morey
- University of California, Irvine, Program in Public Health, Department of Health, Society, & Behavior, Irvine, CA, U.S.A
| | - Yuxi Shi
- University of California, Irvine, School of Medicine, Department of Medicine, Irvine, CA, U.S.A
| | - Soomin Ryu
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI, U.S.A
| | - Susan Redline
- Harvard Medical School, Brigham and Women’s Hospital, Department of Medicine, and Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, U.S.A
| | - Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, U.S.A
| | - Hye Won Park
- University of California, Irvine, School of Medicine, Department of Medicine, Irvine, CA, U.S.A
| | - Sunmin Lee
- University of California, Irvine, School of Medicine, Department of Medicine, Irvine, CA, U.S.A
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Li Q, Whelan JP. Behavioral Addiction from the Asian Americans Perspective: Exploration of Public and Help-Seeking Stigma. J Gambl Stud 2024; 40:367-385. [PMID: 37115421 PMCID: PMC10140728 DOI: 10.1007/s10899-023-10210-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2023] [Indexed: 04/29/2023]
Abstract
Asian Americans have been unlikely to seek mental health services despite their needs for treatment, particularly when experiencing significant gambling or Internet gaming problems. Stigma is often considered to be a barrier to seeking help. To understand how stigma impacts Asian Americans' willingness to seek mental health services, the present study used an online survey to investigate the public stigma associated with addictive behaviors and help-seeking stigma among Asian Americans. Participants (N = 431) who self-identified as Asian American, reside in the US. Using a between-groups vignette study design, it was found that the individual with a behavioral addiction received more stigma compared to the individual who experienced a financial crisis. In addition, participants were more likely to seek help if they experienced addictive behavioral problems rather than financial problems. Lastly, this study did not reveal a significant relation between public stigma attached to addictive behaviors and Asian Americans' willingness to seek help, but it found that participants' willingness to seek help was positively associated with public stigma of help seeking (β = 0.23) and negatively associated with self-stigma attached to help-seeking (β = - 0.09). Based on these findings, recommendations are provided to inform community outreach to reduce stigma and promote mental health service utilization among Asian Americans.
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Affiliation(s)
- Qian Li
- Northport VA Medical Center, 79 Middleville Rd, Northport, NY, 11768, USA.
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Jiang Y, Zhu Y, Tang F, Chung T, Wu B. Residential Segregation, Perceived Neighborhood Environment, and All-Cause Mortality Among Community-Dwelling Older Chinese Americans. J Gerontol B Psychol Sci Soc Sci 2023; 78:2071-2079. [PMID: 37726003 PMCID: PMC10699736 DOI: 10.1093/geronb/gbad132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVES Residential segregation profoundly affects mental and physical health. However, impacts of residential segregation and other neighborhood characteristics on health among older Asian Americans are not fully understood. This study aimed to close this gap by examining effects of residential segregation, perceived neighborhood cohesion, and neighborhood disorder on all-cause mortality among older Chinese immigrants, as well as testing whether the association between residential segregation and mortality would be mediated by perceived neighborhood cohesion and neighborhood disorder. METHODS Data were drawn from a subsample of 3,094 older Chinese Americans aged 60 and older (mean age = 72.8 years) from the Population Study of Chinese Elderly in Chicago. Residential segregation was derived using 2010-2014 American Community Survey data. Participants completed surveys on perceived neighborhood cohesion and neighborhood disorder between 2011 and 2013. All-cause mortality was tracked until December 2021. RESULTS Residential segregation was associated with elevated all-cause mortality risk; this association, however, was no longer statistically significant after controlling for sociodemographic, behavioral, and health covariates. Perceived neighborhood cohesion, but not neighborhood disorder, was significantly associated with decreased mortality risks. There were no indirect effects of residential segregation on all-cause mortality through perceived neighborhood cohesion or neighborhood disorder. These effects were consistent across male and female participants. DISCUSSION These results suggest the importance of neighborhood social environment, specifically perceptions of neighborhood cohesion, in influencing mortality risk among older Chinese immigrants. The findings also indicate the need to conduct further research to examine the health impact of residential segregation among this population.
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Affiliation(s)
- Yanping Jiang
- Center for Population Behavioral Health, Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
- Department of Family Medicine and Community Health, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Yuyang Zhu
- School of Public Health, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Fengyan Tang
- School of Social Work, University of Pittsburgh, Pittsburgh, Philadelphia, USA
| | - Tammy Chung
- Center for Population Behavioral Health, Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
- Department of Psychiatry, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York, USA
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Allidina S, Cunningham WA. Motivated Categories: Social Structures Shape the Construction of Social Categories Through Attentional Mechanisms. PERSONALITY AND SOCIAL PSYCHOLOGY REVIEW 2023; 27:393-413. [PMID: 37212415 PMCID: PMC10559649 DOI: 10.1177/10888683231172255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PUBLIC ABSTRACT Social categories like race and gender often give rise to stereotypes and prejudice, and a great deal of research has focused on how motivations influence these biased beliefs. Here, we focus on potential biases in how these categories are even formed in the first place, suggesting that motivations can influence the very categories people use to group others. We propose that motivations to share schemas with other people and to gain resources shape people's attention to dimensions like race, gender, and age in different contexts. Specifically, people will pay attention to dimensions to the degree that the conclusions produced from using those dimensions align with their motivations. Overall, we suggest that simply examining the downstream effects of social categorization like stereotyping and prejudice is not enough, and that research should look earlier in the process at how and when we form the categories on which those stereotypes are based.
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Vu M, Trinh D, Kandula NR, Pham NHT, Makelarski J, Seligman HK. Low-Income Asian Americans: High Levels Of Food Insecurity And Low Participation In The CalFresh Nutrition Program. Health Aff (Millwood) 2023; 42:1420-1430. [PMID: 37729587 PMCID: PMC11184507 DOI: 10.1377/hlthaff.2023.00116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Little is known about food insecurity and the extent of Supplemental Nutrition Assistance Program (SNAP) participation in the heterogeneous Asian American population. Using California Health Interview Survey data from the period 2011-20, we examined both issues among low-income Asian American adults from six origin groups: Chinese, Filipino, Japanese, Korean, South Asian, and Vietnamese. We found high and varied levels of overall food insecurity, with the highest burden among Filipino adults (40 percent). Food insecurity by severity was also heterogenous; very low food security affected 2 percent of Chinese adults but 9 percent and 10 percent of Filipino and Japanese adults, respectively. Participation in CalFresh (California-implemented SNAP) ranged from 11 percent and 12 percent among Korean and Chinese adults, respectively, to 20 percent among Vietnamese adults. Compared with English-proficient low-income Asian American adults, those with limited English proficiency were no less likely to participate in CalFresh, possibly reflecting language assistance required by California law and provided by community-based organizations. These results underscore the importance of collecting and reporting disaggregated data by Asian origin group that could inform targeted outreach and interventions.
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Affiliation(s)
- Milkie Vu
- Milkie Vu , Northwestern University, Chicago, Illinois
| | - Duy Trinh
- Duy Trinh, Princeton University, Princeton, New Jersey
| | | | - Nhat-Ha Tran Pham
- Nhat-Ha Tran Pham, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Hilary K Seligman
- Hilary K. Seligman, University of California San Francisco, San Francisco, California
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Mintz CM, Knox J, Hartz SM, Hasin DS, Martins SS, Kranzler HR, Greene E, Geng EH, Grucza RA, Bierut LJ. Demographic differences in the cascade of care for unhealthy alcohol use: A cross-sectional analysis of data from the 2015-2019 National Survey on Drug Use and Health. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1890-1903. [PMID: 37864538 PMCID: PMC10590988 DOI: 10.1111/acer.15176] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/07/2023] [Accepted: 08/15/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND The screening, brief intervention, and referral to treatment (SBIRT) model is recommended by the U.S. Preventive Services Task Force to improve recognition of and intervention for unhealthy alcohol use. How SBIRT implementation differs by demographic characteristics is poorly understood. METHODS We analyzed data from the 2015-2019 National Survey on Drug Use and Health from respondents ≥18 years old who used an outpatient clinic and had at least one alcoholic drink within the past year. Respondents were grouped into one of three mutually exclusive groups: "no binge drinking or alcohol use disorder (AUD)," "binge drinking without AUD," or "AUD." Outcome variables were likelihood of screening, brief intervention (BI), referral to treatment (RT), and AUD treatment. The demographic predictors on which outcomes were regressed included gender, age, race and ethnicity, sexual orientation, insurance status, and history of military involvement. Consistent with SBIRT guidelines, the entire sample was included in the screening model; screened persons with either binge drinking without AUD or with AUD were included in the BI model; screened persons with AUD were included in the RT model, and persons referred to treatment with AUD were included in the AUD treatment model. RESULTS Analyses included 120,804 respondents. Women were more likely than men to be screened, but less likely to receive BI or RT. When referred to treatment, women were more likely than men to receive it. Persons aged ≥50 were least likely to be screened about alcohol, but most likely to receive BI, while persons aged 18-25 were least likely to receive BI or AUD treatment. Racial and ethnic minorities were less likely than White persons to be screened; Asians were less likely to receive RT, and Black persons were less likely to receive treatment than White persons. Persons identifying as gay, lesbian, or bisexual were equally as likely or more likely to receive SBIRT or AUD treatment as those identifying as heterosexual. Persons without insurance were less likely to be screened than those with insurance. Persons with a history of military involvement were more likely to be screened and receive BI and RT than persons who had not served in the military. CONCLUSIONS Demographic disparities in SBIRT implementation exist. Addressing the sources of these disparities and minimizing attrition from care could improve outcomes for persons with unhealthy alcohol use.
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Affiliation(s)
- Carrie M. Mintz
- Department of Psychiatry, Washington University in St Louis School of Medicine, Saint Louis, Missouri, USA
| | - Justin Knox
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Sarah M. Hartz
- Department of Psychiatry, Washington University in St Louis School of Medicine, Saint Louis, Missouri, USA
| | - Deborah S. Hasin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Silvia S. Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Henry R. Kranzler
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, and Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, Pennsylvania, USA
| | - Emily Greene
- Physician Assistant Program, The City College of New York School of Medicine, New York, New York, USA
| | - Elvin H. Geng
- Department of Medicine, Washington University in St Louis School of Medicine, Saint Louis, Missouri, USA
| | - Richard A. Grucza
- Department of Family Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
| | - Laura J. Bierut
- Department of Psychiatry, Washington University in St Louis School of Medicine, Saint Louis, Missouri, USA
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Rider GN, Gower AL, Lee H, Thomas D, McCurdy AL, Russell ST, Eisenberg ME. Bias-Based Bullying and Elevated Depressive Symptoms Among Sexual and Gender-Diverse Asian American, Native Hawaiian, and Pacific Islander Adolescents. JAMA Pediatr 2023; 177:2807913. [PMID: 37523204 PMCID: PMC10391352 DOI: 10.1001/jamapediatrics.2023.2388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/05/2023] [Indexed: 08/01/2023]
Abstract
This cross-sectional study analyzes data from 2 statewide school surveys to document the experiences of sexual and gender minoritized Asian American, Native Hawaiian, and Pacific Islander students in grades 9 through 12 who reported bullying related to their identity.
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Affiliation(s)
- G. Nic Rider
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis
| | - Amy L. Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis
| | - Hyemin Lee
- Jeju Institute of Public Health and Health Policy, Jeju National University Hospital, Jeju, South Korea
| | - De’Shay Thomas
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis
| | - Amy L. McCurdy
- Department of Human Development and Family Sciences, University of Texas, Austin
| | - Stephen T. Russell
- Department of Human Development and Family Sciences, University of Texas, Austin
| | - Marla E. Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis
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Kaniecki M, Novak NL, Gao S, Harlow S, Stern AM. Operationalizing racialized exposures in historical research on anti-Asian racism and health: a comparison of two methods. Front Public Health 2023; 11:983434. [PMID: 37483944 PMCID: PMC10359498 DOI: 10.3389/fpubh.2023.983434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 06/16/2023] [Indexed: 07/25/2023] Open
Abstract
Background Addressing contemporary anti-Asian racism and its impacts on health requires understanding its historical roots, including discriminatory restrictions on immigration, citizenship, and land ownership. Archival secondary data such as historical census records provide opportunities to quantitatively analyze structural dynamics that affect the health of Asian immigrants and Asian Americans. Census data overcome weaknesses of other data sources, such as small sample size and aggregation of Asian subgroups. This article explores the strengths and limitations of early twentieth-century census data for understanding Asian Americans and structural racism. Methods We used California census data from three decennial census spanning 1920-1940 to compare two criteria for identifying Asian Americans: census racial categories and Asian surname lists (Chinese, Indian, Japanese, Korean, and Filipino) that have been validated in contemporary population data. This paper examines the sensitivity and specificity of surname classification compared to census-designated "color or race" at the population level. Results Surname criteria were found to be highly specific, with each of the five surname lists having a specificity of over 99% for all three census years. The Chinese surname list had the highest sensitivity (ranging from 0.60-0.67 across census years), followed by the Indian (0.54-0.61) and Japanese (0.51-0.62) surname lists. Sensitivity was much lower for Korean (0.40-0.45) and Filipino (0.10-0.21) surnames. With the exception of Indian surnames, the sensitivity values of surname criteria were lower for the 1920-1940 census data than those reported for the 1990 census. The extent of the difference in sensitivity and trends across census years vary by subgroup. Discussion Surname criteria may have lower sensitivity in detecting Asian subgroups in historical data as opposed to contemporary data as enumeration procedures for Asians have changed across time. We examine how the conflation of race, ethnicity, and nationality in the census could contribute to low sensitivity of surname classification compared to census-designated "color or race." These results can guide decisions when operationalizing race in the context of specific research questions, thus promoting historical quantitative study of Asian American experiences. Furthermore, these results stress the need to situate measures of race and racism in their specific historical context.
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Affiliation(s)
- Marie Kaniecki
- University of Michigan, Ann Arbor, MI, United States
- University of California, Los Angeles, Los Angeles, CA, United States
| | - Nicole Louise Novak
- College of Public Health, The University of Iowa, Iowa City, IA, United States
- Public Policy Center, The University of Iowa, Iowa City, IA, United States
| | - Sarah Gao
- University of Michigan, Ann Arbor, MI, United States
- Harvard Center for Population and Development Studies, School of Public Health, Harvard University, Cambridge, MA, United States
| | - Sioban Harlow
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Alexandra Minna Stern
- University of Michigan, Ann Arbor, MI, United States
- University of California, Los Angeles, Los Angeles, CA, United States
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12
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Mao W, Wu B, Yang W, Chi I. Factors of Dental Care Utilization in Foreign-Born Older Chinese Americans. J Dent Res 2023; 102:895-900. [PMID: 37249263 PMCID: PMC10399079 DOI: 10.1177/00220345231170845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Good oral health is essential for healthy aging. Regular dental care utilization is instrumental to good oral health. Older immigrants tend to experience poorer oral health and less dental care use as compared with their native-born counterparts in the host country. Older immigrants are particularly vulnerable to interrupted or lost social ties and acculturation challenges after immigration to a new country. This study examined whether and to what extent social relations, acculturation, and perceived oral health needs are associated with dental care utilization in foreign-born older Chinese Americans. Data came from the Population Study of Chinese Elderly in Chicago, which were collected between 2017 and 2019 (N = 3,000). Dental care utilization was dichotomized into "yes" versus "no" in the past 2 y. Social relations were measured by positive and negative relations with spouse, family, and friends. Acculturation was measured by length of stay, behavioral acculturation, and residence in Chinatown. Perceived oral health needs were measured by the presence of problems related to teeth, gums, or bleeding. As guided by the Andersen model, separate logistic regression models were used to investigate factors of dental care utilization. An overall 23.1% reported dental care utilization. Individuals with no negative relations with spouse, family, and friends were 31%, 36%, and 38% less likely to visit a dentist, respectively. Individuals with higher levels of behavioral acculturation were 4% more likely to visit a dentist; individuals living in Chinatown were 45% less likely; and individuals with perceived oral health needs were 2.5 times more likely. Findings illustrate the importance of understanding social relations, immigration-related factors, and perceived oral health needs in dental care utilization in older immigrants.
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Affiliation(s)
- W. Mao
- School of Social Work, University of Nevada, Reno, NV, USA
| | - B. Wu
- Rory Meyers College of Nursing, New York University, New York City, NY, USA
| | - W. Yang
- School of Public Health, University of Nevada, Reno, NV, USA
| | - I. Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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13
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Yi J, La R, Lee BA, Saw A. Internalization of the model minority myth and sociodemographic factors shaping Asians/Asian Americans' experiences of discrimination during COVID-19. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 71:123-135. [PMID: 36440675 PMCID: PMC9877560 DOI: 10.1002/ajcp.12635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/20/2022] [Accepted: 10/18/2022] [Indexed: 05/07/2023]
Abstract
Despite appearing positive, the model minority myth (MMM), or the perception that Asian Americans are "problem-free" minorities, maintains unfair racial hierarchies and discredits the pervasiveness of systemic racism faced by Asian Americans and other Black, Indigenous, and people of Color. This study investigated the role of internalized MMM in Asian/Asian Americans' (A/AA) experiences during the syndemic of COVID-19 and our society's racial reckoning. Using a mixed methods approach, we analyzed A/AA college students' open-ended responses to a query about their experiences as A/AA during COVID-19, which resulted in qualitative themes of Personal and Vicarious Discrimination, Vigilance, Safety due to Ethnicity, Safety due to Environment, and No Difference during COVID-19. We then conducted a series of logistic and linear regression models to examine how internalized MMM and sociodemographic factors (i.e., ethnic group, gender, and generational status) were associated with qualitative themes and quantitative measures of COVID-related discrimination. Overall, findings demonstrated that greater internalized MMM, as well as identifying as South Asian, male, and an international/first-generation immigrant student, were linked to fewer qualitative and quantitative reports of vicarious discrimination. We conclude with implications for research and practice in community psychology that further examine the racialized experiences among A/AA college students and ultimately seek to challenge the MMM and racial hierarchies perpetuating systems of oppression.
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Affiliation(s)
- Jacqueline Yi
- Department of PsychologyUniversity of Illinois at Urbana‐ChampaignChampaignIllinoisUSA
| | - Raymond La
- Department of PsychologyUniversity of Illinois at Urbana‐ChampaignChampaignIllinoisUSA
| | - B. Andi Lee
- Department of PsychologyUniversity of Illinois at Urbana‐ChampaignChampaignIllinoisUSA
| | - Anne Saw
- Department of PsychologyDePaul UniversityChicagoIllinoisUSA
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Franz D, Caffery C, Cheng Y, Hua E, Capron CG, Allmendinger A, Chronister K. Emotion Focused Therapy and Chinese American Clients: An Exploration Using the Cultural Lens Approach. INTERNATIONAL JOURNAL OF SYSTEMIC THERAPY 2023. [DOI: 10.1080/2692398x.2023.2183018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Affiliation(s)
- Daschel Franz
- Department of College of Education, University of Oregon, Eugene, Oregon, USA
| | - Celia Caffery
- Department of College of Education, University of Oregon, Eugene, Oregon, USA
| | - Yijun Cheng
- Department of College of Education, University of Oregon, Eugene, Oregon, USA
| | - Elizabeth Hua
- Union of Pan Asian Communities Counseling and Treatment Center, San Diego, California, USA
| | | | - Angela Allmendinger
- Department of College of Education, University of Oregon, Eugene, Oregon, USA
| | - Krista Chronister
- Division of Graduate Studies, University of Oregon, Eugene, Oregon, USA
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15
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Lu Q, Yeung NCY, Tsai W, Kim JHJ. The effects of culturally adapted expressive writing interventions on depressive and anxiety symptoms among Chinese American breast cancer survivors: A randomized controlled trial. Behav Res Ther 2023; 161:104244. [PMID: 36592575 DOI: 10.1016/j.brat.2022.104244] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/27/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Expressive writing interventions confer mental health benefits for non-Hispanic Whites. However, research is lacking in adapting this paradigm for minoritized groups. This study evaluated the impacts of two culturally adapted expressive writing interventions on depressive and anxiety symptoms and potential mediators (perceived stress and intrusive thoughts) among Chinese American breast cancer survivors (CABCS). METHODS AND RESULTS CABCS (N = 136) were randomly assigned to one of three conditions to write three weekly essays: enhanced self-regulation condition (ESR) to write about stress and coping (Week 1), deepest feelings (Week 2), and finding benefits (Week 3); self-regulation condition (SR) to write about deepest feelings (Week 1), stress and coping (Week 2), and finding benefits (Week 3); and control condition to write about facts relevant to their cancer experience (Weeks 1-3). Compared with the control condition, the ESR but not SR, reduced depressive and anxiety symptoms at all follow-up time points (1, 3, and 6-months) through reductions in perceived stress. CONCLUSION A cultural adaptation altering the order of expressive writing prompts resulted in the greatest benefit for CABCS' depressive and anxiety symptoms. Research testing both the content and ordering of components may be vital to advance cultural adaptation science and optimize intervention efficacy. CLINICAL TRIAL REGISTRATION NUMBER NCT02946619.
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Affiliation(s)
- Qian Lu
- Department of Health Disparities Research, the University of Texas MD Anderson Cancer Center, Houston, TX, USA. Address: 1400 Pressler St. Unit 1440, Houston, TX 77030-3906, USA.
| | - Nelson C Y Yeung
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong Address: Room 508, Postgraduate Education Centre, Prince of Wales Hospital, the New Territories, Hong Kong.
| | - William Tsai
- Department of Applied Psychology, New York University, New York, NY, USA: Address: 246 Greene Street 8th Floor, New York, NY 10003, USA.
| | - Jacqueline H J Kim
- Department of Medicine, University of California, Irvine, CA, USA. Address: 100 Theory, Suite 100, Irvine, CA 92617, USA.
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16
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Reply to Wong and Varshney. Pain 2023; 164:e118-e119. [PMID: 36638310 DOI: 10.1097/j.pain.0000000000002815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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17
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Jang Y, Park NS, Park J, Chiriboga DA, Haley WE, Kim MT. The Mental Health Benefit of Friend Networks in Older Korean Americans: The Conditioning Effect of Family Type. J Gerontol B Psychol Sci Soc Sci 2023; 78:143-153. [PMID: 35961306 PMCID: PMC9890900 DOI: 10.1093/geronb/gbac109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES We identified types of family relationships of older Korean Americans and examined how the mental health benefit of friend networks might be conditioned by family type. METHODS Data were from 2,070 participants in the Study of Older Korean Americans, a multistate survey of Korean immigrants aged 60 and older (Mage = 73.3, standard deviation [SD] = 8.01). To identify family types, latent profile analysis (LPA) was performed with marital status, living arrangement, family network, positive and negative interactions with family members, and family mistreatment. Linear regression models examined how mental distress was associated with friend networks and family types, as well as their interactions. RESULTS LPA identified 5 family types: close-knit, intimate but distant, detached, connected but dysfunctional, and dysfunctional. Greater distress was associated with smaller friend networks and belonging to the detached, connected but dysfunctional, and dysfunctional family types in comparison to the close-knit type. The interaction model showed that people in the connected but dysfunctional and dysfunctional groups had a stronger association between friend networks and mental distress than the counterparts in the close-knit group. DISCUSSION We not only confirmed the health-promoting role of friend networks and the value of a close-knit family but also found that the benefit of friend networks was pronounced when quality of the family relationship was impaired. Our findings called renewed attention to older immigrants' social convoys of family and friends, suggesting that the enhancement of friend networks could be particularly advantageous for older immigrants with dysfunctional family relationships.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - Juyoung Park
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Miyong T Kim
- School of Nursing, University of Texas at Austin, Austin, TX, USA
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18
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Wang TS, Kim ES, Duh QY, Gosain A, Kao LS, Kothari AN, Tsai S, Tseng JF, Tsung A, Wang KS, Wexner SD. Proceedings From the Advances in Surgery Channel Diversity, Equity, and Inclusion Series: Lessons Learned From Asian Academic Surgeons. J Surg Res 2022; 278:14-30. [PMID: 35588571 DOI: 10.1016/j.jss.2022.04.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/11/2022] [Indexed: 11/15/2022]
Abstract
In this series of talks and the accompanying panel session, leaders from the Society of Asian Academic Surgeons discuss issues faced by Asian Americans and the importance of the role of mentors and allyship in professional development in the advancement of Asian Americans in leadership roles. Barriers, including the model minority myth, are addressed. The heterogeneity of the Asian American population and disparities in healthcare and in research, specifically as relates to Asian Americans, also are examined.
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Affiliation(s)
- Tracy S Wang
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Eugene S Kim
- Department of Surgery, Children's Hospital of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Quan-Yang Duh
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Ankush Gosain
- Department of Surgery, University of Tennessee Health Sciences Center, Memphis, Tennessee
| | - Lillian S Kao
- Department of Surgery, McGovern Medical School at University of Texas Health Science Center at Houston, Houston, Texas
| | - Anai N Kothari
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Susan Tsai
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jennifer F Tseng
- Department of Surgery, Boston Medical Center and Boston University, Boston, Massachusetts
| | - Allan Tsung
- Department of Surgery, The Ohio State University Medical Center, Columbus, Ohio
| | - Kasper S Wang
- Department of Surgery, Children's Hospital of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Steven D Wexner
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida
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19
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Chen MS, Lee RJ, Madan RA, Ta Park V, Shinagawa SM, Sun T, Gomez SL. Charting a Path Towards Asian American Cancer Health Equity: A Way Forward. J Natl Cancer Inst 2022; 114:792-799. [PMID: 35437573 PMCID: PMC9194616 DOI: 10.1093/jnci/djac055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/17/2022] [Accepted: 02/24/2022] [Indexed: 12/30/2022] Open
Abstract
On July 29, 2021, the US Food and Drug Administration’s Oncology Center of Excellence convened Conversations on Cancer. This Conversation, the first ever by the US Food and Drug Administration, focused on Asian Americans and served as the platform for this Commentary. Panelists elaborated on topics ranging from heterogeneity in Asian American demographics to racism through a path to health equity and supplemented this Commentary with literature citations. Asian Americans are the fastest-growing US race group, yet data aggregation obscures distinctions and cancer disparities within the more than 24 million Asians living in the United States with harmful impacts on communities and patients, as illustrated by breast cancer survivor Susan Shinagawa’s patient-to-advocate journey. Bigotry against Asian Americans has been pervasive since the 19th century, but especially during the COVID-19 pandemic. Asian Americans are unique as the first US population to experience cancer as the leading cause of death. Asian Americans are disproportionately affected by cancers because of infectious origins and have the highest rates of lung cancer among never-smoking women. The infinitesimal proportion of the National Institutes of Health’s budget compared with experiencing the highest percentage increases of any US racial population more than 3 decades highlights the dearth of focused research among Asian Americans. Recognizing the heterogeneity of Asian Americans and that disaggregated data are critical for accurately characterizing distinct ethnic groups, focusing on the impact of racism and COVID-19 on cancer disparities, and focusing and prioritizing funding resources are necessary steps forward for achieving health equity for Asian Americans.
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Affiliation(s)
- Moon S Chen
- Department of Internal Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Richard J Lee
- Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA, USA
| | - Ravi A Madan
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Van Ta Park
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA, USA
| | - Susan M Shinagawa
- Asian and Pacific Islander National Cancer Survivors Network, Spring Valley, CA, USA
| | - Tracy Sun
- Asian and Pacific Islander American Health Forum, Washington, DC, USA
| | - Scarlett L Gomez
- Department of Epidemiology and Biostatistics, UC San Francisco School of Medicine and the Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
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20
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Wong JA, Yi SS, Kwon SC, Islam NS, Trinh-Shevrin C, Đoàn LN. COVID-19 and Asian Americans: Reinforcing the Role of Community-Based Organizations in Providing Culturally and Linguistically Centered Care. Health Equity 2022; 6:278-290. [PMID: 35402769 PMCID: PMC8985534 DOI: 10.1089/heq.2021.0124] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction Methods Results Discussion Conclusion
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Affiliation(s)
- Jennifer A. Wong
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, New York, USA
| | - Stella S. Yi
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, New York, USA
| | - Simona C. Kwon
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, New York, USA
| | - Nadia S. Islam
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, New York, USA
| | - Chau Trinh-Shevrin
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, New York, USA
| | - Lan N. Đoàn
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, New York, USA
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