Academic journal article Health and Social Work

Health Care Needs of Foreign-Born Asian Americans: An Overview

Academic journal article Health and Social Work

Health Care Needs of Foreign-Born Asian Americans: An Overview

Article excerpt

Asian and Pacific Islander Americans are the fastest growing population group in the United States. Between 1980 and 1990 their numbers grew by 108 percent, more than 10 times the rate for the total U.S. population (Ulincy et al., 1995), and between 1990 and 1999 their population grew 43 percent to 10.8 million ("Minorities Fuel United States Population Growth," 2000). It is forecasted that by 2050 Asian and Pacific Islander Americans will represent 10.7 percent of the total U.S. population, or 41 million people (U.S. Bureau of the Census, 1992b).

Asian and Pacific Islander Americans are not a homogeneous group. They claim their descent from 28 different countries in the Far East and Southeast Asia and 25 islands in the Pacific. Although they are significantly different from the larger U.S. population, they also have cultural and ethnic intragroup differences. This article focuses on foreign-born Asian Americans. In 1990 foreign-born people constituted only 8 percent of the total U.S. population yet made up 74 percent of the Asian American population. The different subgroups of Asian Americans are growing at different rates. For example, between 1980 and 1990, the number of Japanese Americans grew by only 21 percent compared with growth rates of 82 percent for Filipino Americans, 104 percent for Chinese Americans, 124 percent for Korean Americans, and 135 percent for Vietnamese Americans (U.S. Bureau of the Census, 1992a, 1992b). The countries from which these new Americans are coming have varying geographical conditions, histories, stages of economic development, customs, languages, religions, and degrees of exposure to Western culture and the English language, which account for the intragroup differences among foreign-born Asian Americans. However, their health status, health-related situations, and health care needs are different not only from those of mainstream Americans but also from those of native-born Asian Americans.

THE KEALTH STATUS OF FOREIGN-BORN ASIAN AMERICANS

Most foreign-born Asian Americans are at different levels of acculturation, which, in terms of health-related effects, can mean that

* many of them brought with them diseases endemic to their native lands, which persist

* they have also acquired new diseases because of the changes in their living conditions and lifestyles

* they are vulnerable to the physical effects of acculturation-related stress

* they are holding on to their old health beliefs, non-Western theories of health and illness, and health practices

* their exposure and access to the American health care system are inadequate.

The validity of these factors is reflected in the prevalence of many serious diseases among the foreign-born Asian American population, including parasitic infestations, tuberculosis, sudden infant death syndrome (SIDS), sudden unexpected nocturnal death syndrome (SUNDS), and hepatitis B (a major risk factor for liver cancer). However, there are also intragroup variations. For example, parasitic infestations are most prevalent in Southeast Asian refugees, in whom the incidence of intestinal parasitic infestations has been as high as 80 percent and the incidence of multiple infestations as high as 55 percent (Hann, 1994a). Tuberculosis is also one of the most common health problems among Southeast Asian refugees. In 1981 the estimated prevalence of tuberculosis at arrival in the United States was 1,138 per every 100,000 refugees, and an additional 407 of 100,000 refugees developed tuberculosis after settlement (Hann, 1994b).

SIDS cases are more prevalent in subgroups like Chinese Americans. An analysis of SIDS cases in California showed an incidence rate of 1.3 per 1,000 (Grether, Schulman, & Croen, 1990). SUNDS is more common among young adult male refugees from Southeast Asian countries. Since the first reported death from SUNDS in 1977, scores of seemingly healthy Hmong refugees have died. …

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