A Concentrated Effort: Pioneering Center at New York University Employs a Community-Based Approach to Addressing Illnesses Disproportionately Affecting Asian-Americans
Lum, Lydia, Diverse Issues in Higher Education
For years, New York health-care providers treated Asian-Americans afflicted by serious, even life-threatening illnesses with ever-increasing frequency. Many doctors in the nation's largest city agreed that Asians seemed particularly at risk for specific health problems just like any other racial group, but there was neither research nor statistics supporting physician observations.
Enter New York University's Center for the Study of Asian American Health (CSAAH), which emphasizes community-based participatory research and problem solving. Established in 2003, it is perhaps the only center of its kind at a U.S. academic medical center dedicated solely to evaluating public health issues of this racial group. Among other things, CSAAH:
* Develops and conducts research to address and eliminate health disparities.
* Builds and improves public and private partnerships to increase outreach and advocacy in response to social and other inequities faced by Asian-Americans.
* Trains health-care professionals about community-based approaches to addressing disparities.
"Before 2003, doctors saw so many individuals suffering," says Dr. Chau Trinh-Shevrin, CSAAH director and co-founder. "But there was no infrastructure among community clinics, private hospitals and NYU. There needed to be a place to centralize community resources and support."
Furthermore, New York doctors were uncomfortable using the limited data on health trends among California's Asians because the population in that state had substantial numbers of third-and fourth-generation Americans, whereas the more than 1 million Asians in New York tended to be first-and second-generation, says Trinh-Shevrin, also an assistant professor of research at NYU's Department of Medicine. She and others believe that advocates and activists at the older and better established Asian-American studies programs on the West Coast helped produce ad hoc research on race-based health matters.
"Here in New York, it was frustrating not to see public health priorities benefiting Asians at the community level," says Dr. Simona Kwon, a CSAAH research scientist.
Kwon and Trinh-Shevrin agree that stereotypes of Asians as uniformly "healthy, wealthy and wise" impede Asians' willingness to seek medical care. But based on surveys by CSAAH staff and community health workers, a long list of additional reasons emerged: language barriers, affordability among low-income Asians who were forced to choose between paying rent and buying medicine, and fear of discrimination by non-Asians.
"Like other minorities, Asians here fear being discriminated against," Trinh-Shevrin says. "If they're on welfare or public assistance, they're often stigmatized, so a disease would be another excuse for others to show prejudice. Some Asians have even feared that, if word got out that they were sick with something dire like Hepatitis B, they'll lose their jobs or automatically be deported."
Soon after CSAAH's inception, which was financed by a National Institutes of Health grant, its scientific efforts began exploring the relationship between viral and bacterial infections and cancer, as well as the risk for cardiovascular disease, among different Asian ethnic groups. Before long, statistics emerged. For instance, three out of five Filipinos in New York had I hypertension as recently as 2008, and two out of five lacked health insurance. Half were overweight or obese. More than any other Asian subgroup in New York, Filipino Americans were more likely to die of heart disease.
Based on such findings, CSAAH staff launched education and awareness projects aimed at encouraging Asian-Americans to seek preventative medical care and help with problems before they become untreatable. CSAAH has periodically hosted seminars for local health-care professionals, community members and policymakers to disseminate data and discuss solutions. …