Addressing Health Disparities among Older Asian Americans: Data and Diversity

By Yoo, Grace J.; Musselman, Elaine et al. | Generations, Winter 2014 | Go to article overview

Addressing Health Disparities among Older Asian Americans: Data and Diversity


Yoo, Grace J., Musselman, Elaine, Lee, Yeon-Shim, Yee-Melichar, Darlene, Generations


Within the umbrella term, Asian American, exist multiple cultures and varied disease prevalence. Addressing disparities in care means we must use culturally and linguistically appropriate measures to educate the various sub-groups.

In 2012, an estimated 18.9 million Asian Americans lived in the United States (U.S. Census Bureau, 2012). Asian Americans represent individuals with ancestry from more than thirty countries. The top six Asian American subgroups include Chinese Americans (3.7 million), Filipino Americans (3.4 million), Asian Indian Americans (3.1 million), Korean Americans (1.7 million) and Vietnamese Americans (1.7 million), and Japanese Americans (1.3 million) (U.S. Census Bureau, 2012). Asian American sub-groups with fewer than 1 million include Pakistani Americans, Bangladeshi Americans, Cambodian Americans, Hmong Americans, Laotian Americans, Taiwanese Americans, and Thai Americans.

In recent years, immigrants have arrived from Bhutan, Burma, Bangladesh, Nepal, and Mongolia, adding to the continued diversity of Asian Americans (U.S. Census Bureau, 2012). Among Asian Americans, those who are ages 65 years and older represent an estimated 10 percent of this diverse population (U.S. Census Bureau, Population Division, 2013).

Asian Americans are a heterogeneous population that includes diverse cultural backgrounds and immigration histories. Early Asian immigrants arrived as laborers to work in sugarcane plantations in Hawaii and in agriculture and in building railroads on the West Coast. Early Asian immigrants were from China, India, Japan, Korea, and the Philippines. Various discriminatory immigration laws were designed to halt the arrival of Asian Americans. By 1924, only students from Asia were allowed into the United States.

The passage of the Immigration and Nationality Act of 1965 admitted professionals and workers in short supply, allowed families to be reunited, and provided refugee status for those leaving the Vietnam war. This changed the makeup of Asian American communities. Immigrants were leaving their countries because of war, political, or economic instability. For those who immigrated after 1965, some immigrated as children following their parents, some came as young adults to study and build lives in the United States, while others immigrated in middle adulthood or arrived as elders to be reunited with adult children who may have immigrated decades earlier. This diverse aging population has been growing and has faced numerous health disparities across various illnesses and diseases, including access to care, quality of care, and challenges managing chronic illnesses. This article will examine the various health disparities affecting older Asian Americans today.

Health Disparities: Physical and Mental Health

The following section discusses and examines physical and mental health issues currently impacting older adult Asian Americans.

Cancer

Cancer is a leading cause of mortality among various sub-groups of Asian Americans, and advancing age is the single most critical risk factor in the development of all cancers. Breast cancer is the most commonly diagnosed cancer found among Asian American women, followed by colorectal and lung cancers, liver, cervix, thyroid, and stomach cancers. Among Asian American men, prostate cancer is the most commonly diagnosed cancer, followed by colorectal and lung cancers, liver, thyroid, and stomach cancers (Lin-Gomez et al., 2013). There are also sub-group differences, such as increasing trends of lung cancer among Filipino American and Korean American women and Asian Indian-Pakistani men, and liver cancer among Vietnamese, Laotian, and Kampuchean women and Filipino, Kampuchean, and Vietnamese men.

Older Asian Americans face challenges throughout the continuum of cancer care, from screening and treatment through survivorship. Among all Asian American sub-groups, access to cancer screenings is significantly low. Barriers to cancer screenings include a myriad of factors-being older, less educated, recent immigrants, poor, or uninsured. …

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