Health and wellness issues among Asian Americans do not seem to get as much attention as other issues. However, in many ways, these issues can be the most important in everyday life. Although health statistics are becoming more comprehensive for the Asian American population, in many cases they still categorize Asians in the virtually useless throw-in category of "Other" or they undercount Asians in the surveys. This can lead to the underreporting of the true incidences of important illnesses and conditions and therefore, distorted portrayals of health and wellness among Asian Americans.
The Cycle of Health Begins at the Top
Perhaps the most important aspect of an Asian American's health and wellness is the one that gets the least attention -- mental health. Many Asian Americans have to deal with several stressful issues at once. For example, recent immigrants have to adapt to a new country, learn a new language, look for a well-paying and secure job, provide shelter for their family, and may also miss their lives, family, and friends in their country of origin.
Further, young Asian Americans have to deal with finding own ethnic identity and how they fit into both their specific ethnic community, the larger Asian American population, and non-Asian society in general. Also, All Asian Americans frequently have to deal with the sad and often painful realities of what it means to be an Asian American and a person of color in American society and the prejudice, discrimination, and racism that sometimes go along with it.
As many sociologists and psychologists have pointed out, dealing with so many stressful events in your life can take a toll on a person's mental well-being. When there are so many variables and not many constants, it can be difficult to feel grounded and calm. When these sources of stress become overwhelming, the result can be depression, loneliness, displaced anger, and even violence and suicide.
Along with social scientists, social workers and other care-giving workers will tell you that these emotions can then lead someone to engage in activities that can seriously damage their health and make matters even worse. For example, when someone becomes depressed and confused, it is easy for him/her to try to find comfort, understanding, acceptance, or temporary escape in the form of starting smoking, taking drugs, engaging in unsafe sex, or physically abusing his/her family.
Silence Can Kill
I used to work at the Asian & Pacific Islander Coalition on HIV/AIDS, a New York City-based community organization that provides education, outreach, and case management services to the Asian American population on issues related to HIV/AIDS. The first issue that I had to confront was the belief among Asians and non-Asians that HIV/AIDS is not a big problem in the Asian American community.
When it comes to official statistics that show a relatively small incidence of the disease among the Asian American population, it is easy for many people to come to that conclusion. However, the problem is that these statistics significantly under-count the real incidence rate. While there are several reasons for this, the most significant is the fact that many Asian Americans who are at risk of infection (i.e., doing drugs or engaging in unsafe sex) are afraid to come forward and ask for help or information.
Why should they be afraid? Because many parts of the Asian American community are still very ignorant and intolerant of HIV/AIDS. Many feel that they personally can never become infected and that those who do are evil, sinful, and deserve to die. As such, they treat those who are the most at-risk (i.e., gays, lesbians, drug users, and sex industry workers) with hostility and many times, abusive violence.
Therefore, not only is the real incidence of HIV/AIDS significantly higher than what the official statistics report, but those who are infected and at risk then become susceptible to other health problems or are even more likely continue engaging in unsafe behavior. This viscous cycle must be broken. Thankfully, organizations such as APICHA are fighting for the lives of Asian Americans when many members of our own community turn their backs on them. But they need more support and understanding, not just from funding organizations that fail to recognize there are problems but also from ordinary people who also think it's not an issue that affects them. Remember, illnesses such as HIV/AIDS do not discriminate.
Denial -- It's Not Just a River in Egypt
Issues of health and wellness always seem to tie into one another. As I described earlier, stressful situations can lead to someone engaging in unsafe or destructive behaviors. Unfortunately, in many parts of the Asian American community, many men deal with the pressures of life by physically abusing their wives, partners, or family. Although statistics for domestic abuse are hard to find, anecdotal evidence suggests that it can be a major problem in many Asian American communities, especially immigrant families.
As organizations such as the National Asian Pacific American Women's Forum point out, where statistics are available, they show that Asian American women are overrepresented among domestic violence homicides. Many barriers prevent Asian American women from receiving the help that they need to escape domestic abuse. Perhaps the most damaging is the tradition and legacy of male dominance and patriarchy within almost all Asian cultures. This leads to the implicit assumption that women are the property of men and that they should always be subservient to men.
As a result of this insidious cultural belief, a pervasive pattern of denial among the community that domestic violence is not a problem or that it should be kept private prevents Asian American women from speaking out and trying to stop the abuse. Because of these barriers within our own community, women are made to feel that it's their fault that their partner is abusing them or that they deserve it.
This problem is further compounded by social and health services that are not "culturally competent" -- they are not properly trained to understand the specific cultural needs of Asian American women, especially immigrants. Also, many agencies do not have staff, materials, or other resources in different Asian languages for those who are not fluent in English. Finally, Asian American victims of domestic abuse sometimes have to deal with insensitive law enforcement and court systems that minimize their suffering and rights to receive justice.
In the end, the Asian American community needs to realize that domestic violence is a serious problem and that it needs to be addressed. In all the talk about how well Asian Americans are doing, we should not overlook the fact that many members of our community are paying the price for our success. Once again, we cannot afford to remain silent any longer.
Smoke and Mirrors
Another prominent health issue is the Asian American community is smoking and tobacco use. As it is for the rest of the country, smoking is the single most preventable cause of disease and death among Asian Americans. The good news is that the Centers for Disease Control and Prevention report that as of 1997, Asian Americans had the lowest prevalence of adult smoking (16.9%) than any other racial/ethnic group. Also, this rate has been slowly declining since 1978.
The bad news is that in some local communities, 70% of Laotian and Cambodian men smoke, which is some of the highest rates among all ethnic groups. Also, research shows that the longer an Asian immigrant lives in the U.S., the more cigarettes a day s/he is likely to smoke. Finally, tobacco companies seem to be targeting Asian American communities disproportionately more than any other racial/ethnic group. A 1993 study in San Diego found that the highest concentration of tobacco billboards was in Asian American communities and the lowest were in White communities.
Also, in their efforts to improve their public image (and to improve their sales), tobacco companies are increasingly funding community organizations and supporting educational, political, cultural, and sports activities -- especially in minority communities. All of this financial support can be very tempting to an under-funded organization. But there is always a price to pay in return, moral and otherwise. Fortunately, organizations seem to understand this. Just in June 2001, the Japanese American Citizens League voted not to accept donations from tobacco companies.
We should remember that smoking contributes to heart disease, many types of cancer, stroke, respiratory disease, and that second-hand smoke poses special risks to pregnant women, babies, and young children. Quitting or not starting smoking can be hard in the face of peer pressure and other psychological factors, but as the evidence clearly shows, the risks of smoking far outweigh the few benefits.
Copyright © 2001- by C.N. Le. Some rights reserved.
Suggested reference: Le, C.N. . "Health and Wellness Among Asians" Asian-Nation: The Landscape of Asian America. <http://www.asian-nation.org/health.shtml> ().
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