1. Asian Americans Health Disparities Nadia Islam, PhD Deputy Director Center for the Study of Asian American Health

2. P60 Project EXPORT Center NIH/NCMHD http://www.med.nyu.edu/csaah

3. CSAAH Mission To reduce health disparities in the Asian American community through research, training and partnership development.

4.  Develop and conduct research to understand, address, and eliminate health disparities in the Asian American community  Build new and strengthen existing private and public partnerships in order to increase outreach, advocacy, and research capacity to address Asian American health disparities and social inequalities;.  To train a cadre of health and public health professionals on community-based approaches to conducting research, outreach, service delivery, and advocacy in the Asian American community CSAAH Aims

5. New Book

6. Who are Asian Americans?  A DIVERSE community comprising over 32 countries of origin, cultures, religions, time in the U.S., age, English proficiency, and socioeconomic status.  In thinking through diversity, it is critical to understand the social, cultural, and demographic context of these communities and the impact of these contexts on health Various migration histories Geographic dispersion and concentration Various stages of community formation and capacity

7. Limitations to Current Health Literature and Mortality Data  Dearth of meaningful available data 342 out of 150,369 federal health grants = 0.2% on AAPI health 1,499 out of 10 million MEDLINE articles = 0.01% on AAPI health Source: Ghosh, C. (2003). Healthy People 2010 and Asian American/Pacific Isladers: Defining a Baseline of Information. American Journal of Public Health, 93(12), 2093-2096.

8. Limitations of Current Health and Mortality Data  Quality of available AAPI health literature and research Aggregated data Small sample sizes Inconsistent definitions of Asian Americans Unevenly distributed by geographic region Barriers to participation due to immigration status and language Lack of in-language data collection

9. Major Health Disparity Areas  Hepatitis B Asians residing in the United States are 20- to 30-times more likely to be infected with hepatitis B virus (HBV) compared to other ethnic groups. The rate of HBV infection ranges from 10% to 30% among Asian communities, with particularly high rates among Chinese and other East Asian populations. In the general population <1%.  Diabetes and other CVD risk factors National data indicates South Asians and Filipinos have significantly higher rates of diabetes compared to White population  Cancer Asian American women have lower rates of breast and cervical cancer screening than the White population

10. Emerging Health Disparity Areas  Mental Health Studies have suggested that Asian American women experience high rates of depression, suicide, and other mental health-related disorders Particular ethnic groups within the AAPI community may face unique mental health disparities as a result of their migration experiences and cultural background.  Health of the Elderly Social isolation and lack of resources/social support  Disability Stigma faced by individuals with disability; lack of social support

11. NY Times: Invisible Immigrants, Old and Left With ‘Nobody to Talk To’ (August 31 st, 2009)

12. Contextual Factors Impacting Health  Health Access Uninsurance and underinsurance Culturally appropriate access (e.g. interpretation, translation, health literacy)  Occupational and Environmental Issues Many Asian Americans are segregated in low-wage, unregulated position  Racism and Discrimination Increasing evidence of structural and interpersonal racism faced by Asian Americans and impact on health

13. Strategies to Improve Health  Improved data collection at local and national levels  Building capacity and leadership to address health  Culturally tailored social service programs  Build partnerships across disciplines and build linkages with non-health sectors  Create programs that address contextual factors impacting health – across racial/ethnic communities

14. Areas and Programs to Support  Building capacity and leadership ex: Community Health Worker Programs  Efforts that engage community and university collaborations ex: Training curricula for university and community partners to develop collaborative research projects  Programs that increase access to healthcare ex: Programs to build health insurance funds  Evaluation Ex: evaluation of media dissemination efforts

15. Contact Information: Nadia Islam, PhD Center for the Study of Asian American Health T: 212-263-7075 E: nadia.islam@nyumc.orgnadia.islam@nyumc.org W: www.med.nyu.edu/csaahwww.med.nyu.edu/csaah