Introduction
The US is home to a substantial number of Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI). There is also a large population of Asian Pacific Islanders (APIs) in the country. According to Nemoto, Iwamoto, Kamitani, Morris, and Sakata (2011), the number of APIs in the US increased from 2.9% of the population in 2009 to 3.7% in 2000. At the time, the group was projected to register a growth of 41% between 2000 and 2010.
Despite the significant size of this population, its access to healthcare and prevention services is limited. Some of the major health problems faced by the group include depression, cancer, alcoholism, hepatitis B, and HIV. According to the National Center for Health Statistics (2006), the leading cause of death among the APIs is cancer. Heart diseases, diabetes, and stroke are other major health problems for this population. The prevalence of these conditions is 60% higher among this group compared to other communities, such as non-Hispanics (National Center for Health Statistics [NCHS], 2006).
In this paper, the author will analyze several issues related to the health of APIs in the US. More specifically, the researcher will look at the programs put in place to address the wellbeing of these individuals. The analysis will be conducted at the federal, national, and local government levels.
Health Issues Associated with Asian/Pacific Islanders: A Background
As the leading cause of death among the APIs, cancer is an issue of major concern to all healthcare authorities in the US. The most common forms of cancers among this group include those affecting the liver and the stomach (Asian American Health Initiative, 2008). It is noted that these types of cancers are more prevalent among the APIs than in other ethnic and racial groups in the US.
The prevalence of HIV and AIDS among APIs is relatively low at the national level. However, the number is rising steadily. Takahashi, Magalong, DeBell, and Fasudhani (2006) postulate that nationally, cases of HIV associated with the APIs are under-represented. Depending on the geographical location, APIs make up between 1% and 4% of the overall HIV and AIDS cases in the US. (Takahashi et al., 2006). The epidemiological portrait is based on the widely accepted minority representation model. APIs are usually regarded as a homogenous, highly educated, and wealthy group. There is a lack of commitment on the part of the government to provide preventive care to this population.
Young people from API communities are less likely to engage in risky sexual activities compared to other Americans (Choi, Han, Hudes & Kegeles, 2002). Despite this, Choi et al. (2002) advance that the prevalence of HIV among this group is increasing as a result of various factors. For instance, knowledge concerning the transmission of HIV among these youngsters is very low (Choi et al., 2002). In addition, social norms associated with these communities discourage open discussions about sex. Stigmatization about HIV is also widespread.
According to Hutton, Tan, So, and Brandeau (2007), approximately 10% of API adults in the US suffer from chronic hepatitis B virus (HBV). In addition, about 75% of individuals in this group are unaware of the infections they are afflicted with. According to Hutton et al. (2007), 25% of the APIs suffering from chronic HBV are likely to die from liver disease. The situation is likely to get worse if antiviral therapies and proper medical management programs are not availed to them.
According to Choi et al. (2002), alcohol consumption and substance abuse are not issues of major concern among the API population. However, in some communities, abuse of alcohol is rampant among the youths (Hutton et al., 2007). The association between alcohol abuse and HIV prevalence is significant with regards to men who have sex with other men (MSMs) in the API community (Nemoto et al., 2011). Nemoto et al. (2011) argue that the abuse of alcohol and marijuana contributes to risky sexual behaviors among APIs, especially MSMs.
According to Choi et al. (2002), APIs exhibit more depressive symptoms than their white counterparts. Among all the Asian groups, South Asian refugees have the highest rates of depression (Nemoto et al., 2011). Despite this, APIs register the lowest rates of utilization of mental health services in the US. To address these disparities, the US government has launched several public health programs. The initiatives span the federal, state, and local levels of government.
Public Health Programs for the APIs at the National Level
Programs addressing the major health issues affecting the API population begin at the federal level. According to Choi et al. (2002), different programs focus on specific health concerns, such as HIV and AIDS. One of the major initiatives for all Americans, including APIs, entails access to healthcare services. According to Nemoto et al. (2011), most of the APIs are unable to access healthcare services due to such issues as language barriers and lack of understanding regarding how the system works.
Under the federal government, access to healthcare entails the ability of an individual to successfully use medical services to optimize their wellbeing. Some of the issues addressed under this program include the provision of health insurance cover and affordable care. Other problems highlighted include the elimination of language barriers and the provision of culturally sensitive facilities (Ponce et al., 2009).
According to Nemoto et al. (2011), one out of every 10 APIs in the US experience problems in accessing healthcare due to ignorance. The lack of medical interpreters compounds the problem. The reason is that APIs have the highest rates of illiteracy and cultural diversity in the US (Ponce et al., 2009).
At the national level, guidelines have been put in place to enable APIs to access healthcare with ease. Such initiatives include the introduction of medical interpreters. Most of the health problems associated with the APIs emanate from the factors barring them from access to healthcare. Apart from the initiatives and guidelines introduced by the national government, the Patient Protection and Affordable Care Act and other legislations have played a critical role in improving the situation. According to Ponce et al. (2009), the increase in the prevalence of health issues is supported by the high cost of healthcare.
According to Nemoto et al. (2011), the Patient Protection and Affordable Care Act is meant to reform the system. The reforms will significantly impact APIs and their welfare. For instance, the cost of care will be reduced. In addition, there will be an increase in the number of healthcare providers (Nemoto et al., 2011). The national government has also launched initiatives and programs to address specific health issues among the APIs. One of them entails the strategy employed nationally to address and eliminate HBV transmission. The approach emphasizes vaccinating newborns, pregnant women, children, and adolescents (Ponce et al., 2009).
The US Advisory Committee on Immunization Practices (ACIP) has developed programs targeting hepatitis B among APIs. According to Asian American Health Initiative (2008), recent recommendations from the committee encourage the introduction of catch-up vaccination among children and adolescents. Approximately 40000 immigrants entering the US have chronic HBV. Fifty percent of them are Asians (Asian American Health Initiative, 2008). Consequently, ACIP has recommended the adoption of screening programs. The initiatives touch on all adults and children born in high-prevalence areas, such as Asia and the Pacific Islands (Asian American Health Initiative, 2008). The screenings are carried out irrespective of previous vaccination status about HBV.
The President’s Advisory Commission on Asian Americans and Pacific Islanders is another major initiative on the part of the federal government (Asian American Health Initiative, 2008). The commission is tasked with the responsibility of developing strategies aimed at providing support to the private and public sectors (Ponce et al., 2009). With the help of the commission, APIs are involved in matters touching on their health, environment, education, and overall wellbeing. The commission also compiles research and data related to API populations to address their issues more effectively.
Public Health Programs for APIs at the State and Local Government Levels
APIs are found in various states in the US. Consequently, several state and local county governments have introduced specific programs to address the wellbeing of this population. For instance, in California, there are more than 5 million APIs (Ponce et al., 2009). Their growth as a minority group is increasing at the state and national levels. State and local governments are working closely to address the major health issues associated with this group.
To solve the problem of hepatitis B in California, the national and local governments have launched screening and vaccination programs for adults and adolescents among the APIs (Asian American Health Initiative, 2008). Since 1999, all 7th-grade students in California continue to be immunized against this disease (Ponce et al., 2009).
Local governments, including Montgomery County authorities, have launched public health programs to address the various diseases affecting APIs. For instance, the County Government of Montgomery funds an elaborate cancer program to benefit this community. The mission of the programs entails increasing awareness about different types of cancers. The clusters include prostate, colorectal, and cervical cancers (Asian American Health Initiative, 2008). The program achieves this objective by providing culturally competent cancer education and screening services for the APIs.
As a result of the program, the national and local governments have fostered public awareness. Through proper screening, early detection of cancer is possible. The development enhances effective prevention and treatment of this condition (Asian American Health Initiative, 2008). The local government works together with the Montgomery County Cancer Crusade and APIs. In addition, the initiative offers free screening services to target groups in the county.
State and local governments have also initiated programs to address the issues of alcoholism, substance abuse, and HIV prevalence among the APIs. For instance, in San Diego California, the local government facilitates self-efficacy programs to deal with these public health problems (Ponce et al., 2009). The self-efficacy program focuses mainly on APIs living in suburbs and within the city. According to Ponce et al. (2009), education is used as a major channel to encourage API youths to abstain from alcoholism and risky behaviors that may lead to HIV. The program has proved that increasing self-efficacy with regards to HIV is not effective on individuals with high levels of education. However, APIs, especially those with limited education, stand to benefit from the program.
Such programs as the California Health Interview Survey and the California Cancer Registry also address various health issues among the API group. The organizations initiate and facilitate new disease registry programs targeting this population (Asian American Health Initiative, 2008). Ultimately, the initiatives enhance the progressive collection of data and comprehension of the health status and needs of APIs. In addition, the US Census Bureau’s American Community Survey maintains socio-demographic information on various Asian subgroups (Asian American Health Initiative, 2008). The information is used to address the different health needs of APIs.
The Funding and Mission of Public Health Programs Targeting APIs
The initiatives tailored for the APIs are either funded by private organizations or governments. In addition, particular programs have specific missions. For instance, the California Health Interview Survey and the Cancer Registry programs are funded by the state government. Both programs seek to collect information that can be used in addressing the health needs of the population at the state level. Such commissions as the US ACIP are funded by the national government. The commission initiates various programs targeting particular health concerns among APIs. Consequently, the mission of the commission is to enhance the well-being of APIs.
Conclusion
The majority of APIs in the US are immigrants. Regardless of this status, various levels of governments seek to address their major health problems. The situation is evident given the various public health programs launched by the federal, state, and local governments to help APIs. However, it is noted that various barriers exist to the delivery of adequate healthcare to this group. The development has led to increased cases of cancers, HIV, depression, and other problems. However, with time, it is possible to overcome these barriers and improve the situation.
References
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