President Barack Obama’s focus on revamping healthcare has focused new attention on the country’s unwieldy healthcare system.

It has also highlighted the importance of personal responsibility and discipline in staying healthy, and this includes a healthy lifestyle (no tobacco, no drug abuse, limited alcohol consumption, regular exercise, no promiscuity, and a healthy social life), regular health checkups and early interventions in cases of disease, a balanced diet (low salt, low sugar, high fiber, sufficient water, and proper nutrition), and the fostering mental and emotional health.

While the stereotype of Asian Americans is that of a generally healthy group, the statistics indicate otherwise. The obesity epidemic, which saps up 9 percent of overall health spending, has affected Asian Americans, with the attendant health problems (elevated risks for heart disease, diabetes, strokes, and some types of cancers), and higher mortality rates.

Asian American Obesity

Asian Americans have been becoming overweight and obese at alarming rates, due to poor diets and sedentary lifestyles. In 2007, Asians over 18 years old have a 29.2 percent overweightedness rate (BMI of 25 or greater) compared to 34.5 percent of non-Hispanic Whites. And while the overall Asian American obesity rate is at 8.9 percent compared to 24.8 percent for non-Hispanic Whites, Native Hawaiian and Pacific Islanders are 3.7 times more likely to be obese than the overall Asian American population.

In addition, a whopping 39.8 percent of Asian Americans 18 and over were physically inactive in 2006.

Asian American Children and Youth

Overweight children have a high likelihood (70 percent) of becoming overweight or obese adults. Common culprits have been “screen time” spent watching television, playing with computer games, and surfing the Internet. The advertising of highly processed, low-nutritional foods to children has also been blamed. According to the Asian American Network for Cancer Awareness, Research, and Training, Asian Americans have the “fastest growing rate of overweight and obese children.”

“Kids tend to adapt American food culture faster than adults since they attend school lunch program during the school year,” says Gary Tang, Director of Aging and Adult Services at the Asian Counseling and Referral Services (ACRS). “Newly immigrated Asian families usually stick to the dietary habits of their home country. Gradually most Asian immigrant families combine Asian and American food in their diet. Religion also plays a big role to shape Asian immigrants eating habits.”

Asian teens also tend to eat more fast food than their white counterparts, according to a 2005 California Health Interview Survey (CHIS), which found that 43 percent of Asian American teens ate fast food daily vs. 35 percent of white teens. Asian and Pacific Islander children, compared to other ethnic and racial groups, are also least likely to get their daily portions of fruits and veggies, according to a CHIS survey from 2001-2003. And Asian and Pacific Islander children are the least physically active of all racial and ethnic groups with only 57 percent of Asian Americans between 11 and 17 engaging in vigorous physical activity in a week. Children growing up in poorer neighborhoods have less access to fresh or healthy foods. Being overweight or obese may lead to depression and social challenges as well.

Public health workers suggest that there needs to be a concerted effort by the schools and families to encourage healthier diets and exercise regimens for children.

Asian and Pacific Islander Health as a Population

An estimated 6.5 percent of the Asian population is in fair or poor health. An estimated 5.5 percent of the Asian American population experiences a limitation to usual activities due to one or more chronic health conditions. Approximately 19 percent of Asian American men over 18 and 5 percent of Asian American women over 18, smoke cigarettes.

In terms of access to health care, 15 percent of those under 65 do not have health insurance coverage. An estimated 5.6 percent of Asian American children under 18 do not have a usual source of healthcare, according to the National Health Interview Survey in 2007. Annually, this Asian American population has approximately 45,000 deaths annually, or 307.4 deaths per 100,000 population. The leading causes of death are cancer, heart disease, and stroke, in this order, in 2004.

Asian Americans have a high rate of liver cancer. Lung cancer is a leading cause of death for many Asian Americans. Vietnamese American women have cervical cancer rates at five times that of Caucasian women. Asian Americans also have some of the highest rates of tuberculosis and hepatitis B in the U.S.

Traditional Dietary Habits

The term “Asian and Pacific Islanders” involves peoples from approximately 50 countries and ethnic groups with unique dietary habits. They hail from Bangladesh, Cambodia, China, India, Japan, Korea, Laos, Pakistan, Thailand, and other regions. Asian or Pacific Islanders number 14.5 million residents in the US as of 2006, according to US government statistics.

Many immigrate with their lifelong dietary habits, which are based around rice, seafood, meats, and vegetables. While these diets may be low in fats and sugar, these diets may lead to various deficiencies (Vitamin A, protein, iron, calcium, and iodine). The lactose intolerance of some Asian Americans may lead to calcium deficiencies unless substitutes to dairy products are consumed; such food products may include soymilk, tofu, and calcium supplements.

The traditional Asian diet has led to lower rates of heart disease, diabetes, some cancers, and other health benefits. Obesity and overweightedness rates are lower across South Asia and East Asia than in the West. Many Asians with traditional diets also have longer lifespans.

Researcher interest has resulted in an Asian Diet Pyramid as an alternative to the USDA Food Pyramid. At the base of this pyramid are rice, rice products, noodles, breads, millet, corn and other grains. On the next level are “fruits; legumes, nuts, and seeds; and vegetables.” This pyramid includes plant-based beverages like teas; some daily sake, wine or beer or other alcoholic beverage is included on the second tier of this pyramid. Small servings of low-fat dairy products and fish are optional. Sweets, eggs, and poultry are not recommended more than once weekly. Red meat is not advised more than once monthly.

Making Long-Term Healthy Changes

Making long-term behavioral changes may be difficult enough, but with parents and heads of housing facing multiple demands, “they have little time to form healthy habits to improve their quality of life,” according to ACRS’ Tang.

The API community will need to work more concertedly towards overall health if they are to beat the larger societal odds towards overweightedness and obesity. Early development of healthy exercise and food habits among children may result in lifelong health and social benefits.

The ACRS food bank supports the health of community members in multiple ways, according to Tang.
“In addition to providing nutritious, culturally-appropriate staples such as rice, ramen and Asian produce at the ACRS Food Bank, we also provide pamphlets on health promotion and healthy diet on a regular basis.” Their staff members also connect clients to Basic Food and the WIC (Women, Infants, and Children) Program.

Tang adds, “There should be public funding to support social service agencies, health department and community centers organize cultural competent programs for Asian families learn to maintain a balance nutritional diet.”.

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