Cardiovascular Health among Asian Americans/Pacific Islanders: An Examination of Health Status and Intervention Approaches

Abstract

Purpose of the Review.

The purpose of this review is to examine the cardiovascular health status of Asian Americans/Pacific Islanders by primary risk factor and review current intervention approaches targeting this population. Asian Americans/Pacific Islanders in the United States have experienced triple digit percentage increases in population for every decade since 1970. Despite their rapidly increasing numbers, little is known about their cardiovascular health status.

Search Methods Used.

This article reviews the literature on the demographics, mortality, and prevalence of major cadiovascular risk factors among Asian Americans/Pacific Islanders. Selected intervention programs are also described.

Summary of Important Findings.

Data on cardiovascular disease mortality for Asian Americans/Pacific Islanders are relatively limited because few states collect ethnically specific mortality statistics. Data on cardiovascular risk factors, particularly smoking and hypertension, for certain Asian American/Pacific Islander groups portend excessive cardiovascular disease burdens.

Major Conclusions.

Data specific to ethnic groups comprising Asian Americans and Pacific Islanders need to be culled. Also, scientifically valid and linguistically appropriate interventions approved by ethnic community leaders are needed to address Asian Americans/Pacific Islanders.

Keywords

Asian Americans/Pacific Islanders Cardiovascular Smoking Diet

Get full access to this article

View all access options for this article.

References

U.S. Department of Health and Human Services. Report of the Secretary's Task Force Report on Black and Minority Health. Volume 1, Executive Summary. Washington, D.C.: U.S. Department of Health and Human Services, 1985.

Magnus

Cardiovascular health among African-Americans: A review of the health status, risk reduction, and intervention strategies. American Journal of Health Promotion, 1991; 5(4):282–290.

Light

Pillemer

Summing Up: The Science of Reviewing Research. Cambridge, Massachusetts. Harvard University Press, 1984.

American Public Health Association. Health of Minorities and Women. Chartbook. American Public Health Association, 1982.

Lin-Fu

Population characteristics and health care needs of Asian Pacific Islanders. Public Health Reports, 1988; 103(1):18–27.

U.S. Bureau of the Census. 1990 Census of Population and Housing. Summary, Tape File 1, Technical Documentation. Issued March 1991.

Rumbaut

Weeks

Fertility and adaptation: Indochinese refugees in the United States. International Migration Review, 1986; 20:428–465.

Myth of Model Minority Haunts Asian Americans, The Washington Post, June 22, 1992.

Asian American Health Forum, Inc. Asian and Pacific Islander American Population Statistics. Monograph Series 1, 1990.

10.

U.S. Department of Commerce, Bureau of the Census. We, the Asian and Pacific Islander Americans. Washington, D.C.: U.S. Government Printing Office, 1988.

11.

Pierce

Fiore

Novotny

Trends in cigarette smoking in the United States. Educational differences are increasing. Journal of the American Medical Association, 1989; 261(1):56–60.

12.

Marmot

Syme

Acculturation and coronary heart disease in Japanese-Americans. American Journal of Epidemiology, 1976; 104(3):225–247.

13.

The health risks of Asian Americans. American Journal of Public Health, 1991; 81:1391–1393.

14.

Forman

Leung

Ponce

Dispelling the myth of a healthy minority. Policy papers. Asian American Health Forum, Inc., November 1990.

15.

National Center for Health Statistics. Health, United States. Washington, D.C.: U.S. Government Printing Office, 1990.

16.

Robertson

Kato

Rhoads

Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii, and California. American Journal of Cardiology, February 1977; 39:239–243.

17.

Yano

McLean

Reed

A comparison of the 12-year mortality and predictive factors of coronary heart disease among Japanese men in Japan and Hawaii. American Journal of Epidemiology, 1988; 127:476–487.

18.

Winkelstein

Jr. Kagan

Kato

Sacks

Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii, and California: Blood pressure distributions. American Journal of Epidemiology, 1975; 102(6):502–513.

19.

Reed

McGee

Yano

Biological and social correlates of blood pressure among Japanese men in Hawaii. Hypertension, May-June 1982; 4:406–414.

20.

Centers for Disease Control. Cigarette smoking among Chinese, Vietnamese, and Hispanics — California, 1989–1991. Morbidity & Mortality Weekly Report, May 22, 1992; 41(20):362–367.

21.

Jenkins

McPhee

Cancer risks and prevention behaviors among Vietnamese refugees. Presentation at the Annual Meeting of the American Public Health Association, 1988.

22.

Levin

Nachampassack

Xiong

Cigarette smoking and the Laotian refugee. Migration World, 1988; XVI(4/5).

23.

Centers for Disease Control. Cigarette smoking among Blacks and other minority populations. Morbidity & Mortality Weekly Report, July 3, 1987; 36(25):404–407.

24.

Montes

Specific cancers affecting Hispanics in the United States. In: Minorities and Cancer. Jones

(Ed.). New York: Springer-Verlag, 1989.

25.

U.S. Department of Health and Human Services. Healthy People 2000. Washington, D.C.: U.S. Government Printing Office, 1990.

26.

Bates

Hill

Barrett-Connor

Cardiovascular disease risk factors in an Indochinese population. American Journal of Preventive Medicine, 1989; 5(1):15–20.

27.

Jenkins

McPhee

Bird

Cancer risks among Vietnamese refugees. Western Journal of Medicine, 1990; 153:34–39.

28.

U.S. Department of Health and Human Services. The Health Consequences of Smoking: Nicotine Addiction. A Report of the Surgeon General. Washington, D.C.: U.S. Government Printing Office, 1988.

29.

Hawks

Smoking and smoking-related cancers among Asian and Pacific Islanders. In: Minorities and Cancer. Jones

(Ed.), New York: Springer-Verlag, 1989.

30.

Klatsky

Armstrong

Cardiovascular risk factors among Asian Americans. American Journal of Public Health, 1991; 81:1423–1428.

31.

Curb

Aluli

Kautz

Cardiovascular risk factor levels in ethnic Hawaiians. American Journal of Public Health, 1991; 81:164–167.

32.

Kumanyika

Diet and chronic disease issues for minority populations. Journal of Nutrition Education, 1990; 22(2):89–96.

33.

Chew

Sodium values of Chinese condiments and their use in sodium restricted diets. Journal of the American Dietetic Association, 1983; 82:397–401.

34.

U.S. Department of Health and Human Services. Report of the Secretary's Task Force on Black and Minority Health, Vol. IV: Cardiovascular and cerebrovascular disease, part 2. Washington, D.C.: U.S. Government Printing Office, 1986.

35.

Whittemore

Williams-Wu

Lee

Diet, physical activity, and colorectal cancer among Chinese in North America and China. Journal of the National Cancer Institute, June 6, 1990; 82(11):915–926.

36.

Harris

Gao

Wynder

Comparative epidemiology of cancers of the colon, rectum, prostate and breast in Shanghai, China versus the United States. International Journal of Epidemiology, 1991; 20(1):76–81.

37.

Kagan

Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii, and California: Demographic, physical, dietary, and biochemical characteristics. Journal of Chronic Diseases, 1974; 27:345–364.

38.

Angel

Armstrong

Klatsky

Blood pressure among Asian-Americans living in northern California. The American Journal of Cardiology, July 15, 1989; 64:237–240.

39.

Stavig

Igra

Leonard

Hypertension among Asians and Pacific Islanders in California. American Journal of Epidemiology, 1984; 119(5):677–691.

40.

Stavig

Igra

Leonard

Hypertension and related health issues among Asians and Pacific Islanders in California. Public Health Reports, 1988; 103(1):28–37.

41.

Choi

McGandy

Dallal

The prevalence of cardiovascular risk factors among elderly Chinese Americans. Archives of Internal Medicine, February 1990; 150:413–418.

42.

National Heart, Lung, and Blood Institute. Data on Asian/Pacific Islanders. Bethesda, Maryland: NHLBI Education Programs Information Center, May 1992.

43.

Haywood

Hypertension in minority populations. Access to care. American Journal of Medicine, 1990; 88(3B):17S–20S.

44.

Literature from Chinese Cardiac Council and Donna Lew, Program Director, San Francisco Chapter, American Heart Association, 1991.

45.

Chin

Video ads urge Asians to stop smoking. San Francisco Examiner, May 17, 1991.

46.

Hughes

Aluli

A culturally sensitive approach to health education for Native Hawaiians. Journal of Health Education, 1991; 22(6):387–390.

47.

Chen

Jr.

The indigenous model for heart health. Health Education, December 1989; 48–51.

48.

Chen

Jr. Zaharlick

Kuun

Implementation of the indigenous model for health education programming among Asian minorities. Beyond theory and into practice. Journal of Health Education, 1992; 23(7):400–404.

49.

Chen

Jr. Kuun

Guthrie

Promoting heart health for Southeast Asians: A database for planning interventions. Public Health Reports, 1991; 106(3):304–309.

50.

Chen

Jr.

Toward health promotion and disease prevention policies for Asian Americans (Ohio). Proceedings from the Fourth National Heart, Lung, and Blood Institute National Minority Forum, 1992; in press.