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.A striking example of health system factors influencing cardiovascularhealth is awareness, treatment and control of the disease.California statewidehypertension study reported that Filipinos had the highest rate of awarenesswith regards to their hypertension status (63%) compared with Chinese (46%)and Japanese (57%) samples.49 Among those treated for hypertension, however,Filipinos were found to have the lowest blood pressure control rate (16%)compared to Chinese (37%) and Japanese (30%).A recent study of FilipinoAmericans with hypertension reported that participants had difficulties main-taining required lifestyle changes and adhering to medication regimens in orderto achieve blood pressure control.50 These studies demonstrate that knowledgeand awareness of cardiovascular disease risk factors, having access to healthinsurance, and being treated with medications are not sufficient for achieving anoptimal cardiovascular health outcome.Hmong Americans, in general, have low compliance to medication regimens.In a 2005 study of Hmong Americans on hypertensive medications, almost allHealth 295reported having some form of health insurance coverage, but more than halfreported low adherence with hypertension care, such as medication adherenceand keeping appointments.51 Another study that examined Hmong Americans in1991 found that their rates of blood pressure control (27%) were worse thanthose of blacks (48%) and whites (55%) with treated hypertension.52 Problemsassociated with understanding disease processes, comprehending medicalinstructions, articulating health concerns to medical staff, navigating medicalsystem, a high prevalence of psychological distress, and discriminations inhealth care settings were important barriers that prevented Hmong Americansand many other Asian Americans groups with hypertension from achievingeffective blood pressure management.53OUTLOOKAccording to public health researchers, improving cardiovascular health ofAsian American populations requires that the health care system respond appro-priately and competently with culturally responsive health education and out-reach programs, including accessible health services for diagnosis andtreatment.54 Researchers highlight the critical need for a better understanding ofissues related to adherence, particularly in managing blood pressure control, toprevent the devastating effects of heart disease and stroke.An understanding ofthe biological, psychosocial, and cultural processes that influence cardiovascu-lar disease risk factors in this ethnic group is seen as crucial in designingcardiovascular health programs and interventions.Public health researchershave also realized that information on different Asian subgroups is still lacking.Today, advocates, practitioners, and researchers continually advocate for thegathering of ethnic-specific data to address the cardiovascular health disparitiesthat still affect various subgroups of Asians in America.FURTHER READINGAmerican Heart Association (AHA).http://www.americanheart.org.Cardiovascularhealth information in Chinese and Vietnamese.Chen, Jyu-LinL, and Yuaner, Wu Y. Cardiovascular Risk Factors in Chinese AmericanChildren: Associations between Overweight, Acculturation, and Physical Activity.Journal of Pediatric Health Care 22, no.2 (2008): 103 110.Hong, B., C.Wong, C, C.Kao, I., Tekawa, I, and I.Yen, I.,  Asian American and PacificIslander Cardiovascular Health Status: What do the data tell us? Asian AmericanAnd Pacific Islander Workshops Summary Report on Cardiovascular Health.NationalInstitutes of Health.National Heart, Lung, and Blood Institute.Office of Prevention,Education, and Control.NIH Publication No.00-3793, March 2000.National Heart, Lung and Blood Institutes, Addressing cardiovascular health in AsianAmericans and Pacific Islanders.Washington DC: U.S.Department of Health andHuman Services, 2000.President s Advisory Commission on Asian Americans and Pacific Islander.Report tothe President and the Nation.Asian Americans and Pacific Islanders AddressingHealth Disparities: Opportunities for Building a Healthier America, 2003.296 Encyclopedia of Asian American Issues TodayNOTES1.D.L.Hoyart and H.C.Kung,  Asian or Pacific Islander Mortality, Selected States,1992, Monthly Vital Statistics Report 43, no.1, Supplement.Final Data from the Cen-ter for Disease Control and Prevention/National Center for Health Statistics.Hyattsville, MD (Aug.14, 1997).2.Mai N.Nguyen-Huynh and S.Claiborne Johnson,  Regional Variation in Hospital-ization for Stroke among Asians/Pacific Islanders in the United States: A Nationwide Ret-rospective Cohort Study, BMC Neurology 5 (2005): 21.http://www.biomedcentral.com/1471-2377/5/21.3.Arthur L.Klatsky and Irene Tekawa,  Health Problems and Hospitalizationsamong Asian American Ethnic Groups, Ethnicity & Disease 15, no.4 (2005):753 760.4.World Health Organization, Obesity: Preventing and Managing the GlobalEpidemic, Report of a WHO Consultation on Obesity.Geneva 3-5 June, 1997.(Geneva:World Health Organization, 1998).5.Department of Health and Human Services, Centers for Disease Control and Pre-vention, National Center for Chronic Disease Prevention and Health Promotion, Officeon Smoking and Health. Tobacco use among U.S.racial/ethnic minority groupsAfrican Americans, American Indians and Alaska Natives, Asian Americans and PacificIslanders and Hispanics: A Report of the Surgeon General, (Atlanta, GA: Centers forDisease Control and Prevention; 1998); W.P.Castelli et al.,  Incidence of CoronaryHeart Disease and Lipoprotein Cholesterol Levels: The Framingham Study, Journal ofthe American Medical Association 256 (1986): 2835 3288; W.B.Kannel et al.,  Fib-rinogen and Risk of Cardiovascular Disease: The Framingham Study, Journal of theAmerican Medical Association 258 (1987): 1183 1186.6.X.Chen et al.,  Patterns of Cigarette Smoking among Asian American Adults inCalifornia, Paper presented at the TRDRP Annual Investigators Meeting, December1998, Los Angeles, CA; M.M.Lee. Smoking and Passive Smoking Patterns inChinese Americans, Report submitted to Tobacco-Related Disease Research Program,State of California (1994).7.P.M.Barnes, P.F.Adams, and E [ Pobierz całość w formacie PDF ]