Better health care being sought for Asian-Americans
The Arizona Republic
Oct. 18, 2003
A grass-roots Asian-American group has launched a groundbreaking effort to
provide better health care for the state's fastest-growing minority
Asian-Pacific Community in Action surveyed 300 Chinese and Vietnamese Valley
residents earlier this year and presented its findings Friday. The survey is a
first step in learning about a community where little health information is
known and where cultural and language barriers often impede effective care.
Dr. Kelly Hsu, who founded the advocacy group last year, said unlike Latinos,
Asians don't share a common language, and that many health care providers are
not as aware of Asian cultures and lifestyles as they are of Latino cultures.
The Asian, Asian-American and Pacific Islander population remains small in the
state, but it is the fastest growing.
"Very commonly you can count at least 15 different languages being spoken in
the Asian community," Hsu said. "What are their responsibilities when they
deal with patients who cannot communicate?"
The Chandler forum drew about 100 health professionals and other community
leaders to Western International University, where they learned about
A health survey included 300 Chinese and Vietnamese Valley residents.
Among the highlights:
• 33 percent do not have health insurance.
• 23 percent could not get medical care when they needed it in the past
year. Of those, 46 percent said they could not afford it and 11 percent did
not seek help because of language issues.
• 53 percent did not have dental insurance.
• 47 percent had never had their cholesterol checked. Of those who had,
45 percent were told they had high levels.
• About 86 percent of Vietnamese women have had pap smears, compared with
63 percent of Chinese women.
Source: Asian-Pacific Community in Action
the survey and heard from three experts on elder care, language and
Hsu and Dolores Casillas, a human services consultant, learned a hard lesson
when they were rejected for a federal grant in 2002 because they lacked local
information on Asian groups.
After their rejection, Hsu and Casillas approached the Arizona Department of
Health. The agency awarded them a $15,000 grant for a six-month assessment and
they focused on Chinese and Vietnamese, the two largest Asian Valley groups
whose primary language isn't English or Spanish. Surveying all Asian groups
would have been too costly.
Casillas said the survey is not as extensive as a random survey whose cost could
run into six figures, but is "a very good beginning."
Casillas and Jenn Yun-Tein, the survey's principal investigators, said it
affords providers a unique opportunity to understand health challenges of a
minority group before they become serious problems.
Tein told the audience of a friend and former college roommate who did not want
her breast removed even after learning she had cancer. She died from the
Casillas said many of the challenges facing Asians mirror those for Latinos and
that it is important to get a head start on educating the community.
"With Latinos the train has left the station and everybody is trying to catch
up," Casillas said. "With this group, the train is still at that station. It is
a perfect opportunity."
Survey takers faced challenges that included translating questions into Chinese
and Vietnamese and training volunteers. About 80 to 90 percent of respondents
answered in their native language.
Volunteers also turned to leaders of local churches, senior centers and popular
markets, like Lee Lee Oriental Supermart in Chandler. Questions ranged from
exercise habits, alcohol consumption and personal health problems to knowledge
of HIV/AIDS, sexual habits and mental stability.
"You have to realize many of the people we serve have lived under communist
control . . . so when we ask them to fill out a form with 80 questions, people
are very intimidated," Hsu said.
Meng Truong, owner of Lee Lee, allowed his workers long breaks to answer
questions. About 30 employees and 60 customers filled out the survey, he said.
"They work for us and I want them to be healthy in the future," Truong said.
Susan Lee, a program specialist from the Orange County Asian and Pacific
Islander Community Alliance in California, enlightened Valley health providers
about being culturally aware even when it comes to the color of the ink they use
in filling out paperwork. In the Korean community writing a name in red ink
could be akin to wishing that person dead. For Cambodians, red signifies
Communism, while purple is associated with funerals for Vietnamese.
"You don't want to do anything to offend them," Lee warned. "That is why
training is so important."
More than 50 percent of the 300 surveyed had little knowledge of risk factors
"What surprised me was the knowledge was so low across the board regardless of
education and income," Casillas said.
A big concern is the reliance on non-professional translators who are often
relatives or friends. Some patients might be too embarrassed to reveal personal
information to a translator and complicate treatment. Hsu hopes Friday's
conference jump-starts further efforts to learn more.
"We need to document our needs," Hsu said. "We need to know numbers and how this
is affecting our community."
Ryan Konig contributed to this article. Reach the reporter at
or (602) 444-7726.