Investigating the Myth of the “Model Minority”: A Participatory Community Health Assessment of Chinese and Vietnamese Adults

Tendulkar, Shalini; Hamilton, Renee Cammarata; Chu, Chieh; Arsenault, Lisa; Duffy, Kevin Harrison; Huỳnh, Văn Minh; Hung, Mei; Lee, Eric; Jane, Shwuling; Friedman, Elisa

doi:10.1007/s10903-011-9517-y

Cited by 23 publications

(19 citation statements)

References 43 publications

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“…Loss to followup, which contributes to inflated survival estimates, may occur because of the return of immigrants with serious illnesses to their countries of origin to die, a phenomenon known as the salmon bias [47,48]. However, studies thus far indicate that salmon bias has limited impact on Asian American survival, likely due to travel being too distant and time-consuming for gravely ill individuals to undertake [49,50]. Lastly, some important covariates, such as residual tumor category, comorbidities, and postoperative complications, are critical factors impacting gastric cancer survival.…”

Section: Discussionmentioning

confidence: 99%

Examining the gastric cancer survival gap between Asians and whites in the United States

et al. 2016

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Background Globally, Asian countries bear a disproportionate gastric cancer burden. Asian Americans, the fastest growing minority population in the US, have higher gastric cancer survival than non-Hispanic whites (NHWs) despite higher incidence. Benefitting from uniform cancer registry standards within the US, we examine for the first time the heterogeneity in the Asian American population, which may elucidate the causes of these disparities. Methods SEER gastric cancer data from 2000 to 2012 were used to calculate 5-year survival estimates for NHWs and the six largest Asian ethnicities. Multivariate analyses were performed to identify critical prognostic factors and survival disparities between Asian groups and NHWs. Results We analyzed 33,313 NHW and 8473 Asian gastric cancer cases. All Asian groups had significantly higher 5-year survival than NHWs, at 29.8%. Among Asians, Koreans and Vietnamese had the highest and lowest survival, at 45.4% and 35.7%, respectively. The Korean survival advantage was largely attributable to relatively high proportions of localized stage and low proportions of cardia tumors. After adjusting for major prognostic factors, the survival disadvantage of NHWs, while attenuated, remained significant in comparison to all Asian groups (HR: 1.33, 95% CI: 1.24-1.43; reference: Korean). The survival disparities within the Asian groups vanished with adjustment. Conclusions This study characterizes distinctive gastric cancer survival patterns among the six major Asian groups and NHWs in the US. The favorable survival for Koreans is largely attributable to specific clinical factors, particularly stage at diagnosis. The causes of the survival disadvantage for NHWs remain elusive.

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Section: Discussionmentioning

confidence: 99%

Examining the gastric cancer survival gap between Asians and whites in the United States

et al. 2016

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“…Such a possibility would be consistent with previous work suggesting that the Bmodel minority myth^and other stereotypes may impede clinician recognition of common health problems in Asian Americans (e.g., hypertension, dementia). [30][31][32] Similarly, clinicians may be less likely to recognize or respond to obesity in Asian American patients compared to other adults. In potential support of this hypothesis, we found that among adults aged ≥ 45 years, the magnitude of the disparity in diabetes screening was unexpectedly widest for obese adults.…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Disparities in Diabetes Screening Between Asian Americans and Other Adults: BRFSS 2012–2014

et al. 2016

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“…9,10 Many prior studies have aggregated outcomes for the entire Asian American population; aggregated analyses may fail to detect important disparities for some subgroups. [11][12][13][14] Further, they have used data predating the implementation of the ACA, which attempted to reduce disparities in access to and affordability of care through expansion of Medicaid eligibility, availability of parental coverage for dependents 26 and under, and reducing cost-sharing for routine preventive visits. Asian Americans made sizable gains in coverage following the insurance expansions in 2014, but substantial variations in rates in uninsurance remained across subgroups.…”

Section: Introductionmentioning

confidence: 99%

Asian American Access to Care in the Affordable Care Act Era: Findings from a Population-Based Survey in California

Nguyen

Trivedi

2019

J GEN INTERN MED

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BACKGROUND: Though Asian Americans made gains in coverage following the Affordable Care Act (ACA), substantial variations in access to care remain across different ethnic subgroups. Several states are considering adoption of policies to collect health data for Asian Americans that is disaggregated by ethnic subgroup, which may identify disparities in access to care. OBJECTIVE: We examined coverage and access to care between non-Hispanic White and Asian American adults following the ACA in California. We first compared outcomes in non-Hispanic White adults with all Asian Americans in our sample, and then evaluated whether we detect disparities when data is disaggregated into five of the most populous ethnic subgroups (Chinese, Korean, Filipino, Vietnamese, and Japanese). DESIGN: Cross-sectional California Health Interview Survey data were collected between January 2014 and December 2016. PARTICIPANTS: Our sample included 19,201 non-Hispanic White and 3077 Asian American non-elderly adults age 18 to 64 living in California. MAIN MEASURES: Our outcomes were (1) being uninsured, (2) having a usual source of care, (3) delaying necessary medical care, and (4) delaying necessary prescription medications. Using multivariable logistic regression models, we examined our outcomes, adjusting for predisposing, enabling, need, and acculturation factors. KEY RESULTS: Compared with non-Hispanic Whites, some subgroups of Asian Americans reported significantly worse access to care: disaggregated, adjusted analyses revealed that Koreans were significantly less likely to report a usual source of care (adjusted odds ratio [AOR] = 0.31, p < 0.01) relative to non-Hispanic Whites. Chinese (AOR = 0.42, p < 0.01) and Vietnamese (AOR = 0.34, p < 0.01) adults were significantly less likely to delay necessary care. CONCLUSIONS: Disaggregated analyses identified differences in access to care for Asian American subgroups following the ACA. State policies to collect disaggregated health data for Asian Americans may reveal heterogeneity in experiences of care and inform specific policies to reduce disparities in access to care.

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Investigating the Myth of the “Model Minority”: A Participatory Community Health Assessment of Chinese and Vietnamese Adults

Cited by 23 publications

References 43 publications

Examining the gastric cancer survival gap between Asians and whites in the United States

Examining the gastric cancer survival gap between Asians and whites in the United States

Racial and Ethnic Disparities in Diabetes Screening Between Asian Americans and Other Adults: BRFSS 2012–2014

Asian American Access to Care in the Affordable Care Act Era: Findings from a Population-Based Survey in California

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