Health Disparities Among Filipino Americans Essay

Health Disparities:Focus on the Filipino-American Population in the USA As a Filipino-American nurse living in Los Angeles, California, this writer has been a witness and an active participant in the multifactorial influences/aspects that affect the Filipino-Americans, in health and illness. Being a grandmother of wonderful grandkids has brought me further exposure to the plight of elderly Filipino-Americans in the United States of America. The Institute of Medicine’s Report on Unequal Treatment: Confronting Racial/Ethical Disparities in Health Care states that cultural bias is one contributor to racial and ethnic minorities having higher rates of poor health outcomes than Whites in the case of disease; even when income, employment status and insurance coverage are controlled. A survey of current literature suggests that as a group, Filipino-Americans are comparatively under-studied vis-a-vis health and health care disparities in the United States. The literature that does cover the subject suggests that Filipino-Americans (as a group) do experience disparities in health and health care. Javier (2007) noted that on a national level, Filipino-Americans are the second largest Asian/Pacific Islander (API) population. Within this population, Filipino-American youth and adolescents in the US show disparities compared to Anglo and other API groups in regard to gestational diabetes, rates of neonatal mortality and low birth weight, malnutrition in young children, obesity, physical inactivity and fitness, tuberculosis, dental caries and substance abuse. Within Los Angeles County, Bitler and Shi (2006) analyzed disparities across groups based on health insurance, health care use and health status. While they did not focus on Filipino-Americans as a discrete subpopulation, they noted that differences in the prevalence of chronic health conditions across different immigrant racial and ethnic groups were reduced after controlling for such factors as family income, net worth and neighborhood characteristics. One possible conclusion is that in neighborhoods that are co-populated densely by both Latino and Filipino-American households with similar earnings and employment characteristics (such as in Historic Filipinotown), Filipino-Americans fare about the same as their Latino neighbors when it comes to chronic disease. This demonstrates that working class and lower income Filipino-American households in LA County suffer from health problems more than other API opulations in the County. Taken together, these studies lend support to the perception among Filipino-American community leaders in Los Angeles that (1) persistent disparities in health and health care do exist for Filipino-Americans relative to other groups; and (2) Filipino-Americans are not adequately researched for ethnic-specific tendencies in health and health care access. A report published in November, 2007 by The Historic Filipinotown Health Network of Los Angeles, California analyzed responses from a series of focus groups and over 400 surveys administered to health care providers, youth, residents, seniors and workers in Historic Filipinotown in central Los Angeles. The study sought to understand how culturally-based experiences and perspectives of Filipino/Filipino Americans in central LA influence this population’s health. The report examines the relationship between cultural themes that came up in the survey and the actual health status and healthcare service use patterns of Filipino/Filipino Americans. Though specific to the Filipino community in Los Angeles, the findings are relevant for Filipino communities throughout the United States. From the report this writer has been able to collate substantial data for this paper on US health disparities focusing on the older Filipino Americans. Elderly Filipino-Americans, like other ethnic minorities in the US, are not exempt from the disparities within the health care system. Health care access, utilization and assimilation in the US health care delivery system can be very challenging particularly for the newly-arrived immigrants. They tend to rely on their families for support since the majority of them are not eligible for government health care funds and social security benefits. In addition to financial constraints, lack of mobility or minimal English proficiency and tenacious adherence to their own Filipino cultural and health beliefs can create a barrier to health care utilization. â€Å"Bahala na† basically means â€Å"whatever will be, will be. As a way of supporting good health and in responding to illness, Filipinos have this unusual ability to accept things as they are. This position enables many Filipino-Americans to accept, and endure, great suffering including suffering from illness or injury. â€Å"Hiya† refers to a deep impulse to protect against a loss of face, especially if there are differences of opinion in a group on a sensitive matter. Such protection can be for one’s own sake or for another person. One example is misunderstandings due to language barriers. Some patients may not express it openly, but feel shamed or embarrassed in front of health care providers when they cannot understand or be understood properly. Further, older Filipino-American patients have difficulty in communicating effectively with health care providers. This can turn into an urgent problem if and when Filipino-Americans suffer from a high incidence of chronic and/or serious illness (such as diabetes or TB). â€Å"Kapwa† suggests â€Å"togetherness† and equality of status regardless of class or race. Cultural norms energize Filipinos to care for others in every sense, as fellow human beings. This type of relationship supports a structure of familism (tight-knit extended family structures). Caring for the health of each member within one’s family or kinship network is thus a top priority. The Filipino-American population has the highest percentage (27%) among Asian Americans of grandparents living with and caring for their grandchildren who are under 18 years of age. Conversely, there is a preference among families to provide direct care to their aging parents at home, regardless of the sacrifices required, rather than moving them into a convalescent facility. In America, this same commitment is extended by Filipino-Americans beyond their kinship groups to neighbors, friends and even strangers. The tradition of putting the group first and looking out for other group members has helped make Filipino-Americans have such a prominent presence as recognized professionals and workers in the U. S. healthcare sector. According to Periyakoil and Dela Cruz (2010), Filipino-Americans who have been in the U. S. A. for a long time are more acculturated to the American health system than those who recently migrated. The less acculturated immigrants adhere more to traditional systems of medicine and prefer indigenous healing practices, such as the use of complementary and alternative medicine. Before seeking professional help, Filipino older adults tend to manage their illnesses by self-monitoring of symptoms, ascertaining possible causes, determining the severity and threat to functional capacity, and considering the financial and emotional burden to the family. Filipino older adults tend to cope with illness with the help of family and friends, and by faith in God. Most of these first-generation immigrants initially resort to traditional medicine and healing methods are passed on from one generation to another. Traditional medicine is regarded as a viable alternative to Western medicine especially among the uninsured and undocumented. Such examples of cultural and health beliefs cause great concern since these older adults only seek medical care when their illness is already very serious or in an advanced stage; missed opportunities for optimal treatment and care result. Thus, to promote stronger health outcomes for the Filipino-American population, knowledge of their cultural strengths and assets, as well as language and other difficulties as immigrant people is imperative. Policymakers should be engaged to take a more culturally informed and sensitized approach to health care reform, focusing particularly on reducing existing disparities among Filipino-Americans in the USA. References Ad Hoc Committee. (2005). Ethnic diversity and cultural competence.