South Asian Americans, whose metro Atlanta population has tripled since 2004 to more than 100,000, are mainly natives of India, Pakistan, Bangladesh, Bhutan, Nepal and Sri Lanka. The general belief in the U.S. about this community is the “model minority” myth — that it achieves a higher degree of success than others. Unfortunately, this is not universally true. Access to quality health care and financial stability is not easy for many in this community.
Little research has been done to promote effective prevention efforts that address its members’ health and well-being. Most federal and state studies aggregate this community with other Asian Pacific Islander groups – Chinese and Korean, for example. Language and cultural barriers, difficulty navigating the health care system, lack of health and financial literacy, poverty, and lack of access to health insurance and information are among the possible causes for health disparities between South Asians and mainstream Americans.
In 2010, 7 of the top 10 causes of death in the United States were chronic diseases. Heart disease, stroke, cancer, diabetes, obesity and arthritis are preventable health problems. Studies separate the costs of illness into direct costs, indirect costs and intangible costs.
For example, the total estimated cost of diagnosed diabetes in 2012 was $245 billion, including $176 billion in direct medical costs and $69 billion in decreased productivity. There is a pressing need to conduct assessments of chronic disease, its economic impact on public dollars, and the economic challenges it poses in South Asian communities. This information is the foundation for creating holistic health programs.
I realized the need for a holistic approach to public health in 2011. My career as a Georgia public health professional and as a practicing physician in India was limited to delivering health-related messages.
In 2011, a resident’s comment transformed my approach to public health delivery. I was giving training on ways to increase consumption of fruits and vegetables. One resident said, “My neighbors and I do not have the means to pay for our next meal. How can you expect us to purchase apples that cost more than what we eat now? Do you have a job for us?” His comment struck me like a sword! I realized I must bring clients holistic messages that address health, food, financial security and other issues.
In the South Asian community, we must break cultural barriers and begin a dialogue that makes health care more acceptable. Last year, I met Fahad, a diabetic who had developed a wound on his right foot that became inflamed. Within weeks, he was unable to walk comfortably. He had no health insurance, so did not visit the doctor and shrugged at going to a clinic. He ultimately ended up in the emergency room, creating a taxpayer-funded bill twice what it would have been if he had been educated on effective diabetes management.
The few South Asian resident health studies/surveys conducted in metro Atlanta show that almost 75 percent of respondents have health insurance. Prevalent health concerns included diabetes, hypertension, high cholesterol and heart disease. Weight-related issues, arthritis and increased stress level were also named. Overall personal health ranged from good to excellent, yet only 40 percent said they exercise at least 30 minutes one to three times per week.
We were impressed by the overwhelmingly positive response to learning more about eating better, getting involved in physical activities and reducing stress. Targeted health data will reveal appropriate roles for government and the private sector to prevent disease. It should guide us to better policies that improve the quality of life worldwide.
Empowering individuals with prevention knowledge, early screening and diagnosis are equally important. They result in successful treatment or delay of chronic diseases. Education about healthy eating and physical activity is essential and should begin with children.
Yet given the barriers South Asians face, we must create a support structure that shows options for reducing the financial burden of chronic diseases; develops culturally specific training materials; engages faith institutions, and teaches methods to navigate and identify health care resources.
Delivering the health message is not enough. We must create access to job training and economic possibility. We must support societal changes that result in better health and food justice for all.