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Utah Asians, Polynesians face health-care barriers

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Diabetes, obesity, mental illness, HIV/AIDS, cancer and heart problems are among the health issues facing Utah's Asian American/Pacific Islander population.

But just as serious are a shortage of interpreters, lack of transportation, inadequate funding and cultural differences that erect large barriers to accessing medical care.That was the message that speakers shared with representatives of the U.S. Public Health Service during a public hearing in the middle of an Asian American/ Pacific Islander community meeting in Salt Lake City Wednesday.

Heart disease, cancer and diabetes came up in discussions by most of the speakers, who represented Japanese, East Asian, Asian Indian, Filipino, Pacific Islander, Vietnamese, Samoan and Chinese immigrants and their descendents.

The logistics of getting to an appointment are daunting, according to Te Phan, who described how a Vietnamese family has to make a doctor appointment, then find transportation and a translator. Without the latter, "some doctors send them home. They have to make another appointment." And start the whole process again.

Phan said that lack of education about preventive measures, such as checkups, also impair the quest for good health.

Dr. Krishna Sundar spoke for a population with very different problems. The Asian Indians (originally from India, Pakistan and Bangladesh) tend to be very literate and have higher incomes than many immigrant groups. Language is less of a barrier.

But they delay seeking medical advice and turn often to alternative forms of medicine, sometimes even returning to their homelands for traditional treatment. Delays in diagnosis causes illnesses to become chronic and more serious.

Cultural norms like the popularity of chewing tobacco leave them with a high incidence of oral cancer. And the elderly members of the group have a hard time finding - or accepting - medical care.

The chief topic among her Japanese friends, said 82-year-old Alice Kasai, is cancer. But they also have reason to worry about blood pressure, diabetes and heart disease. And they are frustrated because many health providers don't recognize the Mongolian Sact - a birthmark on the bottoms of Asian, American Indian and other ethnic children that resembles a bruise.

Forget asking her friends about mental health problems, though, she said. "No one will cooperate in a survey on mental health." The stigma is too large.

That's not news to Jessica Liu, who is Chinese and works for Valley Mental Health. It is difficult for the Asian population to access mental health not only because of a language barrier but also due to "cultural stigma."

The words for mental health, in Asian languages, "have some harsh translations," she said. So they complain of headache, instead of telling a doctor they are depressed. And they would much rather have medication than psychotherapy.

"I will feel better if I take something in my mouth and I will be cured," she said they believe. Even those referred to mental health services by a doctor would rather believe they had a heart problem than an anxiety attack.

The cost of medication can also be prohibitive, she said, especially since so many refugees have lost benefits.

Jeein Kim teaches AIDS education for the Asian Association of Utah. She, too, finds an attitude that ignorance is bliss. "People are not receptive" because if they hear the information it "means there's a problem."

She said the Asian community has two individuals with HIV and 12 with full-blown AIDS - small but significant numbers for Asians, who make up only 2 percent to 3 percent of the state's population.

Cultural "stubbornness" prevents many Filipinos from seeking medical help, Aida S. Mattingley said.

They also have high statistics for AIDS and hepatitis, compared with other Asians. And their eating habits in the United States are "affecting our health."

Eating, in fact, is at the heart of the health crisis for Polynesians, said Dr. Kingi Langi, who lists diabetes, hypertension, arthritis, asthma and obesity as major concerns. Obesity is the biggest problem.

He is convinced that Americans are eating themselves to death. And Polynesians have picked up the habit. "They came to America and use a lot of autos. They drive to the store, one block away. At home, meat was not readily available. Here, it is. They eat and eat and eat."

"If we cut down the diet, we will solve a lot of problems."

But the most devastating problem is communication, because, the physician said, "90 percent of a diagnosis is based on communication." And money issues also prevent people from getting health care.