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June, 2007

Highlights in Minority Health
& Health Disparities
May, 2006
May is Asian American & Pacific Islander Heritage Month
During the observance of Asian American and Pacific Islander (AAPI) Heritage Month, we celebrate the cultural traditions, ancestry, native languages, and unique experiences represented among more than 47 ethnic groups from Asia and the Pacific Islands (speaking over 100 languages) who live in the United States. We also recognize millions of AAPIs whose love of family, hard work, and community has helped unite us as a people and sustain us as a Nation.1
AAPIs represent one of the fastest-growing and most diverse populations in the United States.2  According to 2003 President’s Advisory Commission on Asian Americans and Pacific Islanders (AAPIs), Report to the President and the Nation, AAPIs encompass many populations that make critically important contributions to American life.  AAPI communities often are stereotyped as a “model minority” that generally enjoys superior health status.  In reality, AAPI individuals and families experience genuine health disparities in cancer screening, diabetes, and infectious diseases, among others. It is important to recognize that AAPI subpopulations have distinct languages, cultures, histories, and politico-economic environments.3

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Asian Americans represent both extremes of socioeconomic and health indices: while 9.8% of Asian Americans lived in poverty in 20044, Asian American women have the highest life expectancy (85.8 years) of any other ethnic group in the U.S.5 While Asian Americans have the highest proportion of college graduates of any race or ethnic group (44.1% of Asian Americans have a bachelor’s degree, compared with 24.4% of the total population)6 they contend with numerous factors which may threaten their health.  Some negative factors are infrequent medical visits due to the fear of deportation, language/cultural barriers, and the lack of health insurance.  Asian Americans are most at risk for the following health conditions: cancer, heart disease, stroke, unintentional injuries (accidents), and diabetes. Asian Americans also have a high prevalence of the following conditions and risk factors: chronic obstructive pulmonary disease, hepatitis B, HIV/AIDS, smoking, tuberculosis, and liver disease.5

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The U.S.-associated Pacific Island Jurisdictions comprise three flag territories:  American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, and three Freely Associated States:  the Federated States of Micronesia (FSM), the Republic of the Marshall Islands (RMI), and the Republic of Palau.3  They are U.S. territories made up of hundreds of small islands and atolls spread across about 5 million square miles of ocean—nearly half the size of the United States—with a total population of 469,356 (1999 and 2000 estimates).7 Native Hawaiians and Other Pacific Islanders (NHOPIs) generally experience poorer health than the American population as a whole.8 Major causes of premature death among NHOPIs are obesity, cardiovascular diseases, cancer, and diabetes.3

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  red arrow The incidence rates for liver and stomach cancer were substantially higher among AAPIs than among other races in 1998-2002.*

Incidence Rates per 100,000 Population, US, 1998-2002


African American

American Indian and Alaska Native

Asian American & Pacific Islander

Hispanic/ Latino


Stomach Cancer






Liver Cancer






*Source: National Cancer Institute, Cancer Health Disparities: Fact Sheet, 2005

  red arrow The 5-year relative survival rate for all cancers for Native Hawaiians is 47%, compared with 57% for whites and 55% for all races.7
  red arrow In 2003, Asian American women (ages 18+) were least likely to have had a Pap test (68.3%) compared with other racial/ethnic women (non-Hispanic white: 79.3%, non-Hispanic black: 83.8%, Hispanic/Latino: 75.4%, American Indian/Alaska Native: 84.8%. 9
  red arrow In 2002, Native Hawaiians and Japanese and Filipino residents of Hawaii aged twenty years or older were approximately 2 times as likely to have diagnosed diabetes as white residents of Hawaii of similar age. Prevalence data for diabetes among other Pacific Islanders or Asian Americans are limited, but some groups within these populations are at increased risk for diabetes.10
  red arrow In 2002, the infant mortality rate for Native Hawaiians was 9.6 per 1,000 live births, higher than the rate for all AAPIs combined (4.8), and for all populations (7.0).11
  red arrow In 2002, the AIDS rate among AAPIs was 4.0 cases per 100,000 population.  During 2003, 497 new AIDS cases were reported among AAPIs, an increase of 9.9 percent over 2002 and of 34.7 percent over the 1999 level.12
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In 2001, AAPIs aged 40 years and older were 2.5 times more likely to have Hepatitis B (14.2 per 100,000) than non-Hispanic whites (5.6).13

Of the 1.25 million Americans living with chronic hepatitis B infection, approximately half are Asian American.  In 2002, the hepatitis B-related death rate among Asian Americans was six times higher than the rate among whites. 14.
  red arrow In 2004, Asian Americans were 5.6 times more likely to have tuberculosis than the total US population.  Native Hawaiians and Other Pacific Islanders (NHOPIs) were 3.3 times more likely (Asian Americans: 27.6; NHOPIs: 16.3; Total US: 4.9).15
The tuberculosis (TB) rate (cases per 100,000) in 2004 was 8.4 times higher in the U.S. Pacific Islands (41.4) than in the mainland U.S. (4.9).16
TB is 13 times more common among Asian subgroups such as Cambodians, Chinese, Laotians, Koreans, Indians, Vietnamese, and Filipinos than among the U.S. population.5

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  Asian American Populations
  Native Hawaiian and Other Pacific Islander Populations
  President’s Advisory Commission on Asian Americans and Pacific Islanders (AAPIs), 2003 Report to the President and the Nation
  White House Proclamation: Asian/Pacific American Heritage Month 2006

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  1. The White House Initiative on Asian Americans and Pacific Islanders, President Celebrates APA Heritage Month at White House, 2002
  2. U.S. Environmental Protection Agency (EPA), Asian American and Pacific Islander – Primer, 2006
  3. President’s Advisory Commission on Asian Americans and Pacific Islanders, Asian Americans and Pacific Islanders Addressing Health Disparities: Opportunities for Building a Healthier America, 2003
  4. U.S. Census Bureau, Poverty in 2004
  5. U.S. Department of Health and Human Services (HHS), Office of Minority Health (OMH), Asian American/Pacific Islander Profile
  6. U.S. Census Bureau, Educational Attainment, 2000
  7. Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Health Disparities Among Native Hawaiians and Other Pacific Islanders Garner Little Attention, Chronic Disease Notes and Reports, 15 (2): 14-27
  8. CDC, Office of Minority Health and Health Disparities (OMHD), Native Hawaiian & Other Pacific Islander (NHOPI) Populations
  9. CDC, NCHS, Health US 2005, table 87
  10. CDC, NCCDPHP, National Diabetes Fact Sheet, 2005
  11. CDC, National Center for Health Statistics (NCHS) Health United States 2005, table 19
  12. Health Resources and Services Administration (HRSA), Asian/Pacific Islanders and HIV/AIDS in the United States
  13. HHS, OMH, Immunizations and Asians and Pacific Islanders, 2005
  14. CDC, National Center for Infectious Diseases (NCID), Hepatitis B and Asian Americans Fact Sheet
  15. CDC, National Center for HIV, STD, and TB Prevention (NCHSTP), Reported Tuberculosis in the United States, 2004, table 16
  16. CDC, TB Among US-affiliated Pacific Island Jurisdictions, 2004

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