What We Learned About Food and Eating This Year!

I got this from the most recent issue of New York Times. It is very interesting, and amazingly to the point. Enjoy reading it.

Know More About Diabetes Everyday

Apparently, November is also Diabetes Awareness Month. And today - November 14, 2007 - is World Diabetes Day. This month's campaign theme is "Diabetes in Children and Adoloscents" - a nod to the growing fact that Diabetes - specifically Type 2 which was previously only seen in adults over 45 years old - has become increasingly common among people below 20 years old. According to CDC, 154,000 youths were afflicted with Diabetes in 2006 - 1 in 523 young people.

To address this inching epidemic, NDEP (National Diabetes Education Program) developed an educational program targeted towards youth with or at risk for diabetes and their parents or caregivers. Most notably, educational and support materials focusing on Type 2 diabetes were likewise introduced to warn kids of the growing risk.

No definitive information is yet available on the extent of diabetes among Asia Pacific Islander youths in the U.S. but should nonetheless be vigilant against the disease, considering its prevalence among the adult population of the group.

Here is the NDEP link: http://ndep.nih.gov/diabetes/youth/youth.htm
Click this link: http://www.diabetes.org/communityprograms-and-localevents/americandiabetesmonth.jsp for more information about Diabetes Awareness Month.

November is COPD Awareness Month

Here is an important message about COPD or Chronic Obstructive Pulmonary Disease from NHLBI:

STATEMENT FROM ELIZABETH G. NABEL, M.D., DIRECTOR, NATIONAL HEART, LUNG, AND BLOOD INSTITUTE, NATIONAL INSTITUTES OF HEALTH, ON COPD AWARENESS MONTH, NOVEMBER 2007 COPD (chronic obstructive pulmonary disease), a serious lung disease, is the fourth leading cause of death in the United States. An American dies every 4.5 minutes from COPD. While there are 12 million people with a diagnosis of COPD, there may be another 12 million who have it and don't know it.Despite these alarming numbers, relatively few Americans have heard of COPD. As a result, those at risk are not aware of the symptoms and health care professionals are not always on the lookout for the early symptoms and warning signs.COPD occurs when the tubes that allow the air to get in and out of the lungs are partially blocked, making it difficult to breathe and leaving patients feeling short of breath. Anyone over the age of 40 who smokes or has smoked is at risk for developing COPD. People who have had long-term exposure to things that irritate the lungs, such as chemicals, dust, or fumes in the workplace; secondhand smoke or other pollutants; and people with certain genetic conditions are also at risk.Diagnosing COPD involves a simple breathing test called spirometry that can be done in the doctor's office. Newer treatments for COPD are helping people live longer, more active lives.The National Heart, Lung, and Blood Institute, in collaboration with more than 20 partners, has developed an education campaign, COPD Learn More Breathe Better, in order to promote greater awareness of COPD among those at risk for COPD, patients, and health care providers. We hope that our efforts and those of our partners will serve as a wake-up call for America to help those with the disease and at risk for the disease take steps to improve their own health.For information, visit <www.LearnAboutCOPD.org>.

Immigrant Health

Immigrant health is such a volatile and polarizing topic poised to dominate the upcoming Presidential elections in 2008. At issue are the rising costs of health care and growingly controversial politics of immigration in this country. The inevitable interactions between health, policy, politics and public opinion gave rise to intractable debates among concerned parties, and more consequentially, poor health status of immigrants.

An article published by RAND in its September/October 2007 issue outlined the various sources of vulnerabilities for immigrants and discussed policy options that should be considered in order to improve their health status. According to the article, immigrants are more than likely to receive inadequate, poor or no health care at all compared to US-born citizens. The reasons for this disparity are the immigrants' disadvantaged socio-economic status, limited English proficiency, and the marginalization and stigma that accompany their legal status as immigrants.
The growingly unfavorable shift of policies and laws towards the immigrants only serve to inflame the issue further.

The article stated that the factors above contribute negatively to the health status of the immigrants in this country. As a result, poor access to care, as well the poor quality of care and services they receive, combine to affect serious implications on the health of the immigrants. The article considered certain policy changes that could reduce immigrant's vulnerability to poor health. Expanding the social insurance coverage, addressing the issue of language barrier, expand and strengthen community safety nets, and finally, revise federal laws that restrict immigrants' access to government-subsidized health care.

Please read the entire article in this link: http://content.healthaffairs.org/cgi/content/abstract/26/5/1258

Bush Vetoed SCHIP Bill

Well, he did it. Bush vetoed the SCHIP bill - in private! Please read the full story in New York Times by clicking this link: http://www.nytimes.com/2007/10/04/washington/04bush.html?ex=1349236800&en=f77840ef7bf1ec66&ei=5124&partner=permalink&exprod=permalink

We can only hope that Congress would override it.

As Children Are Left Behind

A month ago, I blogged enthusiastically about Congress passing the bill that extends SCHIP that will cover few more millions of uninsured and impoverished children. I thought, thank goodness, Congress is going for something that is obviously right. Apparently, between then and now, some renegotiations took place to make the bill palatable to Republicans who needed to vote for the bill to get re-elected but could not in their good political conscience turn their backs to their lofty republican ideals. To make the story short, the bill is now once again being voted on in the Congress with some changes that should make everyone happy - including medicare recipients whose benefits were erstwhile in danger of being reduced to finance the SCHIP expenses. Everyone, that is, except the president who threatens to veto the bill as soon as it passes. He claims that the bill which would provide health care to millions of children at the expense of increased excise tax on cigarette smokers is "an incremental step" towards the federalization of health care. I have not given much thought to federalized health care, but I intuitively know that health care to millions of uininsured and poor children should not be denied. I find myself agreeing with NPR's Danile Schorr commentary on the issue- please listen to it on this link:
http://www.npr.org/templates/story/story.php?storyId=14663820

I find it distastefully sad that children and their health care and other needs are used as platforms on which politicians stump their selfish agendas at will. It is particularly appaling to see how politicans can politicize the issue of health care - an issue of life and death to some ill children and their families - and somehow think that they are doing the most people a benefit.
It is unknown to me how many Filipino-Americans and other Asian-Americans stand to benefit or suffer from the outcome of the impending SCHIP debacle. But nonetheless, I urge all of you to be aware of issues such as this, because if they are willing to turn their backs on sick children, only God knows, who's next.

New York Times also ran a story about it on 9/25th, here is the link:
http://www.nytimes.com/2007/09/25/washington/25health.html?ex=1348459200&en=9656c7715fd92fd2&ei=5124&partner=permalink&exprod=permalink

Get to Know Thy Cholesterol

September is designated by the American Heart Association as Cholesterol month. However, for 36.6 million of Americans with a total cholesterol of 240mg/dl or higher, cholesterol is (or should be) an everyday reality. But the rest of us should never remain complacent or even think for a minute that we are immune from high cholesterol. High cholesterol is one of the leading and most preventable risk factor for heart disease and stroke. While there are some people whose genetic make-up predetermined them to have risky cholesterol levels, the rest of us can fight or prevent cholesterol with only the slightest modification to our diet, lifestyles and knowledge. Increasing our cholesterol literacy is the most important step we can make to improve our chances against heart disease and stroke.

In 2004, the CDC published the following findings regarding the health disparities in cholesterol status among minorities in United States. This is what they have to say about Asian-Americans and Pacific Islanders:

In 2001, the age-adjusted death rate for diseases of the heart for APIs was 137.6 per 100,000 population. The age-adjusted death rate for diseases of the heart was 247.8 per 100,000 for all Americans, and 245.6 per 100,000 for white non-Hispanic Americans.
In 2000-2001, 60.5% of Asian men and 63.4% of Asian women in selected communities had ever received cholesterol screening. During the same period of time, 31.4% of Asian men and 23.3% of Asian women had high cholesterol (defined as ever being told by a doctor or other health professional that blood cholesterol was high).
Native Hawaiians disproportionately suffer the burden of heart disease, compared to other ethnic groups in the State of Hawaii. Heart disease is the leading cause of death among APIs.

When surveyed regarding the frequency by which their cholesterol is checked, the Asians and Latinos showed the least frequency. Such finding underscored the need for more education about the importance of having cholesterol checks within these populations. This is special crucial among Filipino-Americans and Vietnamese who showed the highest cholesterol levels within the Asian-American group.With the spotlight on cholesterol this month, the American Heart Association website offers useful information about cholesterol and its management. Recognizing the importance of health literacy in fighting heart disease by way of cholesterol, AHA developed a user-friendly informative digest on cholesterol - a Cholesterol 101 if you will - designed to increase one's understanding and chances to fight one of the most preventable risk factors for heart disease and stroke.

Diabetes: Epidemic in California?

It may appear that I am fixated on diabetes lately, but judging from the most recent brief from the UCLA Center for Health Policy Research, we all should. According to this brief, diabetes continue to rise alarmingly in California. The number of people diagnosed with the disease has reached 1.8 million people in 2005, up from 1.5 million in 2001.

The rising number of diagnosed diabetics is a significant problem healthfully and economically. Diabetes, when neglected, spawns complications that eventually lead to kidney disease, blindness, amputations and even death. According to the brief, these complications cost individuals about $1,600 each year, $10,000 of insurance benefits for each benificiary, and a whopping $22.9 billion in treatment costs nationally in 2006.

The brief further revealed that American Indians, Latinos, and Asians (in this order) experience the greatest increase in diabetes prevalence. Although the over-all prevalence is low among Asians, this group demonstrated significant variations between different ethnic groups. Filipinos follow Japanese in having the highest prevalence of diabetes (8.6% to 10.2%) - significantly higher than the 6.5% prevalence rate for Asians in general. Interestingly, the brief also noted that among adults born outside the United States, those who lived in the country the longest also showed the highest diabetes rates.

The brief contains interesting data on the distribution and status of diabetes in California from which county has the most diabetic population to which group are likely to get foot and eye exams related to diabetes. The effects of poverty level, education, and insurance coverage on the treatment and outcome of diabetes are also discussed in the brief. And most importantly, the brief talks about existing health policies that are likely to influence the status of diabetes in California.

The health policy brief in its entirety can be viewed in this link: http://www.healthpolicy.ucla.edu/pubs/files/Diabetes_Epidemic_PB_082207.pdf.

Get to Know Your Risk for Diabetes

Diabetes is one of the top ten leading causes of death and disability in the United States, and most likely, according to CDC, underreported. Studies have further shown that the risk of death among people with diabetes is about twice that of people without diabetes of similar age.

In 2005, 20.8 million people of all ages – 7.0% of the population – suffer from diabetes, and about 6.2 million of them are undiagnosed. If not dying from the disease or its complications, people with diabetes spend millions of dollars treating it. The total annual cost of diabetes in 2002 was about $132 billion, representing about 11% of the total US health care expenditure that year and accounting for nearly 88 million disability days.

The impact of diabetes on the population’s health and the economy is clearly undeniable, but its impact on racial and ethnic minorities is even more profound. Compared to non-Hispanic whites, non-Hispanic Blacks, Hispanic/Latino Americans, and American Indians/Alaska Natives are roughly two times likely to have diabetes and suffer worse outcomes.

Unfortunately, the prevalence of diabetes among the Asian-American population is largely unknown. Yet in 2002, diabetes ranked 5th among the diseases that caused deaths in the Asian-American population. The potential burden – if it is not already - of this disease on Asian-Americans is immense considering that diabetes is closely associated with heart and cerebrovascular diseases that are the 2nd and 3rd causes of mortality within this group. The few studies that exist on this subject suggest that certain groups within this population have an increased and growing risk for diabetes. An ethnically-targeted information and education drive regarding diabetes is urgently needed for the at-risk Asian-American population.

Banyan Tree (Stephen Malkoff) Like the Banyan tree, our ideas can branch off and take root.

Personally, I am yet to meet a fellow Filipino-American whose family tree does not include someone with diabetes. As a group, we must pay serious attention to this disease and elevate our awareness of its risks and consequences.

In planning for this post, I visited the website of the American Diabetes Association and found a handy test that one can take to assess his or her risk of getting diabetes. The test is of course in no way an alternative to one's own doctor's assessment, but it can serve the purpose of teaching us the risks that we must watch out for. Take the ADA Diabetes Risk Test now. You can also click on this link and learn more about Type 2 diabetes and what you can do about it.

Diabetes is one of the most common and well-studied diseases, yet it continues to plague many people and cost tremendous amount of money as well as production and opportunity losses. There is yet no cure for diabetes once you get it, but you can certainly do something to prevent it.

Filipinos: Don't Be Another Cancer Statistic

Summer months in California usually mean "fiesta time" for Filipino- Americans. Festivals celebrating the Filipino-American culture and heritage are often held in public parks nationwide at this time. I went to such an event two weeks ago at the Yerba Buena Gardens in San Francisco. Besides the usual booths that hawk everything from bbq anything to T-shirts that proudly scream "Pinoy", this particular fair also boasts of a "health pavillion." The "pavillion" was unfortunately propped on the top floor of a building at the margins of the the fair grounds itself so it was sadly overlooked. Nonetheless, it is encouraging to note that a serious effort is afoot to pay more attention to the health affairs of the Filipino-Americans.


A health booth focusing on cancer among the Asian-American population caught my eye for its noticeably ethnically-targeted literature. The Filipino Cancer Education Resource Catalog was particularly impressive in its valinat attempt to put together an information packet that directs Filipino health consumers to specific resources for various kinds of cancer. The pamphlet is written in both English and Tagalog and a product of a collaboration between the Filipino Community Cancer Collaborative and institutions such as the American Cancer Society, UCSF and various Asian and Pacific Islanders health organizations among others.


Such interest in cancer in Asian-Americans made me think of the threat of this disease to this population. While the available information on the burden of cancer in Asian-American population is hardly exhaustive, the literature is promisingly growing. I posted several articles on this blog that I think shed a much-needed light on the status of cancer among this ethnic group.

According to the American Cancer Society, Asian-Americans are the only group for which deaths from cancer exceeded that of deaths from heart disease. Cancer is the leading cause of death for female Asian-Americans since 1980. Plaguing these women's health are cervical and breast cancers - mostly attributed to lack of preventive care and late detection of the disease. Clearly, information about and access to information, services and support is a very serious issue for this group.

Filipinos ranked the poorest in surviving colon and rectal cancers of all the US ethnic groups, perhaps due to late detection of the disease as well. Likewise, Filipinos have more cases of and deaths from prostate cancer compared with other Asians. While the reason for this is not immediately known, high-saturated diet and obesity had been named as likely culprits. Westernized diets and obesity are also implicated in the cases of and deaths from breast cancer among Filipino women which surpassed all other Asian ethnic groups. Educating Filipinos about theirs risks to get cancer is incredibly crucial to stem the alarming upward trend of incidence and mortality rates for specific cancers. Awareness of the risks should convince Filipinos to seek preventive services and to adopt preventive health behavior. After all, when it comes to cancer (and true for other diseases as well) early detection could prevent early death.

Different Folks

(Cover; Documentary: John Wehman, Filipino-Americans: Discovering their Past for the Future, 1994)

According to the the 2005 Bureau of Census estimates, there are now about 14 million people who call themselves Asian-Americans in the United States - accounting for about a little over 5% of the total population. This estimate shows a growth of over 60% since the 1990 census, making the Asian-Americans the fastest growing of all the racial/ethnic groups. Such massive growth is expected in the future given that we are younger than the national population and our life expectancy the longest among all groups.

Why is such information important? Well, this means that as a political and social group, Asian-Americans is certainly a growingly important number to reckon with. As our numbers grow, so do our needs, our impact, and hopefully, proportionally, our influence too. The implications of these statistics on public policies and allocation of resources and services should be seriously considered. We should be at the forefront of such discussions if our interests are going to be well-served.

These days, such discussions often center around health care, access and costs. We must realize that we have unique health needs that are only magnified by our diversity, and that we are faced with barriers that affect our health and well-being.

The Office of Minority Health - an agency created by the Department of Health and Human Services in 1986 charged with improving and protecting the health of racial and ethnic minority populations - recognized this much. The following is an excerpt of the agency's profile of Asian American health:

Asian Americans 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.

Information such as this should alert us about the areas that we must pay close attention to. Ideally, specific resources should abound that would lend us a ready hand when our needs arise, but sadly this is not yet so. But growing work is at hand to fill the the void where resources, research and information should be that are responsive to the needs of the Asian-Americans.

Meanwhile, we must equip ourselves with information that would be helpful in influencing policies and shaping public opinion. Politicians and policy-makers are famous about "knowing their constituency." We must do the same thing; we must know ourselves - who we are, what we do, what our needs are, and why we are relevant. Only by knowing it ourselves can we convince others of our own significance. Every policy or program that deal with populations begins with statistics - indeed, there is power in numbers so to speak. There is a wealth of information in our demographics. I suggest that we start getting interested about what the census say about us. I am posting two links on the Chop Reads section of this blog to two informative documents published by the US Census in 2000 and 2004. These two documents: The Asian Population: 2000 and We the People: Asians in United States, 2004 provide a details about the distribution and important health, economic, political and social characteristics of the Asian-American population.

Score for Needy Children and Families

I cannot help but post this wonderful news about the re-authorization of the SCHIP program. Please read the complete news at the following link:

http://www.nytimes.com/2007/08/03/washington/03health.html?ex=1343880000&en=926c86f7678200b6&ei=5124&partner=permalink&exprod=permalink

Like many disadvantaged groups, many Filipino-American families are reliant on public assistance programs such as SCHIP. While many of these families have working parents, their income is often not enough to purchase health insurance but too much to qualify them for Federal programs like Medicare. It is the saddest place between two hard rocks that no working families should be in. SCHIP is one of those safety-net programs that needy children and families need until such time that the entire flawed health care system can be fixed.

Health Survey Reveals Unhealthy Side of Filipinos in California

California Health Interview Survey or CHIS is one of the largest state health surveys in the United States. It is also one of the few surveys that provide a breakdown of the Asian-American groups under the ethnicity category, providing us a rare glimpse of this group's health status. The information obtained from CHIS is used extensively for health planning, policy-making, and for advocacy actions.

(please click the graph to enlarge)

Filipino-Americans are the second largest Asian-American group in California in 2005.

The survey is conducted over the phone reaching thousands of households every two years. The first CHIS was conducted in 2001. The most recent one was in 2005. The results of the 2007 survey will be rolled out later this year.


The 2005 CHIS results offered interesting yet disturbing statistics about the health status of Filipinos in California. Compared with other Asian-American groups, the Filipino-Americans reported worse health conditions and health behaviors.




The prevalence of stroke, high blood pressure and breast cancer were highest among Filipino-Americans ages 18 to 65, all genders, in 2005.

More Filipinos were also diagnosed with heart disease, diabetes, borderline diabetes and cancer compared with other Asian-American groups.

Although not the worst, the prevalence of binge drinking (5 or more alcoholic drinks in the past month) and smoking were also high among the Filipinos, further increasing their health risks.


Obesity is practically an epidemic in this country. Over-all, Asian-Americans are at the lower end of the obesity scale, but a different picture emerges when this group is broken down. Among Asian-Americans, Filipino-Americans tend to be more overweight and obese. Ironically, the Filipinos also experienced the least food security in 2005. Furthermore, compared with other Asian-Americans, Filipinos also eat the least servings of fruits and vegetables both believed to help decrease the risk for some diseases.

The CHIS survey showed that more attention must be given to the health patterns and behaviors of Filipino-Americans if to prevent or decrease the serious consequences of the chronic diseases that result from them.

Information Gap

If you want to know the health status of Filipino-Americans at the national level, your search will likely produce zero information. National surveys such as NHANES (National Health and Nutrition Examination Survey), NHIS (National Health Interview Survey), and BRFSS (Behavioral Risk Factor Surveillance Survey) usually clump information on Filipino-Americans under an all-inclusive umbrella of Asian and Pacific Islander group. Many unique information about specific Asian and Pacific Islander groups are masked or lost as a result of such homogenizing grouping practice. Putting Asians under one group fails to acknowledge the sheer diversity of this group and overlooks the real needs, concerns, and issues that attend such heterogeneity. Health status in particular suffers when the dearth of information leads to inattentiveness from health providers, researchers, the government, and the community itself. Overlooked groups such as the Filipino-Americans are ill-served by the gaps in research and the resulting absence of interventions and support services that are responsive to their specific needs.

An article published in the Minority Nurse website illustrates the potential benefits of stimulating more interest and research in the health status of Filipino-Americans. Read the full article below:

Study Sheds New Light on Filipino Americans' Health Needs

Even though Filipino Americans are one of the fastest-growing immigrant populations in the U.S., relatively little research has been conducted on this minority group's health status, risk behaviors and health promotion practices. This lack of comprehensive and consistent data makes it extremely difficult for medical and nursing professionals to understand Filipino Americans' health care needs and develop culturally appropriate disease prevention strategies.
A recent study sponsored by the Philippine Nurses Association of Northern California has taken some important steps forward in beginning to fill this information gap. A bilingual (English/Tagalog) team of nurse researchers from the association surveyed a sample of 163 Filipino Americans at health fairs held in the San Francisco Bay Area. The participants were born in the Philippines but had lived in America for an average of 18.8 years; their average age was 58. They were asked to fill out a brief health survey with questions asked in English followed by a Tagalog translation in parentheses.
The study's results, published last year in The Journal of Multicultural Nursing & Health, found that the majority of respondents (70.6%) rated their overall health as "good"-despite the fact that many also reported being treated for medical conditions, such as hypertension, musculoskeletal disorders, cardiac problems and diabetes.
The findings also suggest that older Filipino Americans lead healthy lifestyles that significantly lower their disease risks. A strong 48% of the total sample said they exercised daily, while only 7.4% smoked and 4.3% drank alcohol daily. Most participants reported visiting their physicians and dentists regularly. However, younger Filipino Americans were more likely to smoke, suggesting a need for culturally competent smoking cessation programs targeted specifically to this group.
"These [overall] results are consistent with individuals who value health and engage in health-promoting behaviors," the study concludes, "and with a population that has better health than native-born Americans, despite living in the U.S. for more than 10 years." -

http://www.minoritynurse.com/vitalsigns/may02-6.html

Welcome to CHOP

"I realize that it is not my
role to transform either the world or man: I have neither sufficient
virtue nor insight for that. But it may be to serve, in my place, those few values without which even a transformed world would not be worth living in, and man, even if "new," would not deserve to be repected."

- Albert Camus Actuelles I, Chroniques 1944-1948

The quoted words of Camus above inspire the beginning of this project. We believe that "health" is one of those values without which our lives would not be as promising or a "transformed" world as meaningful. This project is dedicated to foster the development and sustenance of health as as a value among Filipino-Americans.

Filipino-Americans - like other ethnic groups - form a unique community bonded by a common understanding of certain cultural values, norms and world view. Being a part of such community informs and colors the way it perceives, treats and sustains "health."

As part of a minority group, Filipino-Americans likewise face cultural, economic and social challenges that affect their health status. In order for this group to benefit from the current climate of heightened health awareness, the issue of health must be presented to them in a relevant and culturally-sensitive manner.

The Community Health Project aims to raise the awareness of Filipino-Americans about the issues that pertain to their health through targeted information, education and advocacy. This project believes that an informed, supported and involved community will lead to a healthier and happier community.