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.