"In the Asian-American family, usually parents don't want to discuss if they have diseases," Albert Ng recently told NPR while attending San Francisco's Asian Heritage Street Fair. "They just want to discuss the good stuff, but never discuss the weaknesses."Ng was at a booth getting tested for hepatitis B for the first time in his life. One in 10 Asian-Americans is chronically infected with the disease; when left untreated, hepatitis B can lead to liver cancer. San Francisco has the highest liver cancer rate in the country, and this is mostly due to the city's famously large population of Asian-Americans, for whom hep B has become an epidemic. Of the 1.25 million Americans who are affected by hep B, half are Asian-Americans.
Why is hepatitis B so common among Asians? The disease is thought to have originated in Asia centuries ago. It's passed down from infected mothers to newborn infants. While blood tests can detect the hep B virus, most physicians in the U.S. only test those who engage in high-risk behaviors, such as unprotected sex or intravenous drug use. Many doctors simply aren't aware that Asian immigrants, especially those from China, are much more likely to have been infected at birth.
To make matters worse, many Asian-Americans who could have been infected at birth may be completely in the dark about the matter. As Ng pointed out to NPR, traditional Asian values may be partly to blame: It's not unlikely that Asian immigrants who knew they were infected with hep B regarded that fact as something shameful, as something that was better not to be discussed.
Some Asian-Americans that I know well also take a fatalistic attitude toward histories of hep B and liver cancer in their families. "If it's going to happen, it's going to happen," is how the conversation often turns. "Better to live your life without worrying about it."
The thing is, hep B can be suppressed with medication, if it's caught early.
"This is a disease [for] which, unlike HIV, we have all the solutions," Samuel So, director of the Asian Liver Center at Stanford University, told NPR. "We know how to prevent it. We have a very effective vaccine; we have treatments which can help to suppress the virus, and yet we are not doing a good job."
Which brings us back to Albert Ng: In addition to a hard-hitting public awareness campaign, city health officials in San Francisco have begun offering free testing, vaccination and treatment to all residents. Ng was getting tested because it turns out that his own grandfather died of liver cancer caused by hepatitis B.
Nationwide, liver cancer and hep B are becoming an Asian-American epidemic. To combat this epidemic, the community needs to talk, and it also needs to shake a few trees. Take the city of New York, for example: 12% of the population of New York is Asian-American. But as recently as 2008, less than one percent of social services were channeled toward the Asian-American community. According to the Coaltion for Asian American Children & Families, Asian-Americans were 10 times as likely to develop liver cancer as the rest of the population of New York.
San Francisco's program is promising, and other cities plan to replicate its efforts. But to combat liver cancer and hep B, we're going to need to raise money — and our voices.
Photo Credit: San Francisco Hep B Free
Chris Santiago is a freelance writer and editor who until recently was an editor at McGraw-Hill.
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