I’ve heard a lot lately about San Francisco’s Hep B Free campaign, a public campaign to increase hepatitis B awareness and vaccination in the Bay Area. According to Hep B Free’s website, Hepatitis B — which results from infection by the HBV virus – causes liver cancer in 80% of diagnosed patients. Further, the bloodborne HBV virus can survive for more than 7 days outside of the body and is 100 times more infectious than HIV. Sadly, HBV infections are frequently missed by primary care physicians even though diagnosis only requires a simple blood test.
Currently, 1.25 million Americans are infected with HBV, of which roughly half are Asian American. In fact, HBV is one of the leading causes of death for the Asian American community; 1 in 10 Asian Americans are currently infected with Hepatitis B.
In a talk to the 2nd annual Asian American Health Conference, Dr. Francisco Sy of the NIH noted some of the cultural and linguistic barriers that appear to influence the high HBV infection rates amongst Asian Americans:
Decrying that too many health academics do too much “helicopter” research in minority communities — i.e., go in and out to study the population in the short term without really getting to know them — Dr. Sy argued that “community is so important and we need to be treated as partners [in health studies] and not guinea pigs.”
Dr. Sy also contended that the stereotype which characterizes Asian Americans as the “model minority” has contributed to the dearth on health data for the group, a detriment for the community because data is what gets institutions like the NIH to give money to do further studies or finance programs.
“If there is no data,” said Dr. Sy, “there is no funding and communities suffer because Asian Americans are considered Ômodel minorities’ then people think they don’t have any [health] problems.”
The reality indeed is far from such assumptions. According to Dr. Sy, 21% of Asian Americans are uninsured and 12.5% live below the poverty line. Many also have language barriers which, along with the lack of financial resources, keep them form navigating America’s convoluted healthcare system.
Dr. Sy also mentioned that the group’s social and cultural practices — like putting the family over the self, holding a fatalistic view of illness or subscribing to more “traditional” types of healing (for Filipinos this include prayer and religious healing) and keeping topics like domestic violence and sexual orientation taboo have acted as barriers for a healthier Asian American community.
On the West Coast, several campaigns have worked tirelessly within the community to try and break down some of these barriers. Ted Fang, of Asian Week, who is one of the vocal leaders of San Francisco Hep B Free discussed (in the video above) how the high insurance rates of Asian Americans — some 90% of Asian Americans have health insurance — means that it’s not just about improving access to healthcare. Instead, specifically tailored awareness campaigns aimed at both patients and primary care physicians, are needed to break down the cultural stigmas around Hepatitis B.
Not surprisingly, the strategy of actually collecting community-specific data about a disease that disproportionately affects said community actually works. Fang reports in the article that nearly two-thirds of San Francisco doctors have pledged to test at-risk patients for Hepatitis B, and the Hep B Free campaign in the Bay Area is now being considered for adoption in other cities around the country.
It’s great to see recognition for those community leaders who are in the trenches, working on a non-glamorous, but nonetheless important, problem like Hepatitis B. Furthermore, their efforts speak to the critical necessity for more large race-specific, epidemiological studies, so that we can start more dialogues on stigmatized health issues and begin to identify new ways to help save lives within the APIA community.