Regular physical activity: better than an apple a day?

A new study provides further evidence that a physically active lifestyle can extend the quantity and quality of life. The study found that there was a gain in life expectancy of 3.4 years for individuals who averaged 150 – 300 minutes of physical activity per week – when compared to individuals with no regular physical activity. Study results applied to individuals 40 years of age and older.  Similar results in a study in Taiwan suggest the longevity benefits are transnational and cross cultural. Importantly, physical activity provided a benefit for individuals across the spectrum of body mass index, meaning that even obese individuals could expect to see some life expectancy gains with regular physical activity.  Click here for a link to the study.

- Doug Hirano, MPH, APCA Executive Director

A true American hero

On the eve of Election Day, we can all use a reminder about the preciousness of the right to vote in this country. Click here to read about a 93-year-old World War II veteran diagnosed with terminal cancer whose last act as an American citizen was to cast an absentee ballot in the upcoming election. Mr. Frank Tanabe passed away a week after the photo was taken. This story is for those of us who need a little extra encouragement to go to their polling place and vote.



- Doug Hirano, MPH, APCA Executive Director

New APCA Scientific Advisory Council

The APCA Scientific Advisory Council is off and running. The Council met for the first time on August 29th. This new council was established to provide advice to our organization on all issues of science. This will include review of written documents such as screening protocols and grant proposals. It will also include consultation on specific scientific or medical issues as they arise. We have put together a world-class group of scientists with expertise in women’s health, mental health, oncology, gastroenterology, medical anthropology, nursing, epidemiology, clinical research and health promotion. Here’s a list of our members and their affiliations:

• James Campbell, MD (chair)
• Heyoung McBride, MD, Arizona Oncology Services
• Linda Larkey, PhD, Arizona State University
• Mark Wong, MD, Banner Samaritan Medical Center
• Tim Flood, MD, Arizona Department of Health Services
• Angela Chen, PhD, Arizona State University
• Jennifer Weil, MD, National Institutes of Health
• Wendy Astudillo, NP, Phoenix Veterans Affairs Health Care System
• Seline Szkupinski-Quiroga, PhD, Arizona State University

Our first meeting was focused on getting to know each other and providing an introduction to APCA and its work. We had a preliminary discussion about diabetes screening and prevention and the need for tracking short-term outcomes to measure impact. Thanks so much to Dr. Jim Campbell for his willingness to chair this group. We plan to meet again in November and have more focused discussions on issues affecting the health of Asian Americans and Pacific Islanders in Maricopa County.

-Doug Hirano, MPH, APCA Exceutive Director

A Fatal Miscommunication

On early Friday morning, June 15, 2012, Mai Vo Bor, 37, and her elderly Vietnamese American parents were in a car heading west on the I-10 near Tonopah, about 50 miles west of downtown Phoenix. They were returning from a vacation in California. For some reason, they exited the freeway at 411th Avenue and were involved in a single-car accident about a half-mile off the freeway. The accident resulted in minor injuries to the parents and disabled the vehicle. Ms. Bor left her parents with the vehicle and went to seek help. Tragically, her body was found a mile from the accident scene later that same day. The Maricopa County Sheriff’s Office is still trying to determine if her death was due to exposure, injuries sustained during the accident, or perhaps foul play. Results of an autopsy are pending.

Myself, I don’t need to see a copy of the autopsy report to know the real cause of her death. It was not exposure, accident-related injuries, or foul play. I believe that Mai Vo Bor died due to a language barrier. Sheriff’s officers admit that they could not communicate with her parents because they spoke Vietnamese only. Had they been able to communicate with Mai’s parents, the officers would have almost certainly learned that Mai was on foot somewhere in the vicinity seeking help. Instead, the officers cleaned up debris from the crash, cleared away the disabled vehicle and transported Mai’s parents to the hospital, leaving the 37-year-old woman alone in the desolate area.

It was only later that day around 3 pm that an interpreter at the hospital learned from Mai’s parents that Mai had also been involved in the accident and was still missing. A search team found her naked body a few hours later.

Now, there are many unanswered questions related to this tragedy. Why did the family pull off of I-10 at Tonopah? What caused the single-vehicle accident? What was her time of death? Why was she found unclothed? There are probably a dozen other questions of interest to the investigation. However, I would argue that the most important question is this: Why did the officers not communicate with the parents at the scene of the accident? Do officers have access to remote telephonic language interpretation services? If not, then why not? If so, why did the officers choose not to utilize the system to interview the parents?

This is not to place blame on the Maricopa County Sheriff’s Office. But it is important to emphasize that Asian Americans are the fastest growing racial/ethnic group in Arizona, and 40% are of limited English proficiency. Language access is critically important in the kind of emergency situations faced by our public safety officers on a daily basis. Personally, I hope that Ms. Bor’s death will not be in vain and that the Sheriff’s Office and other government agencies will review their policies, protocols and systems around language access to ensure that all Arizona residents, regardless of language spoken, have equal and expedient access to high quality public services.  It can be the difference between life and death.

- Doug Hirano, MPH, APCA Executive Director

The Loudest Duck Gets Shot: Why Asian Americans are Dying in Silence

A few weeks ago, I had a chance to make a presentation at the Arizona Department of Health Services regarding Asian American health disparities. Thank you to the Arizona Health Disparities Center for inviting me to speak and for coordinating this series of workshops around social and racial/ethnic inequalities in health.

I titled my workshop “The Loudest Duck Gets Shot: Why Asian Americans are Dying in Silence.”  My contention is that a “perfect storm” of factors continues to compromise the political effectiveness of Asian Americans in this country and that the result in at least one case (chronic hepatitis B infection and liver disease, which disproportionately impact Asian Americans) is that Asian Americans are dying unnecessarily.

The “perfect storm” begins with a cultural disinclination to make waves (“the loudest duck get shot” is a Chinese proverb) and a proclivity towards “face-saving” (keeping problems within the family). In my mind, these tendencies continue to allow the “model minority” to also be the “invisible minority”.  Elected officials and government don’t hear from their Asian American constituents, and not surprisingly, little gets done to address a preventable health problem like hepatitis B infection, which is killing Asian Americans on a daily basis.  

Another factor has an historical context. Asian Americans, like other people of color in this country, have a longstanding history of being oppressed and disempowered. For Asian Americans, this marginalization began not long after their entry into this country – beginning with the 1892 Chinese Exclusion Act and culminating in the 1924 Asian Exclusion Act, which for 40 years essentially halted all Asian immigration into the United States. To this day, many American-born Asian Americans are asked, “Where are you really from?” as if we are less than real Americans. Dr. Frank Yu coined the term “perpetual foreigner” to describe this state of marginal Americanism. It’s harder to impact the outcome of a game if you’ve been relegated to the sidelines. 

There are other important factors. Asian Americans are a very diverse group, constituting peoples from the Far East, Southeast Asia and South Asia – many of whom literally don’t speak the same language and some of whom are historically bitter enemies. Building political solidarity among such diverse groups can be challenging at best.

My point is that Asian Americans need to be better organized and more vocal to address their own policy and systems related needs. In this country, “the loudest duck gets fed.” So, again using hepatitis B as an example, in addition to fighting the good fight and trying to scrape together resources to conduct hepatitis B education and screening among Asian Americans (working within the system), we also need to put a spotlight on and work to redress the inequities in overall hepatitis B funding (working the system). HIV/AIDS advocates learned this lesson decades ago, and that is largely why federal HIV/AIDS funding dwarfs viral hepatitis funding (even though far more Americans are infected with hepatitis B and hepatitis C, and far more die from these infections). I would venture to suggest that their advocacy, which resulted in a steep increase in federal investment in terms of HIV/AIDS prevention, screening, treatment and research, has saved hundreds of thousands of lives in the meantime. Asian Americans with hepatitis B infection deserve no less – but we must organize and speak up.

I’ve placed my workshop slides here on our website if you would like to view the full presentation.


- Doug Hirano, MPH, APCA Executive Director

The Weight of the Nation

On May 14th, HBO will be premiering a new a series called the “Weight of the Nation”. The focus of this series is on the epidemic of overweight and obesity in this country.

One of the key themes in this series is that the physical and social environment in which people live has a lot to do with their risk of becoming overweight or obese. This is counter to the idea which suggests that obesity is largely an individual problem related to discipline, willpower and personal responsibility.  

In anticipation of the series premiere, the Washington Post has published a brief interview with one of the series’ primary contributors, Marlene Schwartz, Deputy Director of the Rudd Center for Food Policy and Obesity and Yale University. I’m providing a link to this interview because I think Dr. Schwartz provides a simple, clear-eyed and compelling rationale for focusing efforts on the systems, policies and environments that predispose individuals and communities towards obesity, as opposed for instance to a purely educational approach.
  
I hope that this new series spurs much more dialogue on the matter.

- Doug Hirano, MPH, APCA Executive Director

Asian American Health Research: What Community Agencies on the Front Lines Need to Know

In response to a call for papers on Asian American and Pacific Islander health research, I put some thoughts on paper as to the type of research I think is needed for community agencies like APCA to more effective in its work. The paper, entitled “Asian American Health Research: What Community Agencies on the Front Lines Need to Know,” was accepted last year and has now made its way to print in the Spring 2012 issue of Progress in Community Health Partnerships: Research, Education, and Action. In this issue, I’m proud to be published alongside such friends and colleagues as Dr. Marguerite Ro, Dr. Winston Tseng, and Dr. Simona Kwon, among many others. I was also privileged to do an accompanying podcast related to my article. The transcript of the podcast is also published in this issue. To access copies of articles in this issue, click here.

Doug Hirano, MPH, APCA Executive Director