Abstract
NCl CNPs across the country are reporting significant progress with their programs to improve healthcare in Underserved and minority/ethnic populations. For example, Dr. Chen's AANCART targets a population for whom cancer is the leading cause of death (unlike other ethnic groups, for whom it is heart disease). Their cancers also disproportionately have infectious origins, including cancers of the stomach, cervix, and liver. For example, the number of new cervical cancer cases is 8 times greater in Vietnamese women than in white women, whereas Chinese men and women have the highest mortality rate from liver cancer. Breast cancers are also increasing faster in Japanese women than in white women. “Asian Americans are among the least likely to get screened for cancer. It's notthatthey're hard to reach, it'sthatthey're hardly ever reached,” Dr. Chen notes. One reason is because of the language barrier: approximately two-thirds of Asian Americans are foreign-born and do not speak English, and there are as many as 200 Asian languages, he says. AANCART is focusing on the 7 or 8 main languagesto reach people through everything from home visits, posters on buses, and native-language media. In Hawaii, for example, AANCART launched an intensive media campaign to increase Filipino participation in mammography screening. Meanwhile, advertisements on buses showing a toddler “imprisoned” by a cloud of second-hand cigarette smoke have particularly successful in convincing Asians to stop smoking in the home. These advertisements, developed in multiple languages bythe California Department of Health Services, also are credited for helping California to have the second lowest smoking rate in the country, after Utah, Dr. Chen notes. Asian Americans are among the least likelyto get screened for cancer. It's not that they're hard to reach, it's that they're hardly ever reached.— Moon S. Chen, Jr, PhD, MPH
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