Health conditions that disproportionately affect the asian community
Currently, there are 19 million Asian Americans living in the U.S. While a lot of progress has been made in health care provided in Asian American communities, there continue to be health conditions that disproportionately affect the Asian community compared to other populations. In some cases, this disproportion can be explained by genetics. Also, economic, behavioral, and social factors can also contribute to some of these conditions.
Here are five conditions that people in the Asian community should be especially aware of as we work together to keep everyone in the U.S. as healthy as possible.
1) HLA-B*1502 defect
Patients of Asian descent are more likely to inherit certain genetic defects than patients of other ethnicities. One genetic defect found almost exclusively in the Asian population is the HLA- B*1502 defect.
HLA stands for Human Leukocyte Antigen. These are proteins on the cell surface that help to regulate the immune system. A defect in an HLA protein can cause the body to attack harmless compounds or even its own tissue.
Patients with the HLA-B*1502 defect is more likely than any other population to have a possibly fatal reaction called Steven Johnson Syndrome (SJS) when they take a medication called Carbamazepine.
SJS causes painful blisters to form on the skin and the mucous membranes that line the eyes, mouth, nose, and genitals. A few days after the blisters appear, the skin begins to slough off, leaving patients vulnerable to infection, sepsis, and severe dehydration.
Carbamazepine is typically prescribed to treat seizures, nerve pain, and bipolar disorder. Before a provider prescribes this medication to a patient of Asian descent, they should first-order blood work to test for the HLA-B*1502 defect.
2) Stomach cancer
Stomach cancer is the fifth most common malignancy in the world and the third leading cause of death. Asians have a 12-14-fold increased risk of developing stomach cancer compared to other ethnicities.
Researchers attribute this increased risk to several factors. First, genetic defects can make people more susceptible to developing a malignancy like stomach cancer.
Second, stomach cancer is higher in patients with an untreated stomach infection called Helicobacter Pylori (H. Pylori), which can cause chronic inflammation if left untreated. In native Asians, the prevalence of H. Pylori is 54%. H. Pylori can be detected with a breath or stool test. A 14-day course of oral antibiotics usually resolves the infection and significantly decreases the risk of stomach cancer.
A third risk for stomach cancer is a diet high in food that is pickled or smoked, which are commonly found in Asian cuisines.
3) Hypertension
Hypertension (high blood pressure) is more common in Asians than in many other ethnic groups in the U.S. A recent study found that the rate of hypertension in Asians was 38%, while the rate in Hispanics was 33% and the rate in non-Hispanic whites was 27.5%.
Modifiable hypertension risk factors include smoking, a high-sodium diet, obesity, and a sedentary lifestyle. Non-modifiable risk factors include inherited genetic defects, ethnicity, and age.
Uncontrolled hypertension can lead to kidney disease, heart disease, strokes, and heart attacks. Screening patients for hypertension, lowering their modifiable risk factors, and treating hypertension appropriately can lower the risk of all these hypertension-related conditions.
4) Hepatitis B
Hepatitis B is a viral liver infection. One in 12 Asians is chronically infected with Hepatitis B, compared to 1 in 1000 non-Hispanic whites. While Asians make up about 6% of the U.S. population, they account for 58% of the U.S.’s chronic Hepatitis B cases.
Chronic hepatitis can lead to serious liver conditions, including cirrhosis and liver cancer. Asian men have the highest incidence and mortality of liver cancer, so it’s especially important to screen these patients for Hepatitis B.
Antiviral medication can often clear the infection before it causes complications. Also, a 3-shot Hepatitis B vaccine is available to protect non-infected patients against the virus.
5) Tuberculosis
Tuberculosis (TB) is a bacterial infection that typically affects the lungs. A 2018 CDC study found the rate of TB in Asians was 31 times higher than the rate of TB in non-Hispanic whites. The rate is particularly high in non-U.S. born patients.
Symptoms of tuberculosis include night sweats, fevers, weight loss, and coughing up blood. A skin test is often used to screen for TB. Patients who have a positive skin test usually then undergo a chest X-ray, which can distinguish active TB from inactive TB.
Patients with active TB, or high-risk patients with inactive TB, typically undergo a 6–12-month course of antibiotics to clear the infection.
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Sources:
https://www.cdc.gov/nchs/fastats/asian-health.htm
https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=63
https://www.mayoclinic.org/diseases-conditions/stevens-johnson-syndrome/symptoms-causes/syc-20355936
Written by Sarah Thebarge, Physician Assistant