LOGO South Asian Public Health Association

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South Asian Public Health Association
Getting on the Agenda Priorities in South Asian
American Health
Kalpana Bhandarkar, Abhijit Ghosh, MPH, Ushma D.
Upadhyay, MPH
AAPI-NetSAP-SAPHA Health and Wellness
Symposium Washington DC April 27, 2002
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SAPHA Background

• Established in Spring 1999
• Began with 10 members
• Currently over 350 members
• Members from the US and around the world
• Activities in New York City, Baltimore, and
  Washington, DC

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Brown Paper

• To summarize and present health concerns of the
  South Asian American Community
• Project initiated in July 2000
• Includes literature reviews and a resource guide
  for health services focusing on South Asian
  Americans

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Brown Paper

• Methods SAPHA members commissioned to review
  current literature in their fields of expertise
• Topics include Sociodemographic Profile, Elderly
  Health, Youth Health, Womens Health, Gay/Lesbian
  Concerns, Cancer, Cardiovascular Disease,
  Diabetes, HIV/AIDS, Intimate Partner Violence,
  Mental Health, Nutrition, and Substance Abuse

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Brown Paper

• Provide health data to policy-makers, community
  organizations, health and community workers,
  social workers, physicians, and clinicians
• Reach out to community leaders and South Asian
  press to disseminate information
• Raise awareness among SA community about health
  issues
• Encourage future research on SA health issues

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HIV/AIDS among South Asians

• Chapter authored by Linda Groetzinger, Chicago
• Most data is on Asian American and Pacific
  Islanders (AAPIs)
• No break down by Asian subgroups

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Main Findings

• CDC data 1 of PLWA are AAPIs
• 5,728 cumulative cases (through December 2000)
• Unknown mode of transmission
• AAPI women 21
• Americans overall 16
• MSM AIDS cases
• AAPI 72
• Americans overall 56

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Main Findings

• 1999 California Dept. of Health Services
• 26 cases of Indian origin
• 10 cases of Pakistani origin

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Conclusions

• Are South Asians assumed to be safe?
• HIV exists in our community
• Risk increases as denial continues
• Stigma needs to be eliminated
• Need to connect with marginalized South Asians

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South Asian Public Health Association http//www.s
apha.net
Elderly Health and Caring for the Caregiver
Abhijit Ghosh MPH, Rashmi Gupta, Ph.D., LMSW
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Objectives

• Who are South Asian Elders
• What their primary concerns?
• What the Caregivers concerns?
• Recommendations/Next Steps

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Define the Population

• National Indian American Association for Senior
  Citizens 2000 Estimate 10 are gt60 years old
• Two Subgroups
• Late-life Immigrants
• Immigrants from the 1970s-80s

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Primary Elderly Concerns1998 National Indian
American Association for Senior Citizens
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Self-Esteem and Community Connection

• The need for the elderly to connect with a
  community and to feel needed are crucial to
  develop self worth at a stage in their lives in
  the US where cultural shock could also inhibit
  their open interactions.
• Raj Razdan, Executive Director/Founder of Senior
  Citizens Program (Atlanta)

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Primary Barriers to Integration

• Language
• Transportation
• Cost to organize activities
• Trust

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Caregivers Burden

• Burden Definition
• Impact on finances
• Impact/interruption of work schedule
• Lack of assistance by extended family
• Sense of entrapment
• Female burden of care

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Caregivers Concerns

• Trend increase in years of serving as a
  caregiver, there is a great financial burden,
  interruption of work schedule, and heightened
  sense of entrapment due to servicing increased
  health needs.
• We would want our parent(s)/in-laws to back to
  live (South Asia) with our siblings for good but
  when they are in poor health, nobody wants them.
  Caregiver in Dallas, Texas

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Recommendations

• Assist in the development of integration into a
  community through educational programming and
  providing classes such as ESL/civic classes and
  voter registration drives.
• Help seniors develop their own social network
  through planning social and cultural events such
  as movie nights and picnics.
• Work with seniors to develop obtainable goals in
  the future such as fostering hobbies.

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RecommendationsResearch

• Conduct further research doing surveys of health
  indicators for elderly 65 years and older.
• Develop relevant informational material in
  different languages.
• Conduct further research to evaluate potential
  gender-based differences in the role of the
  caregiver.
• Evaluate the needs of those who have aged here
  vs. those who have immigrated in later in life.

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South Asian Public Health Association http//www.s
apha.net
Youth Health
Kalpana Bhandarkar, Amishi Gandhi MPH, Mona
Shah, MSW
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Objectives

• To outline the specific health needs of South
  Asian youth
• To stress the importance of age-sensitive and
  culturally-appropriate youth services
• To increase involvement of the South Asian
  community in young peoples lives

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Main Findings

• Lack of Health Insurance
• 9 million uninsured children
• 5 AAPI
• Lack of Access
• 2-3x more likely to lack regular care
• Financial, language and cultural barriers

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Main Findings

• Symptoms
• lower self-esteem
• heightened feelings of alienation
• signs of depression among AAPI girls
• higher suicide rates among AAPI girls

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Main Findings

• Low Access to Mental Health Services
• Only 1 of all mental health services accessed by
  NYC youth were by AAPIs

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Main Findings

• Explanation
• Language barriers
• Financial barriers
• Distrust
• Cultural stigma

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Recommendations

• Research
• School-based education
• School-based health centers
• Local outreach
• Materials in South Asian languages
• South Asian community involvement

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Role of Community

• Participation
• Health insurance outreach
• Health education
• Translation services

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Brown Paper Recommendations

• Reliable data is needed
• South Asians
• Disaggregated for sub-groups
• More funded research on health status, needs, and
  concerns of South Asians
• Focus on culturally appropriate outreach and
  education
• The model minority myth must be eliminated

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SAPHA

• South Asian Public Health Association
• http//www.sapha.net
• To join the SAPHA listserv send an e-mail to
• sapha-subscribe_at_yahoogroups.com
• or
• ghoshab_at_hotmail.com