Health Promotion in Minority Populations: Chinese American Culture

Health Promotion in Minority Populations: Chinese American Culture

Grand Canyon University: NRS-429VN-O502

Health Promotion in Minority Populations: Chinese American Culture

The growing diversity of the nation conveys opportunities and issues for health care providers, health care systems, and policy-makers to produce and provide culturally competent care. Cultural competence is described as the capability of providers and organizations to successfully perform health care services that meet the social, cultural, and language needs of patients. Culturally competent health care aids in producing a higher quality of care and more optimal patient care further producing the eradication of ethnic health disparities.

Chinese American Culture

“Asian Americans constitute the fastest growing racial/ethnic group in the U.S. and the largest subgroup is the Chinese” (Chen et al., 2019, p.1). Asian Americans represent 4.2% of the total U.S. population, with a 5.2% yearly increase. The U.S. Census Bureau forecasts that the Asian American population will continue to rise to an estimated 37.6 million by the year 2050, predicting 9.3% of the U.S. population consisting of Asian Americans. “Asian Americans have historically been upheld as a “model minority,” experiencing few health problems relative to other minority groups” (“Health,” 2019). It is important to mention that Asian American women hold the highest life expectancy of all ethnic groups within the U.S. with an 86.1 year life expectancy for Chinese women (Minority Health, n.d.). Collective research has noted that Asian Americans are an at-risk group for certain disease processes, namely liver and lung cancers, hepatitis B and tuberculosis due to crowded living conditions. Recently, health disparities affecting Asian Americans have become a focal point with policy-makers concentrating on making healthcare more accessible to Asian Americans to address such health disparities. Race and ethnicity have a distinct influence on health for Chinese Americans. Most generations of immigration have landed in urban, inner-city settings where destitution, poverty and health/environment and social dangers exist. Like other waves of immigration, Chinese American immigration is associated with lowly housing, poverty and bad health as well as prejudice and bias. Minority ethnic groups have a propensity to assume more risky jobs such as physical labor or of low status, resulting in higher incidence of injury and work-related disease and poor health. Poverty regularly denotes approaches to health promotion are challenging or not within cultural goings-on.

Health Disparities and Challenges

Chinese Americans (CA’s) have a higher incidence of diabetes than native born Chinese. The leading cause of death for Asian American women is heart disease and represents the most common cause of death. Asian/Pacific Islanders’ health disparities include cancer, representing the second leading cause of death. Chinese men living in Hawaii show an increased prevalence of thyroid cancer with nasopharyngeal cancer being the most predominant cancer for the Chinese. Chinese people have a low rate of survival with cancer of the liver and leukemias and hepatitis B is highly prevalent in Asian/Pacific Islanders. Prevalent genetic disorders are alpha thalassemia, G6PD, and lactase insufficiency. Nutritional challenges are ever present for Chinese Americans. Chinese Americans are less likely to be accustomed to dietary guidelines or food labels in the U.S. and are prone to depending on friends and Chinese newspapers for nutritional information. Many traditional foods, herbs and spices are not easily accessible and carry a high cost due to importation, making a lot of the foods inaccessible to them. Another major nutritional challenge is the high incidence of lactose intolerance in Asians. Lastly, the abundant use of seasonings like monosodium glutamate (MSG), soy sauce, pickled vegetables and fruits, can produce major challenges when low sodium or high calcium diets are required in patients.

Barriers to Health

There are many barriers to health for CA’s as a result of cultural, socioeconomic, educational and sociopolitical differences. Cultural differences can yield misunderstandings among patients and healthcare professionals. CA’s encounter culture and language barriers that may dissuade or stop them from utilizing health care services accessible to them. CA’s whom do not speak English well or at all, have problems in grasping the health care system In the U.S. and corresponding with healthcare providers. The majority of CA’s feel that healthcare professionals don’t comprehend their culture and its principles. Differences in cultural beliefs on disease also put limitations on people from pursuing proper care. Due to their traditional view on medicine, CA’s often don’t understand the reason to or importance of obtaining care, causing diseases to be diagnosed at later stages producing irreparable damage and an inability to treat certain diseases. Being of low socioeconomic status is a major barrier that stops many CA’s from obtaining health insurance and are often deficient in the required skills, namely language, to attain jobs that provide health insurance. In the same respect, they do not have the financial means to obtain private health insurance or are not a candidate for Medicaid. A large percentage of elder CA’s live in poverty-stricken neighborhoods and possess little or no health insurance at all coupled with inadequate transportation to healthcare facilities. A generation gap is represented by the older generation of immigrants encountering a tougher time trying to familiarize with the Western philosophies than the more recent generation of immigrants.

Health Promotion Activities

Health promotion in Chinese medicine aims to regain the balance between “yin” and “yang” and may be accomplished by practicing acupuncture, acupressure, or moxibustion and women healers may practice fo’fo (massage). Herbal medicine is a mainstay and food and meals are used to reestablish balance with folk healers also being utilized. It is believed that emotions may be articulated through physical symptom within the body. CA’s are frightened by hospitalization and diagnostic tests are not perceived well and may cause distress, particularly if the test is painful. CA’s observe the body as a gift and they may decline any surgical procedures. Because there is a belief in reincarnation, it is thought paramount to die with undamaged bodies.

Health Promotion Prevention

Because Chinese medicine considers the internal and external atmosphere of the body to have an absolute connection with the other, internal disease can be clinically conveyed externally. Consequently, represented by specific irregular variations within the external body, one can assess and hypothesize the effects of the internal disease in the subsequent internal organs.

Primary Prevention

For primary prevention, “CAs have used a hot/cold balance and traditional foods knowledge in their everyday approach to health and wellbeing” (Ho et al., 2018, p. 2203). “Chinese traditional herbal formulations were usually developed by ancestors of TCM, and were based on Chinese medicine theories, including yin and yang, the five elements and meridians” (Lin et al. 2015, p. 1241). They found that foods contain either cooling or warming effects. When you consume cool (yin) foods, they give cooling effects to your body and warm (yang) foods will give warming effects to the body. As a result, “cold” and “hot” foods can be used to restore balance within the body that may have been deficient in yin or yang.

Secondary Prevention

Secondary prevention, in Chinese medicine, specifically screening or diagnosis, is unique and unlike other types of medicine. Diagnosis consists of pulse diagnosis, scent diagnosis, verbal probing diagnosis and observational diagnosis (Chinese Medicine, 2012). Observational diagnosis is considered one of the most effectual methods for diagnosis. “Observational diagnosis consists of: observing the spirit, colour, body form; observing the tongue, facial, five senses and skin; observe what is eliminated from the body or metabolites (some of which is not easily detected, can be obtained through the aid of the patients) etc.” (Chinese Medicine, 2012). Chinese medicine practitioners obtain information through these four types of diagnosis, applying the philosophies of Chinese medicine to examine the cause of symptoms of diseases.

Tertiary Prevention

Tertiary prevention is practiced by illnesses and diseases being treated using the traditional Chinese medicine method of using food as medicine. According to Stephen (n.d.) “hot” illnesses include: infections, fevers, diarrhea, and constipation. These hot illnesses can be treated with “cold” foods: fruits, vegetables, dairy products, and chicken. Some examples of “cold” illnesses are: colds, pneumonia, cancers, stomach cramps and headaches and can be treated with “hot” foods like cheese, eggs, cereal grains, beef, chili peppers, hard liquor and chocolate. Soups are specially prepared and used to cleanse the system and restore health. Chinese favor home cooked meals consisting of vegetables, rice, meats, and seafood, so family members may deliver food to their hospitalized family.

Cultural Beliefs and Model

The Chinese culture believes that health is preserved through an equilibrium between “yin” (cold) and “yang” (hot) energies. A deficiency or absence of “chi” (energy) produces illness. The body is regarded as a gift and requires high esteem cultivated via proper care. The Chinese viewpoint interprets health as the consequence of a balance amid the systems, both interior and exterior to the person. Illness and disease are observed as the result of disharmony or imbalances. This view of health and illness exhibits the broader view which highlights interconnectedness and balance. Chinese medicine is founded upon the religion and beliefs of Taoism. According to Taoism, the universe is a huge and inseparable unit and every being has an ultimate purpose within it. Every being is connected in a chain of harmony. The balance of the two essential powers of yin and yang directs the whole universe including its people and a disharmony in yin and yang yields illness or disease. The clinical model is a straightforward approach and considers health as the absence of signs or symptoms of disease, whereas the existence of signs or symptoms of disease indicate illness and necessitate medical treatment (Falkner, 2018). Health care professionals use the clinical model when the objective of care is alleviation of the patient’s sign and symptoms instead of the eradication of the disease. The clinical model is applicable to the Chinese American culture because they do not seek treatment until acute or serious symptoms arise or even go as far as waiting until emergency intervention is needed.

Chinese philosophies and beliefs powerfully impact the Chinese way of living and perception of health and health care. In order to elicit culturally competent care, nurses should merge information about the patient’s culture with their clinical assessment. The best way to assimilate Chinese values with Western values is by consulting the customary principles while concurrently recognizing an individual’s preferences. The incorporation of Chinese philosophies within healthcare in the U.S. is important to the prospective advancement of nursing research significant to the evolution of culturally competent care for Chinese Americans.

References

Chen, Y.-B., Tong, X.-F., Ren, J., Yu, C.-Q., & Cui, Y.-L. (2019). Current Research Trends in Traditional Chinese Medicine Formula: A Bibliometric Review from 2000 to 2016. Evidence-Based Complementary & Alternative Medicine (ECAM), 1–13. Retrieved from https://doi-org.lopes.idm.oclc.org/10.1155/2019/3961395

Falkner, A. (2018). Health Promotion: Health and Wellness Across the Continuum. Cultural awareness. Retrieved from https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/3

Health status of Asian Americans. (2019, February 22). Retrieved April 10, 2019, from https://en.wikipedia.org/wiki/Health_status_of_Asian_Americans

Ho, E. Y., Acquah, J., Chao, C., Leung, G., Ng, D. C., Chao, M. T., … Jih, J. (2018). Heart healthy integrative nutritional counseling (H2INC): Creating a Chinese medicine + western medicine patient education curriculum for Chinese Americans. Patient Education and Counseling, 101, 2202–2208. Retrieved from https://doi-org.lopes.idm.oclc.org/10.1016/j.pec.2018.08.011

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Ping Ming Health. (2012) Chinese Medicine: Chinese medicine diagnosis: observation. Retrieved from https://www.pingminghealth.com/article/1986/chinese-medicine-diagnoisi-part-i-obervation/

US Census Bureau. (2015, August 28). Decennial Census Reports. Retrieved April 10, 2019, from https://www.census.gov/about/partners/cic/resources/data-links/asian/decennial.html

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