Diabetes: A Silent Killer of Asian Americans

diabetes

Last month marked National Diabetes Awareness Month, yet diabetes remains one of those diseases that remains largely misunderstood by the population at large.

Diabetes refers to a loss of the body’s ability to regulate blood glucose levels by reduced (or absent) activity of a hormone called insulin, which normally helps the body cope with the complex sugars we intake and convert into energy. Too much or too little glucose in the body can produce catastrophic effects on health, and can even be fatal; thus patients with diabetes require close monitoring of their blood glucose levels. Type I diabetics (diagnosed in children) suffer from an inability to make insulin and must inject insulin multiple times a day to keep their blood glucose levels within normal ranges, while Type II diabetics develop an insensitivity to their naturally produced insulin, which can become progressively worse as they age. 

Interestingly, it appears as if Asian Americans (and African Americans) have increased risks for diabetes compared to other racial populations. One study, conducted in 2004, found that Asian Americans with a given body mass index (BMI) had a higher prevalence of diabetes than non-Asians at the same BMI, suggesting that the standard cut-offs of BMI that are used to determine increased risks for disease may be ignoring racial differences in how body-fat is distributed and contributes to disease. Dr Sophia Cheung, with the Joslin Diabetes Center, describes the problem thusly:

According to Cheung, important studies that look at prevention and treatment for people with type 2 diabetes use Caucasian patients primarily. “Due to differences in body size, physiology and cultural differences between Asians and Caucasians, results may not be applicable to Asians,” she states. A classic example of this, she says, is the body mass index (BMI). “At a lower BMI, Asians tend to accumulate more body fat compared to Caucasians,” which she says underscores the need for different BMI thresholds for Asian American patients.

In addition, 7.5% of Asian Americans are diagnosed with diabetes, compared to 6.4% of total Americans, and diabetes is the fifth leading cause of death for Asian Americans, while it is seventh for all Americans. The prognosis is particularly grim for Pacific Islanders, who have about a 13% prevalence for diabetes. This higher incidence of diabetes is associated with higher risk for end-stage renal disease, although it hasn’t been linked to higher risks of other health complications.

Recently, another study revealed that Chinese- and Korean-American women are also at increased risk for developing gestational diabetes, a special form of diabetes that afflicts pregnant mothers that can produce complications for both mother and child. Unique compared to other Asian ethnicties, Korean- and Chinese-American women have about a 10% risk for gestational diabetes, compared to 6.7% in the pregnant female population at large.

The problem with understanding racial and ethnic factors associated with disease is frequently that the data collected remains inadequte to fully understand all the issues. Few studies are able to provide the kind of detail needed to fully understand how certain diseases impact communities like ours. Writing about their gestational diabetes study, Dr. Teresa Hillier said:

“Many previous studies have lumped all Asians and Pacific Islanders together,” study co-author Teresa Hillier said in a statement. “We now know that the risk for developing [gestational diabetes] varies greatly depending on your specific ethnic background. Future studies should also look at whether women in these higher risk groups also have more complications.”

Nonetheless, these increased risk factors underscore the importance of healthcare reform, which will help all Americans — including Asian Americans — prevent and treat their diabetes. Recently, Health and Human Services Secretary Kathleen Sebelius released a report detailing the cost of diabetes and how healthcare reform will help diabetic Americans:

One in six individuals with diabetes report avoiding or delaying needed medical care because of cost. Annual health care expenses for a diabetic topped $11,477 in 2007. A box of 100 test strips for blood sugar monitors can cost up to $60 while the price of a vial of insulin can range from $30 to $70, mainly because generic brands are not manufactured in the United States.

A study showed that 80 percent of people with diabetes went uninsured after having lost coverage due to health insurance
transitions triggered by job change or layoff, a move, divorce, graduation from college, or a change in income or health status.

If all states improved diabetes control to the level of the top four best performing states, at least 39,000 fewer patients would
have been admitted for uncontrolled diabetes in 2004, potentially saving $216.7 million.

Sadly, the prognosis and quality of post-diagnostic care following diagnosis of diabetes is dependent upon insurance status, and many insurance companies refuse to cover people pre-diagnosed with diabetes. And it turns out that while Asian Americans, on average, enjoy higher annual incomes than the total American population, we are still woefully underinsured as a population. The Office of Minority Health notes that only 83.9% of Asian Americans have health insurance, compared to 89% of White Americans. Moreover, the Asian American population, insurance coverage varies widely by ethnicity, with more than 13% of Vietnamese (for example) uninsured.

It’s tempting to, as a community, stick our heads into the sand about issues like health and disease, particularly when we are not confronted on a daily basis with the statistics that show that Asian Americans should care about something like diabetes. After all, diabetes affects all Americans, so it’s not a problem we should specifically make a stink about, right? Sadly, no, diabetes, like several other diseases, is of particular concern to racial minorities like Asian Americans, and yet we spend comparatively little time sponsoring private studies, or petitioning for federal studies, to help shed light on these health risks. These diseases are the silent killers in our community, and we must do more to bring the facts about these illnesses out into the open.

Act Now! I know I missed National Diabetes Awareness Month by about two weeks, but it’s not like there’s a bad time to let your Asian American friends know about the risk factors they face associated with Type II diabetes. Send this podcast, released by the CDC, to your friends and family about the risk factors for diabetes amongst Asian Americans, and what one can do to help prevent the development of Type II diabetes, in particular. The Joslin Diabetes Center, at Harvard University, has also developed a Chinese-English bilingual site to help support Asian Americans with diabetes.

Also, you can donate to the following foundations to help support diabetes research:

How to Otherize your friends for Christmas!

racist-nyt-gift-feature

(Hat-tip: Gawker)

So, let’s say you’ve got to buy Christmas presents for a friend of yours, but you just don’t know what to get her. A gift certificate from the local steakhouse? The latest 50 Cent CD? A gag gift from Toys ‘R Us? A new crockpot?

But what a minute! Your friend is Latina! Surely, that’s a hook to get her the perfect Christmas present! But, gosh, you just don’t know anything about Latina heritage. Well, New York Times has the perfect gift suggestions for you: how about a children’s book on Sonia Sotomayor? How about Iman’s book of beauty tips for women of colour? And, of course, there’s always a “Wise Latina” t-shirt! (Because apparently the hot thing for Latinas this year are Sotomayor-related products.)

And what if you’re buying me a present? Well, clearly, because I’m Asian American, I simply must have a copy of “Asian Faces“, a book that tells Asian women how we’re applying our eye makeup wrong, and how to do it right.

The New York Times isn’t exactly known for its racial sensitivity, but what moron green-lit this racist stereotype-perpetuating gift suggestion feature?

The assumption made here is that people of colour somehow need “race-related” presents, because our race is the be-all and end-all of our identities (and Christmas gift wishes). Not only that, but NYT readeres are encouraged to typecast their friends of colour to find “race appropriate” gifts — so, the friend is no longer just a friend, she’s “the Asian friend” or “the Latina friend” or “the Black friend”, and gifts should be bought reflecting your brand-spanking new racial categorization. Meanwhile, your White friends don’t need to be Otherized, since obviously they don’t have racial identities to contend with, so you can get them meaningful and non-offensive presents!

(Which makes me wonder what you do if you have mixed race friends? Do they just get multiple racist gifts? Or do you just pick the gift most in-keeping with the race you think they look the most like?)

And even if we, just for a second, accept the racist notion that we should be buying gifts based on our friends’ races and ethnicities, why would we buy these stereotype-inspired gifts? How racist is it to suggest that African-American women should receive haircare products specifically geared towards “problem hair” or Carribean cruises featuring a gospel choir (because Black women hate their hair but love some gospel music), while Indian women want nothing more than multi-coloured head-scarves (or coffee-table books celebrating multi-coloured head scarves)? Oh, and, what about the nail polish with benefits going to the people of Haiti — because both your friend and Haitians are people of colour, so somehow there’s a logical Christmas gift-giving connection?

And don’t even get me started on the “Baby Jamz” gift idea: because Black women love hip hop and have lots of babies, so clearly they need a gift that blends the two, right?

Then again, maybe the NYT is on to something. Perhaps this year, I will also give my friends race-inspired presents. In fact, right now, I’m on my way to go buy my Asian friends kimonos, bonsai trees, and pearl-inlaid chopsticks. My Latino friends? Clearly a set of antique maracas and a matching sombrero are the way to go. My Indian friend shall receive a henna kit, a book on yoga, and some bags of incense, and (since I’m an equal opportunity bigot) all of my White friends are getting gift boxes of cheese and coolers full of cheap beer, all the better to tailgate with. And electroman? Well, since he’s Black, he’s in for a special treat: the complete Tyler Perry DVD library collection, including full seasons of “Meet the Browns” and “House of Payne”. Oh, and while I’m at it, all my gay friends will receive adult sex toys, and all my friends over the age of forty will receive tennis balls and denture adhesive.

Sound like a great Christmas? Yeah, I didn’t think so either.

Kate Gosselin wanted China Doll children

kategosselin

Speaking of Jon Gosselin, I stumbled upon this article while researching Jon Gosselin’s ethnicity that described an old episode  of “Jon and Kate Plus Eight” where Kate Gosselin discusses the appearance of her mixed race children. Talk about just plain wrong! Kate not only describes her children as “little China dolls” because they appear (to whom, exactly?) part Asian, but she also wishes that she, herself, were Asian in appearance, presumably because Asian features are attractive to her.

In this particular episode of Jon & Kate Plus 8, Kate was reading e-mails from fans, and one of the fans asked how she felt about the fact that all the kids looked Korean. …

Kate explained that she has always wanted her kids to “look like Jon.” She talked about having daughters who looked like “little China dolls.” She said she wished she herself were Korean. But what Kate doesn’t realize is that the children, at least some of them, have also inherited her looks as well. In a previous article of mine, I explain how Kate has a nearly flawless face.

Ew. Just ew.

With Kate Gosselin’s apparent Asiaphilia over her own children, I’ve gotta wonder what will happen to the Gosselin kids’ racial self-identity and awareness, now that Kate is rumoured to be starrin solo in the spin-off show of “Jon and Kate Plus Eight”. Will Kate Gosselin give these kids a healthy relationship to their Korean ancestry, or is she gonna instill in these kids the same “little China Doll” outlook on their race and ethnicity that she see, herself, sees in their genetics?

Asians Behaving Badly: Jon Gosselin

jon gosselin

Showbiz Tonight, a celebrity tabloid show, has awarded Jon Gosselin, ex-star of TLC’s “Jon and Kate Plus Eight” with the dubious honour of being 2009’s “Most Provocative” celebrity.

Gosselin, who is half-Korean, is notable for the many embarassing news stories that emerged about his personal life following his split with than-wife Kate Gosselin over the summer. Gosselin went from one of the few (perhaps the only?) examples of a nurturing and loving Asian American father on national television, to typecasting himself as an overgrown frat boy, partying heartily into the wee hours at famous clubs around the world. Gosselin also became known as an excessive flirt, and was romantically linked to several women all of whom were nearly ten years his junior.

It was announced in June that Jon and his wife Kate would be separating following rumors of strife in their marriage. The June 22 show, on which the pair announced they were separating, drew 10.6 million viewers — record ratings for its network, TLC.

Jon dominated tabloid news coverage over the summer with his bad boy behavior, dating a string of younger women and being photographed in New York nightclubs.

But what really put Jon Gosselin over the top, according to “Showbiz Tonight,” was not just his ability to remain in the news, but also his willingness to tell all, including a series of eyebrow-raising answers to questions about his separation and impending divorce and his new relationship with girlfriend Hailey Glassman.

Gosselin told ABC’s Chris Cuomo that he “despised” his estranged wife Kate and described in graphic detail how he felt about Glassman, who he had only been dating for a few months.

“Love her,” Gosselin told Cuomo. “Huge word. It’s like when you look at her my heart pounds. I get sweaty. I feel like I love her more.”

It’s not too often we see a person of colour run the gamut from one stereotypical extreme to another. While I saw pre-divorce Jon Gosselin as a well-adjusted, well-meaning father and a good role model for other Asian American men, it was certainly conceivable to criticize early depictions of Gosselin as emasculated by the stronger personality of Kate Gosselin. But, from this one extreme, Jon Gosselin managed to a complete 180 in a matter of months, and spent much of 2009 perpetuating the stereotype of Asian American men as hypersexualized and irresponsible.

In both cases, Gosselin seems to enjoy playing the role of a dehumanized stereotype — and it’s hard to tell how much of the stereotype is due to media bias, and how much is due to Gosselin’s own bad behaviour.

Sarah Palin – A Minority Thing

sarah-palin

Sarah Palin’s got no shortage of embarassing moments in her personal history. From an unflattering, and much lampooned, interview with Katie Couric to being taped by reporters giving statements in front of a graphic turkey slaughter, Palin is a textbook example of “Politics 101: What Not to Do If You Want to Stay Relevant”.

If Palin is gearing up for 2012, she’s gearing up to run for dogcatcher.

But, in what appears to be an effort to keep her name in headlines, Palin released a memoir earlier last month, titled “Going Rogue“. In it, Palin casts herself as an “of-the-people” politician, mishandled by Washington “insider” (a term that Palin finds most damning) political advisors in the McCain campaign. She attempts to address the many embarassments of her 2008 candidacy as McCain’s vice presidential pick. Although the book has been hyped as a vanity project-turned-appeal to voters, Palin has created quite a splash (and caused much head-scratching) by extending her book tour only to strongly sympathetic cities she won over during the 2008 campaign season, and by refusing to allow mainstream media outlets to cover her book tour lectures.

But this week, Palin’s “Going Rogue” has raised even more eyebrows.

Palin recounts in her book how she ventured out of Alaska while attending college. Her first undergraduate institution (of four) was at Hawaii Pacific University, which she attended in the fall of 1982, but quickly left the university to continue her undergraduate education at North Idaho University.

In “Going Rogue”, Palin describes her decision to move away from Hawaii thusly: “Hawaii was a little too perfect… Perpetual sunshine isn’t necessarily conducive to serious academics for eighteen-year-old Alaska girls.”

But Palin’s father paints a far different picture. In an interview given to reporters compiling information for a book titled “Sarah from Alaska”, Palin’s father Chuck Heath, says Palin was made uncomfortable by the high number of Asian Americans in Hawaii. He is quoted as describing the problem as “a minority type thing and it wasn’t glamorous, so she came home.” 

Hold up. What?

Asian Americans, including descendents both of indigenous Hawaiians as well as Chinese, Japanese, Filipino and Korean immigrants during the late nineteenth century, make up more than 40% of Hawaii’s population, making Hawaii home to one of the most populous concentrations of Asian Americans in the United States. Without a doubt, Asian Americans are the numerical majority in Hawaii, and Whites, comprising about 27% of the population, are the minority.

It’s tempting to conclude that Palin’s discomfort with the “minority thing” in Hawaii was due to anti-Asian bias; after all, the quote reads as if Palin couldn’t handle being so close to so many Asian people, as if black hair and mocha skin made her nauseous. And the whole thing rings of the kind of “Yellow Peril” stereotype that grips far too many.

But, I tend to think the problem was “race shock”. Palin grew up in Alaska, where nearly 70% of the state is made up of Whites. She was undoubtedly a member of the racial majority, and probably thought of race issues as the kind of thing only ”outsiders” had to worry about. Stepping foot in Hawaii was not just an exposure to the fact that there are, indeed, different kinds of people in the world, but suddenly Palin had to reconcile herself with the notion that she wasn’t part of the racial majority, or the ”norm”, anymore.

Being a minority isn’t easy; those of us who live our lives every day as part of a racial identity that is a numerical minority in our city or town know all too well the curious looks, the racist assumptions, and the sense of “Otherness” that comes with waking up in our skin.

Palin experienced that feeling for the first time when she was eighteen years old. And, like so many other majority-turned-minority, she ran as far away from that place as she could. In her very own example of hysterical White Flight, Palin packed her bags for one of the Whitest states in the Union: Idaho.

Well, we can say one thing about Palin: when she puts her mind to something, she sure commits. Idaho’s White population made up nearly 97% of the state in 2005.

The problem here isn’t that Palin hates or fears Asians, it’s that she ran scared from the experience of being a racial minority in Hawaii. For a woman who, by all accounts, covets the Oval Office, she demonstrates in this moment in her personal history her lack of readiness to lead a nation wherein racial “minorities” will overtake the number of Whites within the next thirty years. How will Palin fare if the entire country starts looking a little more like Hawaii by the time she’s president? Will she able to handle calling D.C. her home for four years while African Americans still outnumber Whites there by 54% to 40%? Or will Palin turn tail and run back to the suburbs of the Midwest, where she no longer has to face the “discomforts” of race relations?

And above all, Palin has painted herself as a politician of the people. Her schtick is all about her hockey mom persona, and she hopes to rekindle the sense of familiarity and down-to-earth homey-ness invoked by George W. Bush during his 2000 campaign. Yet, how does she plan to make friends with voters across the nation when she has demonstrated fear and discomfort with racial difference? Nearly one third of all voters aren’t White!

Palin values her status as a Washington “outsider”, yet it seems that, in at least one opportunity, she couldn’t handle “outsider” status. Instead, in the height of hypocrisy, she did what she has criticized her political opponents for doing ad nauseum: she sought soothing comfort in the familiarity of being an “insider”.

But then, what does that say about the rest of us “outsiders” who haven’t moved to our iterations of Idaho?