Boat People S SBoat People S SMeeting urgent needs today, empowering communities for tomorrowMeeting urgent needs today, empowering communities for tomorrow

Health disparities among Vietnamese-American women

Presentation by:

Quynh Nguyen

National Program Manager

Health Awareness and Prevention Program

ObjectiveObjective

This project will target a particularly vulnerable subgroup of This project will target a particularly vulnerable subgroup of Asian Americans: Vietnamese across the country and Asian Americans: Vietnamese across the country and Cambodians and Laotians in the Gulf Coast. This priority Cambodians and Laotians in the Gulf Coast. This priority population, mostly post-Vietnam War refugees, has little population, mostly post-Vietnam War refugees, has little access to health care information and services due to access to health care information and services due to multiple barriers: literacy, language, cultural beliefs and multiple barriers: literacy, language, cultural beliefs and stigma, lack of health insurance, and unfamiliarity with the stigma, lack of health insurance, and unfamiliarity with the US health care system.US health care system.

Boat People SOS, a brief summaryBoat People SOS, a brief summary

Our mission statementOur mission statement Our programsOur programs

Our goals and objectivesOur goals and objectives Our communitiesOur communities

Target PopulationTarget Population

A new community: Formed 31 years agoA new community: Formed 31 years ago The 4 waves:The 4 waves:

10% in 1975: 130,000 evacuees10% in 1975: 130,000 evacuees30% from 1976 to 1985: 300,000 first-wave boat 30% from 1976 to 1985: 300,000 first-wave boat

peoplepeople30% from 1985 to 1995: 300,000 second-wave boat 30% from 1985 to 1995: 300,000 second-wave boat

people people 20% from 1990 – present: Orderly Departure 20% from 1990 – present: Orderly Departure

ProgramProgram- 180,000 HO refugees (trauma survivors and family 180,000 HO refugees (trauma survivors and family

members)members)- 80,000 Amerasians and family members80,000 Amerasians and family members- 20,000 repatriated boat people20,000 repatriated boat people

Vietnamese WomenVietnamese Women

The unequal burden of cancer among The unequal burden of cancer among Asian AmericansAsian Americans

While heart disease is the leading cause of death While heart disease is the leading cause of death for all US groups (all ages), cancer has been the for all US groups (all ages), cancer has been the number one killer of Asian-American women number one killer of Asian-American women since 1980.since 1980.

Cervical cancer has the highest incidence rate in Cervical cancer has the highest incidence rate in Vietnamese women and is five times higher than Vietnamese women and is five times higher than the rate among Caucasian women. With the rate among Caucasian women. With prevalence at 37.5 per 100,000, breast cancer is prevalence at 37.5 per 100,000, breast cancer is the second leading cause of death. the second leading cause of death.

Breast cancer has the second highest incidence Breast cancer has the second highest incidence rate in Vietnamese women.rate in Vietnamese women.

Barriers preventing screeningBarriers preventing screening

(1) (1) Cultural beliefsCultural beliefs: As with many other ethnic : As with many other ethnic populations, Vietnamese refugees and populations, Vietnamese refugees and immigrants have cultural values and beliefs that immigrants have cultural values and beliefs that can have negative connotations regarding can have negative connotations regarding cancer; cancer;

(2) (2) CommunicationsCommunications: Limited English proficiency : Limited English proficiency remains an obstacle for Vietnamese to access the remains an obstacle for Vietnamese to access the health services; health services;

(3) (3) Lack of insurance or underinsuredLack of insurance or underinsured: Other : Other reasons for this low utilization of preventative reasons for this low utilization of preventative services include lack of insurance and low services include lack of insurance and low comprehension of insurance benefits.comprehension of insurance benefits.

What is preventing Vietnamese women What is preventing Vietnamese women from seeking early screening and from seeking early screening and

preventative services?preventative services?

They put their family’s welfare before their ownThey put their family’s welfare before their own Cultural beliefsCultural beliefs ReligionReligion Family’s influences and beliefsFamily’s influences and beliefs Limited English proficiencyLimited English proficiency TransportationTransportation Low level of education/literacyLow level of education/literacy MisconceptionsMisconceptions Fearful of the American health systemFearful of the American health system

They put work and their family’s They put work and their family’s welfare before their ownwelfare before their own

WORK:6-7 days a week9-10 hours a day

Household duties

- Cooking - Cleaning

- Laundries

Tending to the:- Children- Husband

Tending to the:- Parents- In-Laws - Relatives

Fearful of the American Health Fearful of the American Health SystemSystem

No InsuranceNo Insurance Limited English proficiencyLimited English proficiency TransportationTransportation Personal gainsPersonal gains

• Too busyToo busy• Missing workMissing work• Line is too long/a hassleLine is too long/a hassle• No documentationsNo documentations• Uncertainty of approvalUncertainty of approval

A History of MisconceptionsA History of Misconceptions

Cultural BeliefsCultural Beliefs SuperstitiousSuperstitious TabooTaboo KarmaKarma God’s willGod’s will

Family’s InfluenceFamily’s Influence ReligionReligion Family’s reputationFamily’s reputation Spouse/male Spouse/male dominateddominated Health historyHealth history

DependencyDependency

Low level of Low level of

education/literacyeducation/literacy Dependant on man of Dependant on man of

the house to the house to read/writeread/write Limited English Limited English

proficiencyproficiency Take heresy for factsTake heresy for facts TransportationTransportation

Know who they areKnow who they are

Family orientedFamily oriented Very busyVery busy Very easily influenced by their co-workersVery easily influenced by their co-workers Won’t go to the doctor unless there are visible Won’t go to the doctor unless there are visible

signs of illnessessigns of illnesses Believes that prayers will cure them of all illnessesBelieves that prayers will cure them of all illnesses

Our goalsOur goals

Prevention through educationPrevention through education Early detection through screeningsEarly detection through screenings Navigate access to low-costs health careNavigate access to low-costs health care Create a network of support groups through peer Create a network of support groups through peer

and familyand family

Raising Awareness through outreachRaising Awareness through outreach

MediaMedia Mach SongMach Song Radio interviewsRadio interviews VATVVATV

Community eventsCommunity events One-on-one educationOne-on-one education WorkshopsWorkshops Health fairsHealth fairs

Prevention through educationPrevention through education

Regular workshops to remind them the Regular workshops to remind them the importance of early screeningimportance of early screening

Provide one-on-one education with bilingual Provide one-on-one education with bilingual informationinformation

Use the train-the-trainer methodUse the train-the-trainer method Invite guest speakers who are an expertise or Invite guest speakers who are an expertise or

professional in the area of interestprofessional in the area of interest

Early detection through screeningEarly detection through screening

Inform the community at large through mass Inform the community at large through mass media (Mach Song, VATV, etc.)media (Mach Song, VATV, etc.)

Collaborate with local clinics and health care Collaborate with local clinics and health care facilities to provide low-cost screeningsfacilities to provide low-cost screenings

Use survivor stories as examples of early Use survivor stories as examples of early detectiondetection

ContactsContacts Headquarter:Headquarter:

6066 Leesburg Pike, Ste 1006066 Leesburg Pike, Ste 100 Falls Church, Virginia 22041Falls Church, Virginia 22041 Phone: (703) 538-2190Phone: (703) 538-2190

Website: Website: www.bpsos.orgwww.bpsos.org Email: Email: Houston, TX - Houston, TX - Quynh.Nguyen@bpsos.orgQuynh.Nguyen@bpsos.org Springfield, MA – Springfield, MA – Khanh.Nguyen@bpsos.orgKhanh.Nguyen@bpsos.org New Orleans, LA – New Orleans, LA – Tony.Tran@bpsos.orgTony.Tran@bpsos.org Falls Church, VA - Falls Church, VA - Alexia.Dinh@bpsos.orgAlexia.Dinh@bpsos.org Camden, NJ – Camden, NJ – Tracy.Nguyen@bpsos.orgTracy.Nguyen@bpsos.org Atlanta, GA – Atlanta, GA – Trinh.Pham@bpsos.orgTrinh.Pham@bpsos.org

Boat People S SBoat People S SMeeting urgent needs today, empowering communities for tomorrowMeeting urgent needs today, empowering communities for tomorrow