Research studies on health disparities have been conducted on Vietnamese elders since their resettlement in the US the last 40 years. Earlier studies were primarily focused on mental health conditions. However, recent research began to emerge and shows the general Vietnamese population in the United States is more susceptible to chronic illnesses such as cancer, heart disease, strokes, hypertension, and diabetes as compared to other Asian American groups.
A surprising fact is one of the causes of the higher occurrence of these diseases for Vietnamese Americans is due to nutritional deficiencies found in the Vietnamese diet after coming to America. How can this be?
Through the acculturation process, the Vietnamese have consumed more low nutrient foods with high fat content and less nutrient-rich foods such as grains, fruits, and vegetables (Ikeda, 2002). This new lifestyle change is due to adapting to the American work and school schedules. Also, contrary to popular beliefs, not all Vietnamese food is nutrient rich to begin with and this change in diet has made matters worse.
The Vietnamese diet consists of high glucose starches, such as white rice and noodles, and high sodium ingredients such as fish sauce (Nước mắm), which tends to worsen conditions and lead to diabetes and hypertension (Tran et al., 2006). The high risks of cardiac and hypertensive problems are also related to the high rates, 35%-42%, of smoking among Vietnamese men. The minimal awareness and understanding of the prevalence of heart disease and hypertension within the Vietnamese community could possibly lead to the increase of cases of Vietnamese elders with cardiac problems (Pham et al., 1999).
In addition, Cancer is the primary leading cause of death for Vietnamese men and women in the U.S. (Hoyert & Kung, 1997). Vietnamese men have the second highest incidence of lymphoma in the US., and both genders have the highest rate of lung and liver cancer than their Asian counterparts. Vietnamese women have a 2.5 times higher incidence of cervical cancer than any other groups (http://www.aancart.org/).
Aside from physical ailments, traumatic experiences caused by the Vietnam War also contributed to an increase in mental health issues with older Vietnamese refugees and immigrants. About 50% of Vietnamese refugees suffer from high levels of major depression, anxiety, and post-traumatic stress (Hinton et al., 1993) due to years in refugee camps, involuntary transplantation from a familiar cultural setting to a completely unfamiliar cultural setting, and difficulties with acculturating and adapting to Western culture.
Another important aspect to the Vietnamese culture causing our elders to seek less medical attention as compared to their Caucasian counterpart is the beliefs they brought with them from the motherland. These beliefs continue to impede on early recognition of symptoms and therefore delay crucial treatments.
How are these issues being addressed?
Preventative care is actively being promoted to the Vietnamese population in order to improve the health of our elders. According to the Public Health Functions Steering Committee, it’s important to encourage a target population to maintain and adopt healthy behaviors with regular physician checkups, health education about health related issues and services, and through disseminating resources tailored to them (Woodall et al., 2006).
1. The most common sources of health information used by more than 50% of Vietnamese Americans are: Vietnamese newspapers/magazines, Vietnamese/English language television, and Vietnamese radio and family members. (Woodall and Colleagues’ study.)
2. Teaching health behavior modifications including regular exercise, a well-balanced diet, and stress management is also an important component.
3. Regular physician checkup is vital to the well-being of Vietnamese Americans.
To improve the health of the Vietnamese population as we age we need to do more. Here are some areas to consider:
Health care access
Health workers with cultural awareness
Family and community interventions to bridge cultural gaps
Decrease and change cultural health barriers and beliefs
Expand community-based services
Decrease medical coverage barriers
Improve health education targeted at Vietnamese Americans
We encourage health practitioners and organizations to consider the implementation of the above mentioned methods to better serve and help Vietnamese elders and patients in your communities.
World Health Organization (WHO) regarding nutritional statistics and facts for men and women in Vietnam
With her driving passion of health sciences, Jullianne aims to provide service, research, and education towards Asian-American communities in order to close the gap of health disparities that people of color face. She has worked alongside physicians and surgeons in the San Joaquin County as a Decision Medicine Intern, and has worked closely with the Vietnamese-American community in the Bay Area to raise awareness about unspoken diseases as a Community Health Outreach Intern at the Asian Liver Center of Stanford University. As an aspiring Physician Assistant with a concentrated service within the Asian-American community, Jullianne hopes to discuss and expose the unspoken diseases and health issues that do not create dialogue within the Vietnamese household and community.