Alarm raised on high diabetes rates among Filipinos in US

SAN FRANCISCO — Seven out of 10 Filipino Americans living in California today are overweight or obese, and many have a much higher rate of diabetes than other populations traditionally thought to be populations at highest risk.

A 2012 Northern California study of over one million adults observed a diabetes rate in Filipinos of 16.1 percent, much higher than rates observed in other Asian ethnic groups, African Americans or Latinos, all often thought to be at highest risk.

These are just some of the health findings unveiled at the 1st Annual National Filipino Health Equity Symposium on chronic diseases that was held at the Philippine Center here April 25.

Diet-related chronic conditions such as obesity, hypertension and diabetes are disproportionately found among Filipinos in the US, according to studies. Diabetes risk, for example, is up to four times higher than among non-Hispanic whites.

New York and San Francisco-based clinical practitioners and experts met with Consulate officials and community leaders to begin a national dialogue on the chronic illnesses facing Filipinos and to help curb these maladies.

The symposium was organized by the National Federation of Filipino American Associations (NaFFAA) with the Philippine Consul General of San Francisco Henry Bensuito Jr., represented by Deputy Consul Jaime Ramon Ascalon.

Raising awareness

An estimated 3.4 million Filipinos live in the US, the second largest Asian ethnic group in America. But little has been accomplished in addressing their public health needs, said experts at the symposium.

“Our goal is to raise awareness of the chronic disease burden of the Fil-Am community,” said Aimee Afable, PhD, MPH, State University of New York (SUNY) Downstate School of Public Health.

Among the steps recommended are to disseminate scientific evidence on the rise of chronic disease among Filipinos and promote the exchange of resources for effective strategies of prevention and management of lifestyle-related chronic diseases.

Rudy Asercion NaFFAA Pacific Region chair, said his group focuses on the youth to help reverse the trends. “We need to start the conversation regarding lifestyle changes, or our kids will have a shorter life span than us.”

Meanwhile, San Francisco City Supervisor Scott Wiener stressed that more young people from the San Francisco Unified School District have Type 2 Diabetes. “The culprit is sugar,” he said, “one 12 oz can of soda is much more than a candy.”

Asercion said NaFFAA will continue its education campaign in 13 other strategic locations in the US with large concentrations of Filipinos, such as Los Angeles, San Diego, New York and Washington DC.

Alarming obesity

Obesity among Filipinos is alarmingly prevalent. Obesity is defined by body mass (weight and height), Afable said. Using the Body Mass Index (BMI) as reference, she pointed to categories between 23-27.4 kg. as overweight, and 27.5 kg. as obese.

Living in the US may influence risk for obesity. The US has the highest rates of obesity compared with higher income countries. In order to balance weight gain and energy,

Afable said, “We need to balance our lives by modifying our lifestyle and managing conditions.”

This was echoed by Charito Sico, MD, medical director of the Center of Excellence in Culturally Competent Care for Filipino Health for Kaiser Permanente, who said, “The latest findings show one in five Americans that have diabetes is a Filipino. One in four has high cholesterol and one in four, high blood pressure.”

Sico reported that Kaiser has a seven-part program (translated in Tagalog) on Filipino health: Community Health and marketing; Heart Healthy Recipes; Health Education Classes; Capturing Race and Ethnicity data in KP Health Connect; Initiating end-of-life conversations; and Face-to-Face Training.

The hospital, for example, held a two-hour class for Filipino Americans in Daly City and South San Francisco (South City) to modify the traditional Filipino diet and teach how to control diabetes through medical management, self-monitoring of blood sugar levels, diet, exercise and managing stress and emotions.

Barriers to care

There are several barriers to diabetes care, said Sico: belief system barriers (fatalism and selflessness); language, limited culturally appropriate resources; westernized approaches to provider-patient dynamics.

Some Filipinos may be working too hard to send money home, or there may not be Tagalog translators available. And a “westernized individualistic approach doesn’t work. We have to include the family where decisions in health care are made as a family,” she said.

Julieta Gabiola, MD, FACP clinical associate professor of medicine educators at Stanford University, noted that while it seems difficult for some Filipinos to stop smoking, control obesity and take up exercise, these are the best ways to prevent hypertension and diabetes.

“Eating is important, but cut back on fat and salt,” she said. “In the Philippines, they pack it up with noodles and rice and not much meat–the food for three meals a day is boiled rice.”

The American Heart Association and the American Diabetes Association recommend 150 minutes of exercise per week, or 30 minutes of brisk walking daily. Samples of physical activity include dancing and even walking while on phone.

Group approach

Another speaker, Rhodora Ursua, MPH, Asian Pacific partners for Empowerment, Advocacy and Leadership (APPEAL), said her group’s culturally tailored outreach to Filipinos encourages a social approach to preventing diabetes. She encouraged Filipinos to promote preventive practices together as social circles, in neighborhoods or workplaces.

A representative from Roche Diagnostics Corp. Diabtes Care, Anne Stokman, RN, MSN, said, “We’re diagnosing too late. “Test your blood sugar,” she urged, “anything beyond 100 is pre-diabetic and preventable, while over 126 is diabetic.”

Lydee Hershey, RN and president-elect of the Philippine Nurses Association of Northern Californica, reiterated the need for a healthier lifestyle for Filipinos. “I encourage you to exercise and diet, cut soda consumption and clean up your pantry.”

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