Health guru talks about what ails FilAms

Dr. Francisco Sy flanked by Rudy Asercion and Ester Asercion of WestBay

SAN FRANCISCO, California—“Do you know that Filipina women even when “balingkinitan” (slim) can still have Type 2 Diabetes?” Was the shocking statement of Dr. Francisco Sy, Director of the Office of Extramural Research Administration, National Institute on Minority Health and Health Disparities. This was just one of the health peculiarities between foreign born and US born minorities as a result of research funded by his office. Dr. Sy was recently in the Bay Area on the invitation of the University of California San Francisco, Asian Health Institute as keynote speaker at their recently held conference on the disparity on Asian health studies.

During a brief interview at the pre-conference dinner, Dr. Sy expressed concern that US born Filipinos have higher incidence of obesity, hypertension and depression compared to the Philippine born cousins. There must be something to the Philippine Tourism slogan that “it’s more fun” in the Philippines. Differing lifestyles of course is the culprit to these diseases. What is common between the two though is both are prone to respiratory diseases (TB) and Hepatitis B.

Disease burden in Filipinos living in the US

• According to 2000-2004 California data, the rate of breast cancer in US born Filipina women exceeded that of White women.
• A 2002 San Diego study revealed that the rate of type 2 diabetes among Filipinas was 4 times higher than that of White women.
• In a 2004-2006 national data, among Asians, Filipinos had the highest rates of overweight and hypertension.
• According to a 2009 report from the California Asian Pacific Islander Joint Legislative Caucus, 80% of Filipino teens and more than 60% of Filipino adults are eating less than the US recommended 5 fruits and vegetables a day.

An NIMHHD study showed that an estimated 1 in 10 Asian Americans in the U.S. is chronically infected with Hepatitis B (HBV) compared to the general US population, with estimates of chronic HBV to about 0.3% to 0.4%. When asked how Hepatitis B is contracted, the good doctor explained that it is acquired either by a contaminated needle, unprotected sex, and for Asians and Pacific Islanders; perinatally from infected mothers (mother to child) or from person-to-person contact in childhood (APIs are infected with HBV earlier in life.)

In light of the fast growth of Asian American immigrants in the nation and the health challenges they poise to healthcare practitioners, the Asian Health Institute, University of California, San Francisco presented its first symposium on the underserved health needs of this emerging communities. The inaugural symposium highlighted the health disparities in this unique group by reviewing five specific areas of disease disproportionately impacting them: cancer, cardiovascular disease, infectious disease, and endocrine diseases, as well as emerging health issues experienced by Asian women. The course gave a comprehensive review of specific diseases impacting Asians mostly within the above areas, which include lung, liver and ovarian cancers, atrial fibrillation, the Brugada Syndrome, strokes, diabetes, thyroid disease, HIV, hepatitis B and C, and infertility and gynecological issues. Special attention was made to dispel the “model minority” myths experienced within this unique cultural context.” Said the conference notes.

Who better to speak on these topics than the multi-awarded Dr. Sy who received his degrees from notable universities: Doctor of Public Health (DrPH) degree in Immunology and Infectious Diseases from Johns Hopkins University; Master of Science in Tropical Public Health from Harvard University; and Doctor of Medicine degree from the University of the Philippines in 1975. Prior to joining NIH in 2004, Dr. Sy served as a Senior Health Scientist at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia. He was also a tenured professor at the University of South Carolina (USC) School of Public Health in Columbia, SC where he taught infectious disease epidemiology for 15 years. Dr. Sy has published a book, several book chapters and scientific articles on various infectious and tropical diseases. He is also the editor of the AIDS Education and Prevention – An Interdisciplinary Journal since its inception in 1988.

Dr. Sy has a long history as team leader in several major programs in the prevention of infectious diseases. He led the Program Evaluation Research Branch in the Division of HIV/AIDS Prevention, National Center for HIV, STD and TB Prevention. In 2003, Dr. Sy participated in the CDC SARS outbreak investigation team. He led the team’s SARS community outreach efforts in Asian American communities. Dissuading the perception that SARS was a Chinese disease. In 2004 he received an award from the Department of Health and Human Services Secretary’s Award for Distinguished Service for his outstanding Community outreach work during the SARS outbreak in 2003; and the 2004 CDC/National Center for Infectious Diseases Honor Award for his outstanding service in the SARS outbreak investigation.

Dr. Diana Lau, Director of the Asian Health Institute at UCSF Medical Center, reiterated the infectiousness of this disease thus AHI, as part of their “Center of Excellence” program is trying to reach out to the greater Asian communities in the Bay Area. Offering free vaccinations and awareness during weekends at Asian cultural or social hubs. They plan to have a mobile clinic sometime soon to be able to reach more people in the greater Bay Area locations. Prevention and awareness are key to stem the spread of this disease, she said.

One Filipino American organization that has received a grant for a medical research study in partnership with UCSF was WestBay Pilipino Multi-Service Center. Rudy Asercion, its executive director said that a $50,000 grant was used to implement the program “Healthy Neighborhoods, Healthy Lives” (HNHL) in 2008. The goal was to engage SOMA (South of Market) youth and families in a critical dialogue about health and reasons for the high chronic disease burden in the Filipino community.

Tips on writing research grants

Dr. Sy encourages universities, organizations and individuals to look to NIMHD’s for grants to study underserved communities such as Asian Americans. His department provides resources and leads in scientific research to improve minority health and eliminate health disparities. To achieve this mission, it plans, reviews, coordinates, and evaluates all minority health and health disparities research and activities at NIH. It also conducts and supports research on minority health and health disparities; promotes and supports the training of a diverse research workforce; translates and disseminates research information, and fosters collaborations and partnerships. Aside from all these, NMHD Extramural Research Programs include loan repayment program; research endowment program, Centers of Excellence Program; Community-Based Participatory Research Program; Investigator-Initiated Research on Health Disparities; Building Research Infrastructure and Capacity; Minority Health and Health Disparities International Research Training Program and lastly, science education initiatives.

The Philippine born Mandarin and Tagalog speaking super-doctor is highly qualified to lead such a tough and serious calling. He has received several accolades in his career including awards in 2005 as Most Distinguished Alumnus Award from the University of the Philippines Alumni Association in America (UPAAA); and in 1990 he received the Outstanding Alumnus Award from the Johns Hopkins University School of Public Health.

His parting words to the august body is for organizations and universities to submit more requests for research grants to study minority groups in an effort to learn more about their health, search for cures, or preventive measures. He also suggested that researchers should start immediate partnership with their target communities and proposed that they include in their proposal the cost of at least three years of pre-study with their participatory community; another five years for the study, and three years more to reach a conclusion and final dissemination of information.

The initiative to reach Asian minority communities is deemed important by the government that there is an Executive Order 13515 known as the White House Initiative on Asian Americans and Pacific Islanders. Chair of the President’s Advisory Commission on Asian Americans and Pacific Islanders is Daphne Kwok. Believe it or not, she is a Chinese Filipino American from Cebu.

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Background of Healthy Neighborhoods, Healthy Lives (Masaganang Purok, Masaganang Pamumuhay) Project – a WestBay Pilipino Multi Service Center Report

Despite its large demographic presence in California, the Filipino population has often been overlooked with regard to its public health needs.  It is well established that lifestyle factors and conditions such as diet, physical activity and overweight are major risk factors for diseases such as hypertension and diabetes.  Unfortunately, Filipinos fair poorly relative to other ethnic populations with regard to many of these factors.  For example, according to a report from the California Asian Pacific Islander Joint Legislative Caucus, more than 1 in 3 Filipinos are overweight and among Asians, Filipinos have the highest proportion (46%) of overweight or obese adults.

Guided by the principles of community-based participatory research (CBPR), HNHL empowers SOMA Filipino youth with two powerful forms of media:  photovoice and film.  Both methods give youth a means to explore the health concerns related to overweight and chronic disease in their community with the hope of encouraging critical dialogue among its audience and community members and creating opportunities for community-led solutions.

Healthy Neighborhoods, Healthy Lives Short Film

Created, directed and filmed by West Bay youth with the guidance of Benito Bautista, nationally-acclaimed independent film director and alumnus of West Bay, this short film chronicled the experiences of SOMA’s Filipino youth in the Healthy Neighborhoods, Healthy Lives project.  Through interviews with community members and health experts, the film documented the public health issues confronting their community in their own voices.