>>WELCOME TO THE SECOND ANNUAL
NIH ASIAN AMERICAN NATIVE
HAWAIIAN PACIFIC ISLANDER HEALTH
RESEARCH CONFERENCE.
THIS EVENT IS SPONSORED BY THE
NATIONAL CANCER INSTITUTE HOST
THE NIH ASIAN AMERICAN NATIVE
HAWAIIAN PACIFIC ISLANDER
SCIENTIFIC AND INTEREST GROUP.
THIS CONFERENCE IS RECORDED AND
OPEN TO THE PUBLIC.
MY NAME IS DAN XI THE PROGRAM
DIRECTOR OF NCI THE CHAIR OF
THIS CONFERENCE TOGETHER WITH MY
COLLEAGUES FROM THE NIH AND HHS
WE PUT TOGETHER TODAY'S
IMPORTANT EVENT TO COMMEMORATE
MAY HERITAGE MONTH TO RECOGNIZE
THE HISTORY AND TO CELEBRATE THE
CONTRIBUTION OF AANHPI TO OUR
NATION.
THIS CONFERENCE BRINGS TOGETHER
THE WORLD'S LEADING SCIENTIFIC
EXPERT IN THE FIELD OF AANHPI
RESEARCH FROM GOVERNMENT,
ACADEMIA AND THE COMMUNITY.
THE PURPOSE OF THIS CONFERENCE
ARE TO CELEBRATE AND EDUCATE THE
HERITAGE.
TO HIGHLIGHT ACHIEVEMENT IN THE
AANHPI HEALTH RESEARCH AND ALL
AANHPI SCIENTISTS TO DISCUSS HOW
RESEARCH THEME.
THE THEME IS IMPROVING THE
HEALTH OF AANHPI.
WE SUSPECT GENETIC ANCESTRY AND
DISEASE MECHANISM.
EARLIER THIS YEAR, WHITE HOUSE
ESTABLISHED THE FIRST EVER
NATIONAL STRATEGY TO ADVANCE THE
EQUITY, JUSTICE AND OPPORTUNITY
FOR THE AANHPI COMMUNITY.
NIH AANHPI INTEREST GROUP
INITIATED A PROJECT WAS SELECTED
AS ONE OF THE FIVE HHS PRIOR TIS
INCLUDED IN THE NATIONAL
STRATEGY.
NIH AANHPI INTEREST GROUP
ESTABLISHED IN 2021.
IN LESS THAN TWO YEARS HAS MADE
EXTRAORDINARY EFFORT IN
ADVANCING NIH MISSION OF
IMPROVING THE HEALTH FOR AANHPI
TOWARDS THE NATIONAL LEVEL.
IN 2021 U.S. REPRESENTATIVES
JUDY CHU INTRODUCED THE FIRST
CONGRESSIONAL RESOLUTION TO
RECOGNIZE MAY 10 AS ASIAN
AMERICAN NATIVE HAWAIIAN PACIFIC
ISLANDER MENTAL HEALTH DAY.
WE ARE THRILLED TO ANNOUNCE THAT
THE NIH AANHPI INTEREST GROUP IS
ESTABLISHED AND U.S. RESPONSE
JUDY CHU AANHPI MENTAL HEALTH
LECTURE.
WE ARE VERY HONORED TO HAVE
PRE-RECORDED REMARKS FROM
REPRESENTATIVE JUDY CHU AND THE
WHITE HOUSE AND TWO KEY NOTE
SPEAKERS.
WILL PROVIDE THEIR PERSPECTIVE
ON THE HEALTH DISPARITY AND BIAS
AND RACISM IN SOME WORKPLACE
FACING AANHPI POPULATIONS.
THE RESEARCH TALKS AND FOUR
SCIENTIFIC SESSIONS WILL
CONTINUE TO PROVIDE THE INPUTS
FOR THE IMPLEMENTING THE
NATIONAL STRATEGY AND HHS FUND
TO CELEBRATE THE 80th
ANNIVERSARY OF MEDICINE AND
THERE WILL BE AN EDUCATION TALK
TOMORROW.
WE WILL NOT TAKE QUESTIONS IN
THE MORNING SESSION BUT WELCOME
COMMENTS IN THE CHAT BOX.
WITHOUT FURTHER ADO, LET ME TURN
IT OVER TO THE NCI STAFF TO PLAY
THE RECORDINGS AND KICK OFF THE
CONFERENCE.
THANK YOU AND ENJOY.
>>HELLO, EVERYONE ON BEHALF OF
EVERYONE THE PRESIDENT AND THE
WHITE HOUSE AND HAPPY ASIAN
AMERICAN NATIVE HAWAIIAN PACIFIC
ISLANDER MONTH.
>>I'M SENIOR ADVISER TO THE
PRESIDENT AND WHITE HOUSE STAFF
SECRETARY.
SINCE THE FIRST DAY IN OFFICE,
PRESIDENT BIDEN MADE CLEAR IT IS
A PRIORITY OF HIS ADMINISTRATION
TO ADVANCE EQUITY FOR UNDER
SERVED COMMUNITIES INCLUDING
ASIAN AMERICAN NATIVE HAWAIIAN
PACIFIC ISLANDERS.
THE BIDEN-HARRIS ADMINISTRATION
HAS BEEN DELIVERING ON HIS
PROMISE AND IMPROVING THE LIVES
OF EVERYONE IN OUR COUNTRY AND
COMMUNITY.
THE ECONOMY IS STRONG WITH WAGES
GOING UP AND PRICES GOING DOWN.
THE PRESIDENT'S BUDGET DETAILS A
ROAD MAP TO BUILD ON THE
HISTORIC PROGRESS OVER THE LAST
TWO YEARS AND FINISH THE JOB.
COMBINED WITH THE HISTORIC
PASSAGE OF THE INFLATION
REDUCTION ACT, THE LOWER COST
FOR ASIAN AMERICAN NATIVE
HAWAIIAN PACIFIC ISLANDER
FAMILIES AND FOR HEALTH
INSURANCE, CHILDCARE,
PRESCRIPTION DRUGS, HOUSING,
COLLEGE, ENERGY AND MORE.
AND THANKS TO PRESIDENT BIDEN
WE'VE BECOME MORE VISIBLE
TOGETHER THAN EVER BEFORE.
WE HAVE THE MOST DIVERSE
GOVERNMENT IN U.S. HISTORY WITH
AN UNPRECEDENTED AANHPI
REPRESENTATION IN THE
ADMINISTRATION INCLUDING OUR
VERY OWN VICE PRESIDENT KAMALA
HARRIS THE FIRST SOUTH ASIAN
AMERICAN TO SERVE IN THE SECOND
HIGHEST OFFICE IN THE NATION.
CURRENTLY, 14% OF OUR POINTES
AND NOMINEES IDENTIFY AS AANHPI.
THIS IS A RECORD WORTH
CELEBRATING AND ADVANCING AND
FORTUNATE TO HAVE A PRESIDENT
WHO HAS OUR BACK AND UNDERSTANDS
OUR COMMUNITY AND SEES US, HEARS
US AND VALUES US.
>>ALOHA.
I'M INDEED HONORED TO SERVE AS
DEPUTY ASSISTANT TO THE
PRESIDENT AND FIRST EVER ASIAN
AMERICAN NATIVE HAWAIIAN PACIFIC
ISLANDER SENIOR LIAISON AT THE
WHITE HOUSE.
THIS IS A ROLE THE PRESIDENT
CREATED TO BE REPRESENTATIVE TO
THE COMMUNITIES.
OVER THE PAST TWO YEARS FROM
HONOLULU, ALBUQUERQUE, PHOENIX
TO ATLANTA WE WITNESS THE IMPACT
OF THE PRESIDENT'S AGENDA AS
WELL AS THE TREMENDOUS STRENGTH
AND RESILIENCE OF OUR COMMUNITY.
THE PRESIDENT IS WORKING TO HELP
OUR COMMUNITY RISE ABOVE OUR
TRAUMA FROM THE RACISM AND
VIOLENCE THAT SPIKED DURING THE
PANDEMIC.
THANKS TO THE COVID-19 HATE
CRIMES ACT THE DEPARTMENT OF
JUSTICE DESIGNATED THE FIRST
ANTI-HATE RESOURCES COORDINATOR
AS WELL AS THE FIRST EVER
FULL-TIME LANGUAGE ACCESS
COORDINATOR.
THE PRESIDENT WENT TO MONTEREY
PARK, CALIFORNIA TO GRIEF WITH
THE COMMUNITY SHAKEN BY THE
MURDERS IN JANUARY AND ANNOUNCED
EXECUTIVE ACTION TO REDUCE GUN
VIOLENCE IN OUR COUNTRY.
NOW, BOTH THE PRESIDENT AND VICE
PRESIDENT HAVE MET WITH THE
FAMILIES OF THE VICTIMS AND
DEMONSTRATED WITH THEIR WORDS
AND THEIR ACTIONS AND THEIR
PRESENCE HOW MUCH THEY SINCERELY
CARE FOR OUR COMMUNITY.
AND HOW MUCH HOPE THEY HAVE FOR
OUR FUTURE.
WE BELIEVE THAT TOGETHER WE'LL
BE STRONGER AND MORE VISIBLE AS
A COMMUNITY AND AS A COUNTRY.
>>THANK YOU, ERICA.
I'M PHILLIP KIN AND PROUD TO
SERVE IN THE BIDEN-HARRIS
ADMINISTRATION AS SENIOR
ADVISER.
I AM MOVED IN REMINDED EVERY DAY
OF THE BEAUTY OF OUR DIVERSE
COMMUNITY AND THE UNPRECEDENTED
WAYS THE ADMINISTRATION HAS SEEN
AND UPLIFTED US.
YOU'LL SEE IN THE HERITAGE MONTH
PROCLAMATION HOW HE AND FIRST
LADY DR. BIDEN HOSTED A
RECEPTION THROUGH LINE DANCES
AND DUMPLINGS AND HELD SPACE TO
SHOW TRAGEDY DOESN'T DEFINE US
AND WE'RE STRONGER TOGETHER AND
HAVE INVESTED TO SUPPORT OUR
AANHPI COMMUNITIES PROVIDING
DIRECT RELIEF, STRENGTHENING
MENTAL HEALTH AND EXPANDING
ECONOMIC OPPORTUNITY ALL THROUGH
THE AMERICAN RESCUE PLAN,
BIPARTISAN INFRASTRUCTURE LAW
AND OTHER INITIATIVES.
THE WORK ISN'T FINISHED.
AS THE PRESIDENT SAID DURING THE
STATE OF THE UNION WE'RE DOING
ALL WE CAN TO FINISH THE JOB.
WE DON'T DO THIS ALONE BUT
THROUGH COALITIONS INSIDE AND
OUTSIDE THE AANHPI COMMUNITY
WITHIN AND OUTSIDE THE FEDERAL
GOVERNMENT AND MOST OF ALL WITH
YOU.
SO THANK YOU FOR ALL THAT YOU DO
IN PARTNERSHIP WITH THIS
ADMINISTRATION TO ENSURE WE'RE
VISIBLE TOGETHER.
>>I'M HONORED TO SERVE AS THE
EXECUTIVE DIRECTOR OF THE WHITE
HOUSE INITIATIVE AND PRESIDENT'S
ADVISORY COMMISSION ON ASIAN
AMERICAN NATIVE HAWAIIAN PACIFIC
ISLANDERS.
PRESIDENT BIDEN REINVIGORATED
BOTH ENTITIES IN MAY OF 2021 AND
CO-CHAIRED BY HEALTH AND HUMAN
SERVICES SECRETARY XAVIER
BECERRA AND KATHERINE TY.
THE WHITE HOUSE HAS RESPONDED TO
THE NEEDS OF OUR COMMUNITIES
DURING TIMES OF BOTH JOY AND
TRAGEDY.
AMONG OUR PRIORITY HAVE BEEN
EFFORTS TO ADDRESS ANTI-ASIAN
HATE, PRIORITIZE DATA DIS
DISAGGREGATION AND WE'LL ADVANCE
EQUITY AND JUSTICE AND
OPPORTUNITY FOR AANHPI
COMMUNITIES THAT DETAILS OUR
WHOLE OF GOVERNMENT APPROACH TO
ADDRESS BARRIERS IMPACTING OUR
COMMUNITIES INCLUDING EFFORTS TO
IMPROVE INTER-AGENCY POLICY
MAKING, PROGRAM DEVELOPMENT AND
OUTREACH.
WE'VE ALSO BEEN BUSY TRAVELLING
ACROSS THE COUNTRY TO MEET
THROUGH ANY OF YOU THROUGH OUR
ECONOMIC SUMMITS AND OTHER
ENGAGEMENTS TO CONNECT
COMMUNITIES WITH FEDERAL
RESOURCE.
WE'RE GRATEFUL TO BE PART OF A
WHITE HOUSE THAT WORKS SO HARD
TO EMPOWER AANHPIS AND DELIVER
ON THE PROMISES MADE BY THE
PRESIDENT.
WE LOOK FORWARD TO SEEING YOU ON
THE ROAD AND BE VISIBLE
TOGETHER.
>>ONCE AGAIN ON BEHALF OF
PRESIDENT BIDEN AND THE
ADMINISTRATION.
>>WE WISH EVERYONE A WONDERFUL
ASIAN AMERICAN NATIVE HAWAIIAN
PACIFIC ISLANDER MONTH.
>>SIGN UP FOR STAKEHOLDER
CALLS.
>>AND SIGN UP FOR NEWSLETTERS.
>>THANK YOU.
HELLO, I'M CONGRESS MEMBER JUDY
CHU FROM CALIFORNIA'S 28th
DISTRICT AND CHAIR OF THE ASIAN
AMERICAN CAUCUS.
I'M THRILLED TO JOIN YOU FOR THE
NATIONAL INSTITUTES OF HEALTH'S
ASIAN AMERICAN NATIVE HAWAIIAN
PACIFIC ISLANDER HEALTH
SCIENTIFIC INTEREST GROUP'S
SECOND ANNUAL CONFERENCE.
I'M SO INCREDIBLY HONORED TO
HAVE THE LECTURE SERIES NAMED
AFTER ME.
I AM STUNNED TO BE ABLE TO GET
SUCH AN HONOR FROM SUCH A
PRESTIGIOUS GROUP LIKE YOURS.
IT IS WONDERFUL TO GET IT AT
THIS YEAR'S CONFERENCE WHICH IS
AN EXCITING OPPORTUNITY FOR
ASIAN AMERICAN NATIVE HAWAIIAN
AND PACIFIC ISLANDERS TO COME
TOGETHER AND DISCUSS THE LATEST
IN HEALTH RESEARCH AND CELEBRATE
OUR ACHIEVEMENTS AND CULTURES
DURING THIS MONTH.
AS THE FIRST CHINESE AMERICAN
WOMAN ELECTED TO CONGRESS THIS
HELPS UPLIFT OUR ACCOMPLISHMENTS
AND CONTINUE TO BREAK DOWN
BARRIERS IN THE PRESENT ARE
CLOSE TO MY HEART.
AS CHAIR OF THIS CHAMPIONING THE
INTEREST OF ASIAN AMERICAN
NATIVE HAWAIIAN PACIFIC
ISLANDERS IN THE HAULS OF
CONGRESS HAS NEVER BEEN MORE
PARAMOUNT.
BECAUSE OUR COMMUNITIES HAVE A
SEAT AT THE TABLE WE
SUCCESSFULLY PASSED BILLS LAST
CONGRESS LIKE THE COVID-19 HATE
CRIMES ACT AND THE BILL CREATING
A COMMISSION TO STUDY THE
CREATION OF A NATIONAL MUSEUM OF
AANHPI HISTORY AND CULTURE.
I'M PROUD PRESIDENT BIDEN SIGNED
BOTH PIECES OF LEGISLATION INTO
LAW.
IT'S SO CRITICAL TO RESEARCH AND
IMPROVE ON HEALTH EQUITY AND
WELLNESS FOR OUR COMMUNITIES
BOTH PHYSICAL AND MENTAL
ESPECIALLY AS WE CONTINUE TO
RECOVER FROM BOTH THE COVID-19
PANDEMIC AND THE SCOURGE OF
ANTI-ASIAN HATE.
AS A FORMER PSYCHOLOGY
PROFESSOR, I'M ACUTELY AWARE
WHEN IT COMES TO MENTAL HEALTH
AANHPIs ESPECIALLY FACE UNIQUE
BARRIERS.
WE KNOW AANHPIS HAVE THE LOWEST
HELP-SEEKING RATE OF ANY RACIAL
OR ETHNIC GROUP WITH ONLY 25% OF
ASIAN ADULTS WITH A MENTAL
ILLNESS RECEIVING TREATMENTING
AND WHILE SUICIDE IS THE TENTH
LEADING CAUSE OF THE UNITED
STATES OVER ALL IT'S BEEN THE
FIRST LEADING CAUSE OF DEATH FOR
AANHPI YOUTH AGES 10-24.
THESE HEALTH DISPARITIES ARE DUE
TO A VARIETY OF FACTORS
INCLUDING A LACK OF ACCESS TO
AFFORDABLE MENTAL HEALTH
SERVICES AND THE STIGMA ATTACHED
TO MENTAL HEALTH ISSUES.
THAT'S WHY EVERY YEAR I
INTRODUCED TWO PIECES OF
LEGISLATION.
THE STOP MENTAL HEALTH STIGMA IN
OUR COMMUNITIES ACT WHICH
PROVIDES RESOURCES TO MEET THE
DIRECT MENTAL HEALTH SERVICE
NEEDS FOR AANHPIs AS WELL AS THE
RESOLUTION MARKING AANHPI MENTAL
HEALTH DAY ON MAY 10 WHICH
RAISES NATIONAL AWARENESS ABOUT
MENTAL HEALTH WITHIN OUR
COMMUNITIES.
LET ME BE CLEAR, THESE KINDS OF
EFFORTS IN CONGRESS DON'T HAPPEN
BY OUR EFFORTS ALONE.
THEY'RE ACHIEVED BY WORKING
CLOSELY WITH AND LEARNING FROM
ALL YOU HERE TODAY, THE
SCIENTISTS DRIVING THE RESEARCH
ADDRESSING THE UNIQUE HEALTH
DISPARITIES OF OUR FAMILIES AND
CHILDREN.
YOU ARE ALL STRENGTHENING OUR
COMMUNITIES IN SUCH VIBRANT AND
IMPORTANT WAYS.
SO THANK YOU AGAIN TO THE NIH,
AANHPI, HSIG FOR INVITING ME TO
JOIN YOU AT THIS INCREDIBLE
CONFERENCE AND NAMING THE
LECTURE SERIES AFTER ME.
I WISH YOU A HAPPY AANHPI
HERITAGE MONTH.
NOW, I WILL TURN THE PODIUM TO
DR. MING LI ADVISER OF THE
AANHPI STAKE GROUP TO INTRODUCE
THE RESEARCH LEADERS.
>>GOOD MORNING.
ON BEHALF OF ALL OF US HERE AND
NIH LEADERS FOR THEIR CONTINUED
SUPPORT OF OUR COMMUNITY.
I AM HONORED TO INTRODUCE THEM
TO YOU BEFORE THEIR REMARKS.
OUR FIRST SPEAKER IS
DR. LAWRENCE TABAK OUR ACTING
DIRECTOR SINCE DECEMBER 2021.
PRIOR TO THAT, DR. TABAK SERVED
AS THE PRINCIPLE DEPUTY DIRECTOR
AND THE DIRECTOR OF THE NATIONAL
INSTITUTE OF DENTAL AND
CRANIOFACIAL RESEARCH AND ALSO A
CO-CHAIR OF THE NIH UNITE
INITIATIVE THAT PROMOTES EQUITY
AND SYSTEMATIC CHANGE.
DR. TABAK IS A LEADING
RESEARCHER ON GLYCOPROTEIN
SYNTHESIS STRUCTURE AND FUNCTION
AND CONTINUES TO LEAD ACTIVE
RESEARCH IN LABORATORY IN
ADDITION TO HIS BUSY
ADMINISTRATIVE RESPONSIBILITIES.
HE IS AN ELECTED MEMBER OF THE
NATIONAL ACADEMY OF MEDICINE.
DR. TABAK EARNED HIS
UNDERGRADUATE DEGREE FROM THE
CITY COLLEGE OF NEW YORK, A DDS
FROM COLUMBIA UNIVERSITY AND
Ph.D. FROM THE UNIVERSITY OF
BUFFALO.
PRIOR TO JOINING NIH IN 2000 HE
WAS A SENIOR ASSOCIATE DEAN FOR
RESEARCH AND PROFESSOR AT A
UNIVERSITY OF RODCHESTER.
WITHOUT FURTHER ADO, DR. TABAK.
>>OKAY.
I HAVE ACHIEVED UNMUTING.
WONDERFUL.
THANK YOU FOR THE KIND
INTRODUCTION AND THANK YOU TO
THE NIH ASIAN AMERICAN NATIVE
HAWAIIAN PACIFIC ISLANDER HEALTH
SCIENTIFIC INTEREST GROUP FOR
ORGANIZING WHAT IS NOW THE 2nd
ANNUAL CONFERENCE TO CELEBRATE
AANHPI HERITAGE MONTH AND I'M
GLAD TO SEE IT RETURN.
ADVANCING AANHPI HEALTH IS AN
INTEGRAL PART OF NIH'S PRIORITY
FOCUSSED ON MINORITY HEALTH
DISPARITIES RESEARCH AND SO AS A
RESULT I'M DELIGHTED TO JOIN YOU
ALL ON THIS EVENT TO REFLECT ON
THE HISTORY AND CELEBRATE THE
ACHIEVEMENTS OF ALL ASIAN
AMERICAN NATIVE HAWAIIAN PACIFIC
ISLANDERS.
SO LET ME START WITH SOME
ADDITIONAL THANKS.
FIRST THE STAFF AT NIH AND HHS
WHO PLANNED THIS EVENT AND ALL
THE SPEAKERS IN THE AUDIENCE FOR
YOUR SUPPORT OF NIH RESEARCH AND
AANHPI HEALTH AND FOR YOUR
SUPPORT FOR THIS CONFERENCE IN
GENERAL.
NOW, SOME OF YOU MAY KNOW I
JOINED NIH AT THE TAIL END OF
THE CLINTON ADMINISTRATION.
IN 1999 IT WAS THEN PRESIDENT
CLINTON WHO ESTABLISHED THE
FIRST WHITE HOUSE INITIATIVE ON
ASIAN AMERICANS AND PACIFIC
ISLANDERS WITH A FOCUS ON LIFE
AND INCREASING OPPORTUNITIES TO
PARTICIPATE IN FEDERAL PROGRAMS.
TO THE BIDEN-HARRIS
ADMINISTRATION IN MAY OF '21 THE
ADMINISTRATION REINVIGORATE THE
INITIATIVE NOW CALLED THE WHITE
HOUSE INITIATIVE ON ASIAN
AMERICAN NATIVE HAWAIIAN PACIFIC
ISLANDERS.
THE WHITE HOUSE RELEASED THE
FIRST EVER NATIONAL STRATEGY TO
ADVANCE EQUITY, JUSTICE AND
OPPORTUNITY FOR AANHPI
COMMUNITIES IN JANUARY OF 2023.
AND ACTION PLANS FROM 32
DIFFERENT AGENCIES INCLUDING ALL
15 EXECUTIVE DEPARTMENTS AND
CABINET.
THE STRATEGY NOTABLY SETS
ACTIONABLE PRIORITIES INCLUDING
DATA DISAGGREGATING AND
COMBATTING ANTI-ASIAN LATE.
AS PART OF THIS EFFORT THE
DEPARTMENT OF HHS IDENTIFIED
FIVE GOALS TO ACHIEVE OVER THE
FIVE YEARS ADVANCING EQUITY,
JUSTICE AND OPPORTUNITY FOR
ASIAN AMERICAN NATIVE HAWAIIAN
PACIFIC ISLANDER COMMUNITIES.
FIRST GOAL IS TO ENHANCE THE
AVAILABILITY, QUALITY AND
COLLECTION AND USE OF
DISAGGREGATED DATA ON AANHPI
POPULATIONS.
THE SECOND GOAL IS TO INCREASE
LANGUAGE ACCESS ACROSS HHS
PROGRAMS FOR AANHPI COMMUNITIES.
THE THIRD IS TO RAISE AWARENESS
OF HATE CRIMES AND INCIDENTS AND
ADDRESS ANTI-ASIAN
DISCRIMINATION AND FOURTH IS TO
COMBAT HUMAN TRAFFICKING OF
AANHPI POPULATIONS AND THE FIFTH
GOAL RELEVANT TO THE NIH IS
STRENGTHEN AANHPI HEALTH
RESEARCH.
I WANT TO CONGRATULATE THE NIH
AANHPI HEALTH SCIENTIFIC
INTEREST GROUP FOR ITS
LEADERSHIP, ITS DEDICATION AND
THEIR OUTSTANDING CONTRIBUTIONS
IN HELPING TO ESTABLISH AND
IMPLEMENT THE OVER ALL WHITE
HOUSE NATIONAL STRATEGY AND IN
PARTICULAR FOR THEIR EFFORTS IN
HELPING TO DEVELOP HHS PRIORITY
GOAL FIVE WHICH IS BEING LED BY
NIH.
SO THE GROUP'S ACTIVITIES
INCLUDING THE INAUGURAL HEALTH
RESEARCH CONFERENCE OF LAST MAY
PROVIDED A FOUNDATION FOR HHS'S
GOAL FIVE AND THE AIM OF
STRENGTHENING AANHPI HEALTH
RESEARCH IS COMPLEMENTARY AND A
WELCOME ADDITION TO THE NEWLY
RELEASED FY23 THROUGH '27 NIH
WIDE STRATEGY PLAN FOR
DIVERSITY, EQUITY, INCLUSION AND
ACCESSIBILITY.
TAKEN TOGETHER THE ROAD MAPS AND
NIH IS COMMITTED TO EMBRACING,
STRENGTHENING AND INTEGRATING
DEI EFFORTS ACROSS ALL OF OUR
AGENCY'S ACTIVITIES.
AGAIN, I WANT TO EXPRESS MY
SUPPORT FOR YOUR EFFORTS AND I'M
LOOKING FORWARD TO THE
COMPLETION OF THE
RECOMMENDATIONS AND ACTION PLAN
FOR THE HEALTH AND HUMAN
SERVICES GOAL FIVE.
NOW, THIS YEAR IS THE 80th
ANNIVERSARY OF THE CHINESE
EXCLUSION REPEAL ACT KNOWN AS
THE MAGNUSON ACT.
THIS ENDED A LAW THAT WAS IN
PLACE SINCE 1882 THAT BANNED
CHINESE IMMIGRANTS AND IMPOSED
ONEROUS RESTRICTIONS ON CHINESE
PEOPLE ALREADY IN THE COUNTRY.
IN 1992, CONGRESS ESTABLISHED
MAY AS ASIAN AMERICAN AND
PACIFIC ISLANDER HERITAGE MONTH
TO HONOR THOSE WHO CONTRIBUTED
SO MUCH TO OUR COUNTRY'S
SUCCESS.
TODAY I'D LIKE TO ACKNOWLEDGE
THE MANY EXTRAORDINARY
CONTRIBUTIONS FROM ASIAN
AMERICAN NATIVE HAWAIIAN PACIFIC
ISLANDERS FOR THE WORK AT NIH
AND BIO MEDICAL RESEARCH IN
GENERAL.
I RECOGNIZE MANY OF YOU ARE
CONCERNED ABOUT READING ABOUT
SCIENTISTS MANY OF WHOM ARE
CHINESE AMERICANS WHO HAVE LOST
THEIR JOBS REGARDING
INVESTIGATIONS REGARDING TRUST
AND INTEGRITY ISSUES.
I WANT TO FIRST ASSURE YOU NIH
IS NOT TARGETING OR
DISCRIMINATING AGAINST ANY
PARTICULAR RACE OR ETHNIC GROUP
IN OUR EFFORTS TO MITIGATE
BREACHES OF TRUST THAT UNDERMINE
THE INTEGRITY OF U.S. RESEARCH
BUT WILL NOT TOLERATE
DISCRIMINATION AGAINST CHINESE
AMERICANS SUCH AS WE DON'T
TOLERATE DISCRIMINATION AGAINST
ANY RACE OR ETHNIC GROUP AND
THEY'RE NOT UNIQUE TO ANY ONE
ETHNICITY OR NATIONALITY.
TO SUM UP SOME ISSUES THERE'S A
SMALL NUMBER OF NIH-SUPPORTED
INVESTIGATORS WHO HAVE FOUND TO
HAVE SIGNIFICANT CONFLICTS IN
THEIR COMMITMENT.
SIMPLY, YOU CAN'T EXPECT THE
GOVERNMENT TO HAVE A GRANT THAT
PAYS YOU FOR MORE THAN 100% OF
YOUR TIME.
IN OTHER WORDS, TWO FULL-TIME
JOBS.
THAT'S DIFFERENT THAN LEGITIMATE
SCIENTIFIC COLLABORATION WHICH
WE WELCOME AND CERTAINLY
ENCOURAGE AND THAT IS CERTAINLY
VERY DIFFERENT FROM LEGITIMATE
DECLARED CONSULTING THAT
INDIVIDUALS MAY DO DEPENDING ON
THEIR OWN INSTITUTIONAL POLICIES
BUT THESE DON'T HAVE TO BE
SEPARATE FROM NIH-SUPPORTED
ACTIVITIES.
AND AGAIN, A VERY SMALL NUMBER
OF SCIENTISTS HAVE APPLIED FOR
AND HAVE RECEIVED FUNDING FROM A
FOREIGN COUNTRY FOR THE EXACT
SAME WORK THEY HAVE AN ACTIVE
NIH GRANT ON.
THAT DOESN'T REPRESENT A
MISTAKE.
LET'S CALL THAT FOR WHAT IT IS.
IT'S GREED.
NOW, NIH'S INVOLVEMENT IN THESE
ISSUES BEGAN IN 2016 WHEN THE
FBI CONTACTED US ABOUT CONCERNS
ABOUT OUR PEER-REVIEW SYSTEM.
THE FIGURE YOU HAVE UP THERE IS
A COMPILATION OF ALL RESEARCH
INTEGRITY ALLEGATIONS WE
RECEIVED AT NIH AND IT'S THE
GREEN PORTION OF THE BAR WHICH
REPRESENTS THINGS RELATED TO
SO-CALLED FOREIGN INFLUENCE.
THERE ARE A LARGE NUMBER OF
CASES IN 2017 AND 2018 AND WHY
YOU SEE IN 2018 AND 2019 A BURST
OF CASES.
A LARGE BURST OF CASES.
NOW, THIS EFFORT HAS ALWAYS BEEN
SEPARATE AND DISTINCT FROM THE
DEPARTMENT OF JUSTICE'S SO CALL
CHINA INITIATIVE.
IT'S A SEPARATE ISSUE.
AS YOU LOOK AT THE DATA AND THE
REPORT IS PROMISING AND THERE'S
A DIMINUTION THE GREEN BAR HAS
GONE DOWN IN THE LAST FEW YEARS
AND MODEST FOR 2022 AND OUR HOPE
IS THAT NOW THERE IS A GREATER
UNDERSTANDING AND GREATER
ADHERENCE TO THE RULES GOING
FORWARD.
NOW, ALL THIS SAID, TO THE GROUP
AND COMMUNITY TO HAVE FURTHER
DISCUSSIONS IF YOU WOULD LIKE TO
DO SO BECAUSE I DO WANT TO BE
ABLE TO REASSURE YOU AND ANSWER
ANY QUESTIONS THAT YOU MAY HAVE
ABOUT THIS IMPORTANT ISSUE.
I'LL CLOSE BY THANKING YOU ONCE
AGAIN THE AANHPI HEALTH
SCIENTIFIC INTEREST GROUP, THE
TRANS-NIH PLANNING COMMITTEE AND
ALL THE SPEAKERS AND ATTENDEES
FOR THIS ANNUAL CONFERENCE.
THE CONFERENCE IS A WONDERFUL
WAY TO COMMEMORATE MAY AANHPI
HERITAGE MONTH AND I APPRECIATE
ALL YOUR HARD WORK TO IMPROVE
THE HEALTH OF ASIAN AMERICAN
NATIVE HAWAIIAN PACIFIC
ISLANDERS AND TO ADVANCE THE
OVER ALL NIH'S MISSION.
BEST WISHES TO ALL OF YOU AND
THANK YOU.
>>THANK YOU, DR. TABAK FOR YOUR
ASSURING WORDS AND CONTINUED
EFFORT TO HELP SAFEGUARD THE
INTEGRITY AND FAIRNESS FOR THE
BIOMEDICAL RESEARCH COMMUNITY.
OUR NEXT SPEAKER IS DR. ELISEO
PEREZ-STABLE.
HE'S A LEADING RESEARCH IN SMOKE
CESSATION AND TA BACK --TOBACCO
CONTROL AND DIRECTOR OF THE
INSTITUTE ON MINORITY
HEALTH AND HEALTH DISPARITIES
AND PART OF FIGHTING THE
COVID-19 PANDEMIC IN COMMUNITIES
OF COLOR.
DR. PEREZ-STABLE EARNED A B.A.
IN CHEMISTRY AND M.D. FROM THE
UNIVERSITY OF MIAMI AND
COMPLETED HIS INTERNAL RESIDENCE
IN MEDICINE AT THE UNIVERSITY OF
CALIFORNIA SAN FRANCISCO AND WAS
A PROFESSOR AT UCSF FOR MORE
THAN 30 YEARS BEFORE JOINING THE
NIH.
DR. PEREZ-STABLE.
>>THANK YOU SO MUCH, MING.
YOU ARE PART OF THAT EFFORT THAT
LED TO THE AWARD SO THANK YOU
FOR ALL YOU'VE DONE ON THIS.
I ALSO WANT TO ACKNOWLEDGE AND
THANK THE ORGANIZERS OF THE 2nd
ANNUAL CONFERENCE AND MOVE
FORWARD WITH THE PERSPECTIVES
FROM NIMHD.
SO I'M GOING TO MAKE A FEW
POINTS BASED ON SOME OF THE WORK
WE'RE INVOLVED WITH AND
EMPHASIZES FROM A RESEARCH
PERSPECTIVE SINCE OUR THEME IS
RESEARCH ON HEALTH.
WE ARE ALL AWARE ASIAN AMERICAN
NATIVE HAWAIIAN PACIFIC
ISLANDERS ARE RACIAL ETHNIC
MINORITY POPULATIONS IN THE
U.S. AND THEREFORE ARE INCLUDED
IN THE NIMHD DEFINED FOR NIH
PURPOSES POPULATIONS WITH HEALTH
DISPARITIES.
THE IMPORTANT POINT OF THIS
AGGREGATION HAS BEEN REPEATED
EMPHASIS OF THIS COMMUNITY OF
SCIENTISTS AS WELL AS THE
GENERAL COMMUNITY.
THE FIRST STEP IS TO SEPARATE
PACIFIC ISLANDERS NATIVE
HAWAIIANS AS SEPARATE RACE AND
THE STATISTICS FROM THE CENTERS
FOR DISEASE CONTROL LUMPED THEM
TOGETHER MOSTLY BECAUSE THE
STATES TOOK ABOUT 17 YEARS FOR
ALMOST 20 YEARS TO SEPARATE OUT
THE TWO CATEGORIZATIONS.
CDC COLLECTS DATA FROM EACH
STATE ON THAT AND AS OF 2017 THE
DATA ARE AVAILABLE SEPARATELY.
BUT THAT SAID, THE TERM OF API
MORTALITY OR API RATES SHOULD BE
FULLY ABANDONED.
AANHPI IS USED BUT REALLY SHOULD
BE TWO SEPARATE CATEGORIES.
WITHIN THE ASIAN AMERICAN
POPULATION THERE'S A DAUNTING
LEVEL OF HETEROGENEITY I THINK
EXCEEDS ANY OF THE OTHER RACIAL
AND ETHNIC POPULATIONS WE WORK
WITH OVER 100 LANGUAGES AND
HERITAGES AND DIFFERENCES IN
VASTNESS OF TERRITORY THAT
REALLY EXCEED THAT SEEN IN THE
AMERICAS.
ONE EXAMPLE OF A MAJOR
DIFFERENCE ARE SOUTH ASIAN
PEOPLE FROM INDIA AND NEPAL AND
PAKISTAN WHO ARE REALLY MIXED
EUROPEAN AND AFRICAN AND SOME
EAST ASIAN ANCESTRY TOWARDS
BURMA AND MANY OF US THINK THEY
SHOULD BE A SEPARATE ETHNIC
GROUP OPPOSED TO BEING LUMPED
WITH ASIAN AMERICANS AND CHINESE
AMERICANS ARE THE MOST COMMON IN
THE U.S. FOLLOWED BY PEOPLE FROM
SOUTH ASIA AND INDIAN AND
PAKISTANIS AND THEN VIETNAMESE
AND JAPANESE AND FILIPINOS.
IN WORK WE CONDUCTED IN
COLLABORATION WITH COLLEAGUES AT
NIH AND THE INSTITUTE OF HEALTH
METRIC ADMINISTRATION IN THE
UNIVERSITY OF WASHINGTON WE
SHOWED AND PUBLISHED THAT ASIAN
AMERICANS IF YOU FOCUS ON THIS
QUADRANT DOWN HERE IN THE LOWER
LEFT HAVE A BETTER LIFE
EXPECTANCY THAN WHITE AMERICANS.
SIMILAR TO HISPANIC LATINOS
EXCEPT LONGER LIFE EXPECTANCY
THAN LATINOS.
CDC PUBLISHED MORTALITY RATES
ABOUT THE SAME TIME AND
GEOGRAPHICALLY THERE'S NOT MUCH
VARIATION ACROSS THE COUNTRY
WHERE ASIAN AMERICANS ARE
CONCENTRATED FROM HAWAI'I TO THE
NORTHEAST.
LIFE EXPECTANCY IS BETTER FOR
ASIANS COMPARED TO WHITES.
ISSUES FROM OUR PRIORITY AT
NIMHD WE HAVE RELATIVELY GOOD
POPULATION OUTCOMES AND RATHER
THAN SAY WELL, WE'RE DONE, ONE
IS IN A RESEARCH PERSPECTIVE AND
WHY IS THIS?
WHAT ARE THE GOOD ASPECTS AND IS
IT ALL IMMIGRANT EFFECTS 70% OF
ALL ASIANS ARE FIRST GENERATION
IMMIGRANTS.
THERE WERE DISPARITIES IN
COVID-19 AMONG ASIAN AMERICANS
AND THERE WERE SOME AREAS WHERE
IT WAS NOT TRUE LIKE IN PLACES
LIKE CALIFORNIA AND IT REFLECTS
THE TYPE OF EMPLOYMENT AND THE
ABILITY TO SELF-ISOLATE OR WORK
FROM HOME THAT VARIED ACROSS THE
COUNTRY.
AND HEPATITIS B IS A
PARTICULARLY CHRONIC PROBLEM FOR
ASIAN AMERICANS WITH HIGH RATES
OF TRANSMISSION AT CHILDHOOD AND
AT BIRTH AND THIS IS PREVENTIBLE
WITH A VERY EFFECTIVE VACCINE
AND WE'VE SEEN TREMENDOUS
PROGRESS IN SOME COUNTRIES IN
ASIA BY BROAD IMMUNIZATION
CAMPAIGNS.
WE NEED TO FOLLOW THOSE
FOOTSTEPS IN THE UNITED STATES
NOT ONLY PREVENTING HEPATITIS B
AND CHRONIC LIVER DISEASE AND
LIVER DISEASE CAUSED BY THE
HEPATITIS B VIRUS IN LIVER CELLS
AS WELL AS WITH PEOPLE WITH
CHRONIC HEPATITIS B AND
INFLAMMATORY LIVER DISEASE AND
STOMACH CANCER IS MORE COMMON
AND LUNG CANCER HAS BEEN
IDENTIFIED AS A CHALLENGE FOR
NEVER SMOKERS PARTICULARLY
WOMEN.
WE DON'T FULLY UNDERSTAND THE
MECHANISMS WHY THIS IS HAPPENING
AND REALIZE THE CONFERENCE IS
SPONSOR THE NCI AND THERE'LL BE
A FOCUS ON CANCER.
WE OBSERVE EXCESS RATES OF
DIABETES DESPITE LESS OBESITY
COMPARED TO AFRICAN AMERICANS
AND LATINOS AND AMONG WHITE
AMERICANS AMONG SOUTH ASIANS AND
THOSE STUDIED AND THE DATA
INDICATES THE OVER ALL HEALTH OF
THIS POPULATION IS ACTUALLY
WORSE THAN ASIAN AMERICANS AND
WORSE THAN LATINOS AND HISPANICS
AND WHITES BUT WORSE THAN FOR
AFRICAN AMERICANS AND CLOSER TO
THE RANGE WE SEE FOR AMERICAN
INDIANS AND THERE'S PROCESSES OF
CARE REPRESENTATIVE WHICH
ALLUDED TO THIS.
THE ENGAGEMENT WITH THE HEALTH
CARE SYSTEM IS OFTEN FRAUGHT
WITH DISTRUST.
ASIAN AMERICANS CONSISTENTLY
SCORE THE HIGHEST LEVEL OF
DISSATISFACTION WITH HEALTH CARE
COMPARED TO OTHER GROUPS DESPITE
NOT HAVING PERHAPS WORSE HEALTH
OUTCOMES AS I ALLUDED TO.
WE SEE LOWER SCREENING RATES FOR
CANCER WHERE THE POWERFUL
RECOMMENDATION OF THE CLINICIAN
IS OFTEN A FACTOR INFLUENCING
PATIENT'S DECISIONS TO GET
SCREENED.
THE CHALLENGE OF MENTAL HEALTH
ISSUES AND THE DISASSOCIATION OF
MENTAL HEALTH AND PHYSICAL
HEALTH AND THE IMPORTANCE OF
SEEING IT AS A CONDITION OPPOSED
TO A CHARACTER FLAW IS ONE AND
THE STIGMA ASSOCIATED WITH IT
ARE GREATER CHALLENGES IN ASIAN
AMERICANS.
THERE'S HUGE LANGUAGE BARRIERS
ESPECIALLY FOR OLDER ADULTS AND
IMMIGRANT AND LACK THE PHYSICIAN
ABILITY TO SPEAK THE DIFFERENT
LANGUAGES.
I WITNESSED A LOT OF THIS IN SAN
FRANCISCO WHICH IS A HEAVILY
ASIAN CITY AND WE KNOW CLINICIAN
CONCORDANCE IS AN IMPORTANT
ISSUE.
THE QUALITY OF CARE AS A
MENTIONED IS PERCEIVED TO BE
WORSE AND ASIAN AMERICAN
PATIENTS ARE GENERALLY LESS
SATISFIED IN THE SURVEYS.
THE FEW THAT INCLUDED
SUBSTANTIAL SAMPLES I WOULD ADD
BECAUSE MANY OR MOST STUDIES
HAVE NOT.
THEN WE HAVE THE IMMIGRATION
EXPERIENCE AND WE SAW THE RACISM
AGAINST ASIAN AMERICANS IN
RECENT YEARS.
IT'S BEEN PRESENT ALL THIS TIME.
DR. TABAK HIGHLIGHTED THE
HISTORICAL IMPORTANCE OF THE
CHINESE EXCLUSION ACT.
THIS WAS HEAVILY INFLUENCED IN
CALIFORNIA WITH CHINESE
IMMIGRANTS HAVING BEEN BROUGHT
TO THE COUNTRY FOR WORKING IN
RAILROADS AND SETTLED AND LIVED
IN SAN FRANCISCO FOR GENERATIONS
BEFORE THIS WAS LIFTED.
AND SO THIS HISTORY IS NOT
RESOLVED EXCLUSIVELY WITH
LEGISLATIVE ACTION AND WE DO
NEED TO BE ATTUNE TO THIS.
AN EXAMPLE WAS A STUDY CONDUCTED
BY NIMHD INTRAMURAL
INVESTIGATORS SHOWING THE
COVID-RELATED DISCRIMINATION IN
DECEMBER.
THE SURVEY WAS CONDUCTED TO
FEBRUARY 2021 WAS HIGHEST AMONG
ASIAN AMERICANS NOT JUST IN
COMPARE TO WHITE AMERICANS, 30%
VERSUS 10% BUT ALSO COMPARED TO
OTHER RACIAL AND ETHNIC
POPULATIONS IN THE COUNTRY.
NIMHD FUNDS ABOUT 13% OF OUR
AWARDS PRIMARILY RO1s ON ASIAN
AMERICAN HEALTH AND ABOUT 8% ON
NATIVE HAWAIIAN PACIFIC ISLANDER
HEALTH IT'S PART OF OUR MISSION
AND WILL CONTINUE TO BE SO.
ACROSS NIH ABOUT 21% OF RO1
GRANTS AND 20% OF Ks ARE AWARDED
TO ASIAN AMERICANS INVESTIGATOR
AND YOU SEE THE TINY FRACTION OF
RO1s BY NATIVE HAWAIIAN AND
PACIFIC ISLANDERS AT NIMHD AND
THEY REPRESENT SOMEWHERE AROUND
.5% OF THE U.S. POPULATION SO WE
SEE WE HAVE A WAYS TO GO.
I WANT TO THANK EVERYONE FOR
THEIR ATTENTION AND WE LOOK
FORWARD TO THE OTHER
PRESENTATIONS.
THANK YOU.
>>THANK YOU, DR. PEREZ-STABLE.
THE NEXT SPEAKER IS DR. CHAN
FROM THE NATIONAL EYE INSTITUTE.
WHILE I'M DOING THE BRIEF
INTRODUCTION I HOPE OUR I.T.
COLLEAGUES CAN GET ACCESS TO
DR. CHAN AS A SPEAKER, PLEASE.
DR. CHAN IS A LEADING RESEARCHER
IN THE DEVELOPMENT AND
APPLICATION OF INFORMATICS
METHODS TO CLINICAL STUDY AND
LED THE ARTIFICIAL INTELLIGENCE
FOR RETINALPATHY THAT RECEIVED A
BREAKTHROUGH STATUS FROM THE
FDA.
DR. CHAN RECEIVED A B.S. IN
ELECTROENGINEERING AND BIOLOGY
FROM STANFORD UNIVERSITY AND
M.D. FROM THE HARVARD MEDICAL
SCHOOL AND HARVARD M.I. T.
PROGRAM IN HEALTH SCIENCE AND
COMPLETED RESIDENCY AND
FELLOWSHIP AT JOHNS HOPKINS AND
HAD FACULTY POSITIONS AT
COLUMBIA AND HEALTH SCIENCES
UNIVERSITY BEFORE JOINING THE
NIH.
DR. CHAN.
>>MING, THANK YOU VERY MUCH FOR
THE INTRODUCTION AND TO YOU AND
DAN FOR THE OPPORTUNITY TO SPEAK
HERE AND GIVE BRIEF REMARKS.
I'M GRATEFUL NIH IS DOING SO
MUCH TO CELEBRATE AANHPI
HERITAGE MONTH.
FROM A PERSONAL PERSPECTIVE I
GREW UP IN THE 1970s AND 1980s
IN DETROIT, MICHIGAN.
AT THE TIME THERE WAS WHAT I
WOULD SAY SIGNIFICANT ANTI-ASIAN
SENTIMENT IN THE COUNTRY AND
ESPECIALLY IN DETROIT BECAUSE OF
ANTI-JAPANESE FEELINGS FROM
COMPETITION IN THE AUTOMOTIVE
INDUSTRY.
AND THAT SUPER IMPOSED ON
PEOPLE'S WHAT I CALL INNATE
BIASES.
WHEN I LOOK AT THE LANDSCAPE NOW
I SEE A LOT OF SIMILARITIES BUT
ON A MUCH LARGER SCALE AND I
THINK THAT'S PARTLY DUE TO
ANTI-ASIAN FEELINGS FROM THE
PANDEMIC AND SOME POLITICAL
ISSUES DR. TABAK MENTIONED.
AND I THINK IT'S ALSO COMMON TO
OVERLOOK AANHPIs IN AREAS LIKE
LEADERSHIP BECAUSE OF THE BIAS
THEY'RE BETTER WORKERS THAN
COMMUNICATORS AND I'M GLAD
DR. D'SOUZA IS GIVING THE KEY
NOTE AND DR. BYRNES AFTER ME.
I'LL SAY FROM A HEALTH
PERSPECTIVE I'M GLAD
DR. PEREZ-STABLE BROUGHT TO
ATTENTION THE FACT THAT AANHPIs
ARE A VERY HETEROGENEOUS GROUP
WITH A LOT OF DIFFERENT I'D SAY
UNIQUE NEEDS.
AND SO WHAT I'M GOING TO DO IS
JUST TALK ABOUT IT AND SHARE A
FEW SLIDES HERE DEALING WITH EYE
HEALTH IN AANHPI COMMUNITIES.
FROM THE PERSPECTIVE OF
FOLLOWING ON WHAT ELISEO SAID
THIS GROUP IS DYNAMIC.
ASIANS ARE PREDICTED TO BE THE
LARGEST IMMIGRANT GROUP IN THE
U.S. BY 2055.
IN 2018 THE TOP COUNTRY OF
ORIGIN FOR NEW IMMIGRANT WAS
CHINA, 149,000 PEOPLE.
I WANTED TO GIVE EXAMPLES OF
UNIQUE NEEDS WITHIN THE AANHPI
COMMUNITY AS IT PERTAINS TO
VISION AND EYE CARE.
THERE WAS A GROUP AT THE
UNIVERSITY OF SOUTHERN
CALIFORNIA THAT CONDUCTED WHAT
WAS KNOWN AS THE CHINESE
AMERICAN EYE STUDY AND IT'S A
POPULATION-BASED STUDY OF ABOUT
5,000 CHINESE AMERICANS WHO WERE
50 YEARS AND OLDER RESIDING IN
SOUTHERN CALIFORNIA IN MONTEREY
PARK.
IT WAS DESIGNED TO ADDRESS A
LACK OF DATA ABOUT EYE AND
VISION HEALTH IN OLDER CHINESE
AMERICANS.
AND WHAT THE GROUP REALLY FOUND
WAS THAT CHINESE AMERICANS HAD A
PREVALENCE OF VISUAL IMPAIRMENT
SIMILAR TO NON-HISPANIC WHITES
AND LATINO INDIVIDUALS IN THE
U.S. WITH SIMILAR CAUSES.
AND UNRECORRECTED A GLASSES AND
CATARACTS WERE COMMON CAUSE OF
LOSS OF VISION NOW, ONE OF THE
THINGS THAT CAME UP THAT WAS
UNIQUE WITHIN THE GROUP WAS ONE
OF THE MOST COMMON CAUSES WAS
MYOPIC RETINOPATHY AND IT'S
DEGENERATIVE DISEASE OF THE
RETINA THAT IS NOT AS COMMON IN
OTHER RACIAL OR OTHER ETHNIC
GROUPS.
AND BUILDING ON THIS THE
RESEARCH COMMUNITY HAS REALLY
CONTINUED TO DO SOME STUDIES IN
DISEASES THAT ARE UNIQUE TO OR
MORE COMMON IN PEOPLE OF AANHPI
DESCENT.
ONE EXAMPLE OF EARLY CAREER
SCIENTISTS THAT LEAD A STUDY
THAT EVALUATES A NEW METHOD OF
DIAGNOSING PRIMARY ANGLE CLOSURE
GLAUCOMA AND IS SIGNIFICANTLY
HIGHER IN PEOPLE OF CHINESE AND
SOUTH ASIAN DESCENT COMPARED TO
EUROPEANS AND HAS A HIGHER RISK
OF SEVERE IMPARMENTD AND PAIN
COMPARED TO WHAT WE SEE MORE
OFTEN WHICH IS COMMON GLAUCOMA
AND IS EVALUATE ING A METHOD
INVOLVING METHODS LIKE
ARTIFICIAL INTELLIGENCE,
AUTOMATED DIAGNOSIS.
AND THE ONLY OTHER THING I WANT
TO CALL ATTENTION TO IS MYOPIA.
A COMMON DISEASE,
NEAR-SIGHTEDNESS BUT IN THE
POPULATION AT LARGE THE
PREVALENCE OF MYOPIA IS
INCREASING RAPIDLY.
OVER THE PAST 20, 30 YEARS THE
TREND LINE HAS GONE UP
SIGNIFICANTLY.
NOW, BEFORE I GET INTO THE
AANHPI SPECIFIC ASPECT OF IT,
I'LL JUST SAY THAT NOBODY REALLY
UNDERSTANDS WHY THAT IS.
DURING THIS PANDEMIC THE
PREVALENCE HAS INCREASED FAIRLY
SIGNIFICANTLY AND THERE ARE OVER
200 GENETIC LOCI IDENTIFIED AND
WHAT CAUSES THE EYES TO GET
LONGER AND NEAR SIGHTED AND
DOESN'T DESCRIBE THE RAPID RISE
IN PREVALENCE.
THERE'S ENVIRONMENTAL FACTORS
THAT HAVE BEEN SUSPECTED BUT
PEOPLE DON'T AGREE WHAT THEY
ARE.
SOME OF THE ENVIRONMENTAL
FACTORS ARE READING, STUDYING,
LACK OF OUTDOOR TIME, AIR
POLLUTION, CERTAIN WAVE LENGTHS
OF LIFE HAVE BEEN IMPLICATED.
BUT IT'S NOT REALLY -- THERE'S
NOT CONSENSUS ON WHAT THOSE
FACTORS ARE AND THERE'S REALLY
NOT A VERY GOOD UNDERSTANDING OF
WHAT THOSE PERFORM GENE
ENVIRONMENT INTERACTIONS ARE.
THE STATISTICS SHOW THAT -- IT'S
BEEN ESTIMATED BY 2050 THERE
WILL BE 5 BILLION PEOPLE
WORLDWIDE WITH MYOPIA AND 1
BILLION WITH HIGH MYOPIA AND
WITH GLASSES MINUS 6.0 OR WORSE
AND PEOPLE OF ASIAN AND EAST
ASIAN DESCENT CONSIDER HIGH
INCIDENCE OF MYOPIA AND YOU KNOW
THIS AND IN MOST COUNTRY IS 90%
AMONG YOUNGER PEOPLE ESPECIALLY.
THE OTHER FACTOR IS IT'S NOT
JUST EYE GLASSES.
BY AGE 75 ALMOST 4% OF PEOPLE
WHO ARE NEAR SIGHTED AND ALMOST
40% OF PEOPLE WITH HIGH MYOPIA
THE MINUS 6 AND WORSE WILL HAVE
IMPAIRMENT ASSOCIATED WITH
MYOPIA, RETINAL DEGENERATION OR
GLAUCOMA OR OTHER DEGENERATIVE
DISEASES OF THE RETINA THAT ARE
CAUSED WHEN THE EYE GETS REALLY
LONG.
SO WHAT ARE WE DOING ABOUT THIS?
WE ARE WORKING WITH NASEM ON A
CONSENSUS STUDY OF MYOPIA
LOOKING AT BASIC SCIENCE AND
HEALTH DISPARITIES OBJECTIVES.
FROM A SCIENTIFIC PERSPECTIVE
WHAT CAUSES EYES TO GROW TOO
LONG AND BECOME NEAR SIGHTED
FROM AN ENVIRONMENTAL FACTOR
WHAT ARE THOSE AND HOW DO WE
STUDY THEM AND FROM A SOCIO
ECONOMIC PERSPECTIVE, WHY IS IT
SO HARD TO GIVE PEOPLE GLASSES?
IN OTHER WORDS, IN THIS COUNTRY
WHY DO SO MANY PEOPLE WHO STILL
HAVE VISION LOSS FROM
UNREFRACTED CARE AND THERE'S A
LARGE PUBLIC MEETING PLANNED IN
2023 THROUGH NASEM AND MORE AND
IN CLOSING I WANT TO SAY THANK
YOU TO MING AND TO DAN FOR
LETTING ME SAY A FEW WORDS AND I
HOPE THAT THIS WORKSHOP CAN
REALLY DRAW ATTENTION TO SOME OF
THESE UNIQUE ISSUES THAT ADDRESS
PEOPLE OF AANHPI DESCENT AND
CREATE A BROADER CONVERSATION
ABOUT A LOT OF THE THIS
COMMUNITY IS DEALING WITH SO
THANK YOU VERY MUCH.
>>THANK YOU VERY MUCH,
DR. CHAN.
I THINK THE PERSPECTIVE THE
AANHPI COMMUNITY IS DIVERSE AND
ALSO CLOSELY CONNECTED AND
TOGETHER IN THIS.
THANK YOU SO MUCH.
OUR NEXT SPEAKER IS DR. NONI
BYRNES FROM THE CENTER OF
SCIENTIFIC REVIEW.
SHE STARTED HER CAREER AT NIH --
HER NIH CAREER AS THE CSR AS AN
SRO AND SERVED AS CHIEF DIVISION
DIRECTOR, ACTING DEPUTY DIRECTOR
AND ACTING DIRECTOR BEFORE
TAKING THE HELM IN 2019.
AMONG HER MANY ACCOMPLISHMENTS
DR. BYRNES LED CSRs DEVELOPMENT
AND IMPLEMENTATION OF A
DATA-DRIVEN FRAMEWORK FOR
CONTINUOUS EVALUATION OF A MORE
THAN 170 STUDY SECTIONS THAT
SERVED ALL NIH FUNDING AND THE
ENTIRE BIOMEDICAL COMMUNITY AND
HOLDS A B.S. AND Ph.D. IN
ANALYTIC CHEMISTRY FROM EMORY
UNIVERSITY.
DR. BYRNES.
>>THANK YOU VERY MUCH, MING.
I DON'T HAVE SLIDES BUT I AM
DELIGHTED TO BE HERE AND WELCOME
EVERYONE AND DELIGHTED TO
WELCOME YOU TO THE 2nd ANNUAL
NIH ASIAN AMERICAN NATIVE
HAWAIIAN PACIFIC ISLANDER HEALTH
RESEARCH CONFERENCE.
THANKS TO DR. XI AND THE NIH
AANHPI HEALTH SCIENTIFIC
INTEREST GROUP FOR THEIR
COMMITMENT TO ADVANCING THE
HEALTH OF AANHPI POPULATIONS
WITH THIS IMPORTANT CONFERENCE.
IN ADDITION TO THE EXCITING
RESEARCH THAT WILL BE PRESENTED
TODAY I THINK THIS CONFERENCE
WILL ALSO SHOWCASE THE RICH
DIVERSITY WITHIN THE BROAD
UMBRELLA WE CALL AANHPI AND
RAISE AWARENESS ABOUT THE
IMPORTANCE OF UNDERSTANDING AND
ADDRESSING THE SPECIFIC HEALTH
CHALLENGES FACED BY THE
DIFFERENT AANHPI POPULATIONS.
EARLIER THIS YEAR I JOINED
DOCTORS BERNARD AND SCHWETZ AS
THE FOURTH CO-CHAIR OF THE UNITE
INITIATIVE A BROAD EFFORT TO
BREAK DOWN STRUCTURAL BARRIERS
AND ADVANCE EQUITY IN ALL
ASPECTS OF NIH'S ACTIVITIES.
THEY RANGE FROM NIH-SUPPORTED
BIOMEDICAL RESEARCH ECO SYSTEM
TO OUR OWN INTERNAL WORKFORCE
AND SYSTEMS.
MY OTHER ROLE AT NIH INVOLVES
DIRECTING CSR, THE CENTER FOR
SCIENTIFIC REVIEW WHICH CONDUCT
THE PEER REVIEW OF GRANT
APPLICATIONS FROM BASIC SCIENCES
TO TRANSLATIONAL, CLINICAL AND
SOCIAL, BEHAVIORAL AND COMMUNITY
RESEARCH.
A KEY SHARED INTEREST OF CSR AND
UNITE IS TO ENSURE FAIRNESS AND
MITIGATE BIAS IN THE IMPORTANCE
OF PEER REVIEW PROCESS THAT
UNDER LIES NIH FUNDING
DECISIONS.
WE BELIEVE THERE'S A CRITICAL
NEED FOR THE NIH TO HEAR DIVERSE
PERSPECTIVES TO FULFILL
PEER-REVIEW MISSIONS OF
IDENTIFYING THE BEST MOST
DISRUPTIVE NOVEL SCIENCE.
AS SUCH THE MOST EFFECTIVE
REVIEW COMMITTEES ARE BROADLY
DIVERSE IN MULTIPLE DIMENSIONS
INCLUDING DEMOGRAPHIC,
SCIENTIFIC CAREER STAGE AND
EXPERIENCE WITH PEER REVIEW.
WE'VE BEEN WORKING HARD WITH
SOME SUCCESS TO BROADEN THE
DIVERSITY OF OUR REVIEW
COMMITTEES AND WE REGULARLY POST
THE DATA ONLINE ON CSRs WEBSITE.
WHILE THE AGGREGATE
REPRESENTATION OF COMMITTEES
MATCHES OF THAT THE APPLICANT
POOL IS AROUND 25% WE'RE VERY
AWARE THIS NUMBER DOES NOT
REPRESENT THE HETEROGENEITY OF
THIS POPULATION.
IT'S ALSO CLEAR THAT WE HAVE
LOWER REPRESENTATION OF AANHPI
REVIEWERS AND APPLICANTS IN THE
AREA OF BEHAVIORAL, SOCIAL AND
COMMUNITY HEALTH RESEARCH.
THIS HAS BEEN AN AREA OF FOCUS
FOR RECRUITMENT AND REQUIRES A
BROAD BASED STRATEGY TO INVOLVE
UNITE AND CSR.
ADDITIONALLY WE HAVE INITIATED
CHANGES TO THE PEER-REVIEW
FRAMEWORK FOR RESEARCH PROJECT
AND FELLOWSHIP GRANT APPLICATION
TO REDUCE THE EFFECTS OF
REPUTATIONAL AND INSTITUTIONAL
BIAS.
WE ESTABLISHED DIRECT AVENUES
FOR THE EXTRAMURAL SCIENTIFIC
COMMUNITY TO REVIEW BIAS TO CSR
LEADERSHIP AND DEVELOPED BIAS
AWARENESS TRAINING WHICH HAS
BEEN COMPLETED BY OVER 19,000
SCIENTIFIC PEER REVIEWERS.
THROUGH UNITE A NUMBER OF
INITIATIVES WILL SOON BE
AVAILABLE NIH WIDE.
ULTIMATELY A FAIR PEER REVIEW
PROCESS WITH SCIENTIFIC EXPERT
WHO BRING VARIED PERSPECTIVES TO
THE TABLE IS CRITICAL TO
ENSURING NIH IDENTIFIES THE MOST
PROMISING RESEARCH TO ADDRESS
THE HEALTH OF THIS COUNTRY'S
RICH AND DIVERSE POPULATION.
OVER THE COURSE OF THIS TWO-DAY
CONFERENCE YOU'LL HEAR ABOUT
RESEARCH RELATED TO AANHPI
HEALTH AND HEALTH DISPARITIES
SPAN BROAD RANGE OF SCIENTIFIC
AND DISEASE AREAS INCLUDING WITH
ALL NIH AND UNITE LEADERSHIP I
LOOK FORWARD TO THE REPORT AND
RECOMMENDATIONS THAT WILL EMERGE
IN THESE DISCUSSIONS.
THANK YOU FOR THE OPPORTUNITY TO
SPEAK WITH YOU AND I'LL TURN
THIS BACK OVER TO MING.
>>THANK YOU, DR. BYRNES.
I SHOULD HAVE POINTED OUT YOU
ARE A CO-CHAIR OF THE UNITE
INITIATIVE.
IT'S VERY IMPORTANT AND OUR NEXT
SPEAKER IS DR. KOROSHETZ FROM
THE CENTER OF NEUROLOGICAL
DISORDERS AND STROKE AND PRIOR
SERVING AS THE DEPUTY DIRECTOR
AND ACTING DIRECTOR OF THE
INSTITUTE AND ALSO HELD
LEADERSHIP ROLES IN A NUMBER OF
TRANS-NIH PROGRAMS INCLUDING THE
BRAIN INITIATIVE AND NIH OFFICE
OF EMERGENCY CARE RESEARCH.
DR. KOROSHETZ' OWN RESEARCH
FOCUSSED ON DEVELOPING MEASURES
THAT REFLECT THE UNDERLYING
BIOLOGY OF NEUROLOGICAL
DISORDERS USING MR SPECTROSCOPY
HE LOOKED AT HUNTINGTON DISEASE
PATIENTS AND HIS TEAM PIONEERED
THE IMAGING IN ACUTE STROKE.
DR. KOROSHETZ OWNERED HIS
UNDERGRADUATE DEGREE FROM
GEORGETOWN UNIVERSITY AND
MEDICAL DEGREE FROM THE
UNIVERSITY OF CHICAGO AND HAS
FELLOWSHIP TRAINING AT THE
UNIVERSITY OF CHICAGO AND
MASSACHUSETTS GENERAL HOSPITAL
AND A PROFESSOR AT HARVARD
MEDICAL SCHOOL AND MASS GENERAL
PRIOR TO JOINING NIH IN 2007.
DR. KOROSHETZ.
>>THANK YOU, MING.
IT'S A PLEASURE TO TALK TO YOU
TODAY AND TWO MAIN POINTS.
ONE IS NINDS AS WELL AS ALL OF
NIH INVESTED IN PROFESSIONAL
DEVELOPMENT AND THE
CONTRIBUTIONS OF ALL ASIAN
SCIENTISTS AND THE SECOND ONE I
CAN'T HELP BUT GO INTO A PUBLIC
HEALTH ISSUE WHICH IS STROKE AND
IN PARTICULAR WITH REGARD TO
STROKE AND ASIAN AMERICANS.
THIS SLIDE BASICALLY SHOWS AS I
MENTIONED THAT AANHPI
INVESTIGATORS HAVE A CRITICAL
COMPONENT OF GRANTEES AND NESNRY
AND ABOUT 30% OF OUR MENTEES ARE
OF ASIAN HERITAGE AND RECOGNIZE
AND HAVE RECOGNIZED OVER THE
PAST COUPLE YEARS THE SERIOUS
CONCERN OF DISCRIMINATION
DR. TABAK MENTIONED AND I'LL GO
TO COMMON CONDITIONS AND ONE IS
ALZHEIMER'S DISEASE AND THIS IS
GOING TO COME TO A HEAD I THINK
SHORTLY AS THE ANTI-AMYLOID
DRUGS COME TO THE SECTOR AND THE
QUESTION IS WHO BENEFITS AND WHO
WILL HAVE MORE RISK THAN BENEFIT
FROM THE THERAPIES AN THERE'S
REASON TO BELIEVE THERE MAY BE A
HETEROGENEITY IN ANSWERS TO
THOSE QUESTIONS WITH RESPECT TO
ONE'S HERITAGE.
AND THEY'RE SMALLER MORE
COMPARATIVELY IN ASIAN AMERICANS
AND NOT SURE WHAT THIS MEANS
WITH REGARD TO THE ANTI-AMYLOID
THERAPY BUT THERE'S MAJOR
BIOLOGICAL DIFFERENCES THAT WE
HAVE TO TAKE CARE TO
INVESTIGATE.
NOW, STROKE IT'S IMPORTANT FOR
THE ASIAN AMERICANS TO PAY
SPECIAL ATTENTION TO STROKE RISK
BECAUSE AND PARTS OF CHINA
REALLY THE ONLY PLACE IN THE
WORLD WHERE STROKE IS A GREATER
CAUSE OF MORTALITY THAN HEART
DISEASE.
FOR WHATEVER REASON THE BLOOD
VESSELS IN THE BRAIN MAY BE MORE
VULNERABLE TO THINGS LIKE
HYPERTENSION AND SMOKING THAN
THE HEART VESSELS IN ASIANS AND
THAT ALSO CAN AFFECT ASIAN
AMERICANS.
IF YOU LOOK AT THE U.K. AND
ASIAN AMERICANS LIVING IN
BRITAIN AND THE PATTERN OF SOUTH
ASIANS, THOSE FROM INDIA, AND
THE INCIDENTS OF STROKE IS LESS
IN HONOLULU STUDY THAN THE
FRAMINGHAM STUDY AND YOU HAVE
CONDITIONS LIKE AGGRESSIVE
STENOSIS OF THE INTERNAL CAROTID
ARTERIES AND THIS IS MUCH HIGHER
INCIDENTS AND PREVALENCE IN
JAPAN THAN IN NON-HISPANIC
WHITES, FOR INSTANCE.
THE OTHER POINT MADE BEFORE IS
THAT THE DIFFERENCE ASIAN
SUBPOPULATIONS ARE ACTING
DIFFERENTLY AND SO WE NEED TO
DISAGGREGATE THE SUBGROUP DATA
TO PROVIDE INTERVENTIONS AND
REDUCE ALL-STROKE MORTALITY.
AND THIS IS A PICTURE OF THE
STANDARDIZED DISABILITY LEADING
INTO THE BRAIN AND THE PRIMARY
CAUSE IS HYPERTENSION AND YOU
CAN SEE HERE THE LIGHT BLUE AND
YELLOW TO REDS AND HIGH
INCIDENTS AND INCREASES AND
INCIDENTS IN SOUTHEAST ASIANS
AND CHINA AND THIS IS LEADING TO
THE BRAIN AGAIN WE THINK MUCH
MORE COMMON IN ASIAN AMERICANS
AS WELL AS THOSE LIVING IN THESE
COUNTRIES COMPARED TO
NON-HISPANIC WHITES.
THE TAKE HOME MESSAGE HERE IS
AGGRESSIVE BLOOD PRESSURE
CONTROL AND YOU SEE THE RED AND
YELLOW HERE AND AGAIN STROKE
MUCH MORE COMMON IN ASIANS AND
IN ASIAN AMERICANS.
IF YOU LOOK AT U.S. DATA OF
ASIAN AMERICANS THE MORTALITY
COMPARED TO NON-HISPANIC WHITES
IS AS HIGH AS 1.6 FOR ALL ASIAN
AMERICAN AND GOES UP TO 1.8 FOR
VIETNAMESE MEN AND AGAIN THE
TAKE HOME POINT IS ASIAN
AMERICANS ARE MUCH MORE
SUSCEPTIBLE TO STROKE, DEATH AND
MOBILITY AND THE NEXT SLIDE
SHOWS DATA FROM THE GUIDELINE
PROJECT ACROSS THE U.S. LOTS OF
PEOPLE IN THIS 1. 7 MILLION
WHITES AND 6.4 MILLION ASIAN
AMERICANS AND WE SEE GREATER
STROKES IN ASIAN AMERICANS AND
HIGHER MORTALITY AND LONGER
LENGTH OF STAY, LESS LIKELY TO
LEAVE WITH DISCHARGE AND HAVE
MORE HEMORRHAGES AFTER BEING
TREATED AND MORE COMPLICATIONS
AND ACTUALLY THEY ARE TREATED
SIMILARLY IF NOT BETTER IN TERMS
OF GUIDELINES THROUGH ISSUES
MORE RELATED TO BRAIN AND THE
VASCULAR DISEASE THAN AN PROCESS
MEASURED.
THIS IS LOOKING AT
ATHEROSCLEROSIS AND AS I
MENTIONED BEFORE THAT IN ASIAN
AMERICANS AND PEOPLE LIVING IN
ASIA THERE'S A PROPENSITY FOR
ATHEROSCLEROSIS TO INVOLVED THE
INTRACRANIAL VESSELS AND YOU SEE
THE DIFFERENCES BETWEEN EXTRA
CAROTID ATHERO VERSUS
INTRACRANIAL AND FOR ASIAN
AMERICANS AND CHINESE IT'S
HIGHER ON THE INTRACRANIAL SIDE
THAN THE CAROTID SIDE.
IN PARTICULAR STROKES ARE COMMON
IN ASIAN AMERICANS PARTICULARLY
CHINESE.
HERE YOU CAN SEE THE DATA IN
HONG KONG WITH REGARDS TO THE
PATIENTS WITH STROKE DUE TO
INTRACRANIAL SCLEROSIS AND WHAT
WE'RE DOING AT NIH IS FUNDING A
TRIAL OF INTRACRANIAL STENOSIS
AND HAVE DONE A NUMBER OF TRIALS
OVER THE YEARS LOOKING AT MORE
AGGRESSIVE ANTI-PLATELET AGENTS
FOUND TO BE MOST EFFECTIVE.
BUT LOOKING ALSO AT THE DRUG
THAT REQUIRES METABOLISM LESS
EFFECTIVE IN ASIAN AMERICANS AND
WE'RE LOOKING AT THAT AND OF ALL
THE DIFFERENCES BETWEEN ASIAN
AMERICANS AND CAUCASIANS THAT
NEED TO BE TAKEN INTO ACCOUNT.
THIS SHOWS THE DIFFERENCES
BETWEEN DIFFERENT SUBGROUPS OF
ASIAN AMERICANS IN THE STROKE
RISK.
THE VIETNAMESE IS ACTUALLY THE
HIGHEST OF ALL.
NEXT IS THE GREEN WHICH IS
ASIAN-INDIAN AMERICANS AND AGAIN
THEY'RE 1.6 TIMES HIGHER THAN
FOR NON-HISPANIC WHITES AND THE
TAKE HOME MESSAGE IS MORE BLOOD
PRESSURE CONTROL AND WE JUST HAD
A MEETING WITH REGARD TO THE
FIRST ITEM I BROUGHT UP WITH THE
EXTRAMURAL ENGAGEMENT GROUP TO
IMPROVE THE CULTURE OF PEOPLE TO
TALK ABOUT THEIR ISSUES AND ALSO
BRING ANYTHING THAT CAN BE
SOLVED TO THE LEADERSHIP OF
NINDS.
AS I SAID OUR GOAL WAS TO MAKE
THIS A WELCOMING PLACE FOR
EVERYBODY TO WORK .
WITH THAT, THANK YOU FOR YOUR
ATTENTION AND TAKE CARE OF YOUR
BLOOD PRESSURE.
>>THANK YOU VERY MUCH,
DR. KOROSHETZ AND THANK YOU TO
ALL THE NIH LEADERS WHO HAVE
SPOKEN AND THIS CONCLUDES THIS
SEGMENT OF THE CONFERENCE AND
NOW I WILL TURN THE PODIUM TO MY
COLLEAGUE, AND TO INTRODUCE OUR
KEYNOTE SPEAKER.
NEXT IS DIRECTOR OF THE DIVISION
OF HEALTH AND BEHAVIORAL AND
VICE CHAIR OF RESEARCH AT THE
DEPARTMENT OF POPULATION HEALTH
AT NYU SCHOOL OF MEDICINE.
RESEARCH HAS FOCUSSED ON
PREVENTION AND REDUCING HEALTH
DISPARITIES AND ADVANCING HEALTH
EQUITY.
THEY HAVE DEVELOPED EXPERTISE IN
PARTICIPATORY RESEARCH AND
IMPLEMENTATION RESEARCH.
A
AND ALSO IS FROM NCI CANCER
CENTER AND HELD A DOCTORATE IN
PUBLIC HEALTH FROM COLUMBIA
UNIVERSITY AND CO-AUTHORED
PUBLICATIONS AND BOOKS AND ONE
ON POPULATION HEALTH APPROACHES
FOR ASIAN AMERICAN COMMUNITY.
PLEASE WELCOME DR
DR. TRINH-SHEVRIN.
>>THANK YOU.
I'M SHARE ON RESEARCH ON ASIAN
AMERICANS.
I'M A FIRST GENERATION IMMIGRANT
AND CAME TO THE UNITED STATES IN
1975 AND THIS NEWSPAPER CLIPPING
CAPTURES THE MOMENT WHEN MY
FAMILY ARRIVED IN SHREVEPORT,
LOUISIANA.
CURRENTLY I'M AT THE NYU SCHOOL
OF MEDICINE WHERE I LEAD FUNDED
HEALTH EQUITY RESEARCH PROGRAMS.
I HAVE NO CONFLICTS OF INTEREST
IN THE PRESENTATION TODAY.
I CO-LEAD WITH THE NATIONAL
CENTER FOR THE STUDY OF ASIAN
AMERICAN HEALTH AND GOING IN OUR
21st YEAR AS THE CENTER OF
EXCELLENCE.
WE WORK WITH COMMUNITY PARTNERS
AND ACADEMIC PARTNERS ON
SUPPORTING COMMUNITY-ENGAGED
RESEARCH AND WE ALSO SERVE
NATIVE HAWAIIAN AND PACIFIC
ISLANDER POPULATION TO PROMOTE
EQUITY AND DATA COLLECTION FOR
OUR AGENCIES AND CO-LEAD WITH
THE MOUNT SINAI SCHOOL OF
MEDICINE AND INSTITUTE FOR
FAMILY HEALTH A COMMUNITY
ENGAGEMENT ALLIANCE TO END COVID
DISPARITIES.
IT'S FOCUSSED ON BLACK AND LATIN
AMERICAN COMMUNITIES IN NEW YORK
AND OUR WORK IS PRESENTED WITH
THIS AND THE NEW YORK SEAL
AWARD.
THE PRESENTATION WILL TOUCH ON
SOCIAL AND HEALTH CONTEXT
DRIVERS OF HEALTH DISPARITIES
AND ADVANCING HEALTH EQUITY AND
WELL BEING AMONG ASIAN AMERICAN
POPULATIONS.
A LITTLE CONTEXT ASIAN AMERICANS
ARE THE FASTEST GROWING MINORITY
GROUP AND EXPECTED TO SURPASS 36
MILLION FUELED IN PART BY
IMMIGRATION TRENDS.
ALSO MANY ETHNICITIES FALL IN
THE POPULATION AND BROAD
CATEGORIES INCLUDE SOUTHEAST AND
ASIANS AND THERE'S SUB GROUPS IN
THOSE CATEGORIES.
AND THEY'RE ALSO DISPERSED MORE
THAN HALF LIVE IN FIVE STATES
AND NEW YORK HAS THE HIGHEST
CONCENTRATION ABOUT 1.4 ASIAN
AMERICANS.
THERE'S A GREATER PERCENTAGE OF
ASIAN AMERICANS WHO ARE FOREIGN
BORN AND WHEN YOU LOOK AT THE
DATA DISAGGREGATES THERE'S A
HIGH OF 85% AMONG TWO GROUPS AND
HIGHER IN THE U.S. RATE.
IN THE AGGREGATE ASIAN AMERICANS
SEEM TO HAVE A HIGHER LEVEL OF
EDUCATION ATTAINMENT COMPARED TO
THE REST OF THE U.S.
BUT WHEN THE DATA IS
DISAGGREGATED YOU SEE TREMENDOUS
DIFFERENCES ACROSS GROUPS AMONG
CAMBODIAN, BURMESE AND OTHERS
ARE BELOW THE NATIONAL AVERAGE.
INCOME ALSO TELLS A SIMILAR
STORY.
IN THE AGGREGATE ASIANS APPEAR
TO HAVE A HIGHER IMMEDIATE
HOUSEHOLD INCOME AND YOU SEE
DIFFERENCES IN INCOME LEVELS
ACROSS GROUPS.
FOR EXAMPLE SOME ARE A MUCH LESS
HOUSEHOLD INCOME.
IN NEW YORK CITY, ONE OUT OF
FIVE ASIANS ARE LIVING IN
POVERTY.
THIS IS OFTEN AN UNDER
RECOGNIZED MARKER OF
DISADVANTAGE.
AND DIFFERENT ENGLISH PROF
PROFICIENCY RATE AND HAS
IMPLICATIONS WITH RESPECT TO
LANGUAGE ACCESS.
HERE WE HAVE DATA FROM
CALIFORNIA THAT DEMONSTRATE THE
LEADING CANCER TYPES DIFFER
CONSIDERABLY ACROSS GROUPS AND
AS MENTIONED EARLIER THEY'RE
PROMINENT FOR MANY GROUPS AND
SOME ARE PREVENTIBLE AND YET
UNDER DETECTED.
COMPARED TO OTHER GROUPS, CANCER
SCREENING RATES OF PREVENTIVE
BEHAVIORS ARE LOWER AMONG ASIAN
AMERICANS.
IN TERMS OF DIABETES WE SEE IN
NEW YORK CITY THAT SOUTH AND
SOUTHEAST ASIAN HAVE AMONG THE
HIGHEST PREVALENCE AFTER MEXICAN
AMERICANS.
WHEN YOU LOOK AT OTHER DATA SETS
IN GEOGRAPHIC AREAS, ASIA ASIAN
AMERICANS AND FILIPINOS HAVE A
GREATER DIABETES PREVALENCE AND
DISTINCT DIFFERENCES ACROSS
GROUPS.
AND I WANT TO TOUCH ON MENTAL
HEALTH DISPARITY.
SUICIDE IS THE EIGHTH LEADING
CAUSE OF MORTALITY FOR ASIAN
AMERICANS COMPARED TO THE TENTH
FOR OTHER ETHNIC GROUPS AND
SUICIDE IS THE LEADING CAUSE OF
MORTALITY FOR ASIAN AMERICAN
YOUTH UNDER THE AGES OF 19.
PART IS DUE TO CHALLENGES OF
ACCESSING MENTAL HEALTH SERVICES
DUE TO STIGMA AND CULTURAL NORMS
AND LANGUAGE ACCESS AND LARGELY
DUE TO THE LACK SHORTAGES OF
BILINGUAL WORKFORCE AND I WANT
TO GIVE A QUICK COMMENT BEFORE
COVID WE OBSERVED MANY OF THE
DISEASES THAT WE TARGET SUCH AS
HYPERTENSION AND DIABETES AND
CANCER, MENTAL HEALTH AN STRESS
ARE PROMINENT FEATURES OF WHAT
IS SHARED BY STUDY PARTICIPANTS
IN OUR COMMUNITIES.
AND POST COVID IT HAS IMPACTED
COMMUNITIES OF WELL-BEING AND
LOOKS AT OTHER HEALTH
CONDITIONS.
WE LOOK AT HEALTH DISPARITIES
UNIQUE TO THE ASIAN AMERICANS
POPULATION.
THE MODERN MINORITY MYTH IS A
PERSISTENT STEREOTYPE AND HELP
TO REPRODUCE INEQUITIES FOR
ASIAN AMERICAN COMMUNITIES.
THE STEREOTYPE IS THE NOTION
THAT ASIAN AMERICANS ARE
HEALTHIER AND WEALTHIER AND
WISER THAN OTHER COMMUNITIES AND
WHILE SEEMINGLY POSITIVE HAS
IMIMPACTED SOCIAL POLICIES AND
DIRECT IMPACT ON RESEARCH
FUNDING.
HERE'S THE COVER OF TIME
MAGAZINE REFLECTING ASIAN
AMERICANS AS WIZ KIDS BUT IN
REALITY DOESN'T REFLECT THE FULL
ETHNIC AND DIVERSITY OF ASIAN
AMERICANS IN THE U.S. MORE HAVE
AND HOW IMMIGRATION PATTERNS
AFFECT MENTAL HEALTH AND TRAUMA
AND LANGUAGE INCREASES BARRIERS
AND DISPARITIES.
THERE'S BEEN A HISTORY OF
NEGATIVE PROPAGANDA AND
RESTRICTIVE POLICIES DIRECTED TO
ASIANS AND THE END RESULT
STIGMATIZING THEM AS NOT
TRUSTWORTHY AND SEEN AS
OUTSIDERS NOT FIT FOR AMERICAN
CITIZENSHIP AND THE INTERNMENT
OF ASIAN AMERICANS DURING WORLD
WAR II.
THEY'RE ALSO VIEWED AS DISEASE
CARRIERS AND SUCH RHETORIC
INCREASES VIOLENCE SINCE MARCH
OF 2020 HAVE LED TO COMMUNITY
TRAUMA AND STIGMATIZATSTIGMATIZ.
ASIANS WERE ONCE VIEWED AT
OUTSIDERS AND LUMPED TOGETHER
AND REINFORCING ATTITUDES AND
STEREOTYPES.
LESS FOCUS GOES TO SOCIAL NEEDS
AND LESS DATA IS PRODUCED.
AND WITH THAT LIMIT IN DATA IT
LEADS THE DATA TO BE AGGREGATED
AND OBSCURING DISPARITIES AND
THE CONCLUSION IN THE 1985 BLACK
AND MINORITY HEALTH REPORT OVER
ALL THIS IS A POPULATION
HEALTHIER THAN OTHERS AND
ENFORCING THE NOTION WE'RE ONE
MONOLITHIC POPULATION.
THIS HAVECONTRIBUTE TO WHAT HAS
PLAYED OUT WITH COVID AND
RESEARCH WAS FOCUSSED ON BLACK
AND LATIN POPULATIONS WHO FACED
DISCRIMINATION EARLY IN THE
PANDEMIC AND THERE'S
IMPLICATIONS IN TERMS OF THE
EARLIER RESOURCE ALLOCATION
POLICIES.
ADMINISTRATIVE DATA CONTRIBUTE
TO THE CHALLENGE OF POOR DATA
AND REINFORCING BIASES AND
MISCONCEPTIONS.
IN DATA LAST FALL WE SEE HOW
MISSING AND AGGREGATED DATA
OBSCURES HEALTH INEQUITIES HERE
AND THERE'S A SUBSTANTIAL
PROPORTION OF DATA CLASSIFIED AS
OTHER AND ARE MISSING AND FOR
THOSE NOT MISSING THEY'RE
AGGREGATED AND THOSE CLASSIFIED
AS OTHER FALL WITHIN THE GROUPS
NOTED ON THE RIGHT INCLUDING
ASIAN AMERICANS AND NATIVE
HAWAIIAN AND PACIFIC ISLANDERS.
TO UNDERSTAND THE DISPARITIES
DURING COVID COLLEAGUES WORKED
WITH THE HEALTH AND HOSPITALS
CORPORATION WHICH IS THE LARGEST
SAFETY NET SYSTEM IN THE NEW
YORK CITY AND EXAMINED DATA
DURING THE HEIGHT OF THE
PANDEMIC IN NEW YORK CITY AND
THROUGH THAT INNOVATIVE METHOD
THEY WERE ABLE TO SUPPORT
DISAGGREGATED DATA COLLECTION
AND REVEALED SOUTH ASIANS
RELATED DISCRIMINATION LEADING
TO HOSPITALIZATION AND DEATHS
AND LESS THAN 1% OF NIH FUNDING
HAS BEEN FOCUSSED ON THIS ASIAN
AMERICAN NATIVE HAWAIIAN PACIFIC
ISLANDER POPULATIONS AND FOUND
CONSISTENTLY OVER TIME IN TWO
DIFFERENT REPORTS AND SEVERAL
RECENT ARTICLES INCLUDING
ANOTHER AND THERE'S INCREASING
RECOGNITION OF THE KNOWLEDGE
GAPS AND INEQUITIES IN RESEARCH
FUNDING AND SUPPORT BY THE
CURRENT ADMINISTRATION AS WELL
AS THE 2021 TRANS-NIH WORKSHOP
IN TODAY'S CONFERENCE TO SUPPORT
DATA IN RESEARCH EQUITY FOR OUR
COMMUNITIES.
SO QUICKLY RECOMMENDED
STRATEGIES IN TERMS OF FUTURE
DIRECTIONS, AGAIN, ADVANCING
DIALOGUE AND OUR COMMUNITY
PARTNERS WANT DATA EQUITY AND
DATA AGGREGATED AND BROKEN DOWN
BY GENDER AND RACE AND WANT IT
TO INFORM THEIR PRIORITIES.
WE'RE WORKING WITH NATIONAL
PARTNERS INCLUDING THE ASIAN
AMERICAN HEALTH BOARD TO LOOK AT
DATA AND IMPROVE THAT CAPACITY
IN THE ELECTRONIC HEALTH RECORDS
AND OTHER SURVEYS TO PROMOTE
DISAGGREGATED DATA PROMOTION AND
ANALYSIS.
AND THERE'S A NEED FOR PRACTICE
RELEVANT TO MINORITY BASED
COMMUNITIES AND RESEARCHERS
SKILLED IN REACHING SMALLER
POPULATIONS NOT WHERE HE FLECTED
IN LARGER STUDIES.
IN THE WORK WE DO IN THE STUDY
OF ASIAN HEALTH WE REDUCE
BARRIERS TO AC ACCESS AND THOSE
ASSOCIATED WITH SOCIAL
DETERMINATES OF HEALTH AND
REALIZING HEALTH OCCURS AT
MULTIPLE LEVELS.
FOR EXAMPLE, OUR COMMUNITY
CLINICAL LINKAGE INTERVENTIONS
FOR CANCER, DIABETES AND
HYPERTENSION HAVE APPLIED THE
NIMHD FRAMEWORK AND
IMPLEMENTATION RESEARCH AND
PARTICIPATORY APPROACHES TO
TACKLE MULTIPLE LEVELS OF
INFLUENCE TO ENSURE REACH,
ADOPTION AND SUSTAINABILITY.
RECENTLY IN OUR WORK OF CANCER
PREVENTION COLLABORATING WE
INCORPORATED RACIAL EQUITY IN
OUR HEALTH EQUITY PRINCIPLES.
FOR EXAMPLE, STRATEGIES THAT
PROMOTE POWER SHARING AND
CAPACITY BUILDING AND
ACCOUNTABILITY BUILDING AND
RESEARCH SHARING AND ADDRESSING
SOCIAL AND SYSTEM LEVEL CAUSES
OF DISPARITIES.
WE WORKED CLOSELY WITH COMMUNITY
PARTNERS AND MEMBERS TO ENSURE
THE STRATEGIES THAT WE DEVELOP
ARE APPROPRIATE AND MEANINGFUL
AND CULTURALLY AND LINGUI
LINGUISTICALLY RELEVANT.
WE WORK WITH COMMUNITIES WITH
LIMIT TO ENGLISH AND MISTRUST IN
SCIENCE AND APPROACHES ARE
INTEGRAL IN DETERMINING THE
APPROACH AND REACHING UNDER
SERVED COMMUNITIES AND CLINICAL
PROVIDERS AND FACILITATING
BEHAVIOR CHANGE AND ADHERENCE
AND TRUSTED MESSENGERS.
CHW COMMUNITY HEALTH WORKERS CAN
PLAY A CRITICAL ROLE IN
MITIGATING SYSTEM-LEVEL BARRIERS
AND ACCESS TO CARE.
STUDIES HAVE DOCUMENTED THIS FOR
MANY PROGRAMS FOCUSSED ON
CANCER, DIABETES AND
HYPERTENSION DISPARITIES.
NEXT, I WANT TO BACK TO THE
ISSUE OF MENTAL HEALTH AND
TRAUMA AND NOW THAT WE ENTERED A
POST-COVID PERIOD IT'S BECOME
IMPORTANT TO THINK THROUGH AS WE
DEVELOP INTERVENTIONS WHETHER IT
BE FOR CANCER OR DIABETES TO
INTEGRATE MENTAL HEALTH
STRATEGIES IN OUR WORK.
IN THE CASE OF MENTAL HEALTH AND
CANCER THAT RELATIONSHIP IS
OFTEN OVERLOOKED YET MENTAL
HEALTH IS A FUNDAMENTAL
COMPONENT OF IMPROVING CANCER
OUTCOMES.
WE KNOW SUICIDE RATES ARE HIGHER
AMONG CANCER PATIENT SURVIVORS
COMPARED TO THE GENERAL
POPULATION.
THINKING THROUGH HOW DO WE
IMPROVE CANCER OUTCOMES AND
IMPROVE MENTAL HEALTH AND LOOK
IS CRITICAL AND MORE IMPORTANT
NOW.
IN THE WORK WE'RE DOING WE USED
CULTURE PARTICIPATORY FRAMEWORK
DESCRIBED EARLIER AS WELL AS
DESIGNED THINKING APPROACHES TO
UNDERSTAND THE CHALLENGES OF THE
COMMUNITY AND SYSTEM LEVEL FROM
THE PERSPECTIVE OF PATIENTS
ANDERS ON ACCESSING MENTAL
HEALTH CARE AND SOCIAL SUPPORT.
IN DOING THAT WORK, HERE'S A
PRELIMINARY MAP OF THE CANCER
PATIENT JOURNEY AND THE PAIN
POINT AND OPPORTUNITIES FOR
SCREENING AND SOCIAL
DETERMINATES OF HEALTH AND
THINKING THROUGH HOW DO WE
SUPPORT THE CAPACITY AND CAN WE
INTEGRATE COMMUNITY HEALTH
WORKERS FOR EXAMPLE TO ADDRESS
SOME OF THOSE GAPS WITH RESPECT
TO MENTAL HEALTH WORKFORCE AND
WORK IN CLOSE RELATIONSHIP WITH
CLINICAL PROVIDERS TO PROVIDE
THE RIGHT KIND OF CARE.
AND THE PATIENT-CENTERED
APPROACH IS NEEDED.
IN ADDITION WE'RE DOING WORK
AROUND SOCIAL DETERMINATES OF
HEALTH TO ADDRESS FOOD
INSECURITY THAT IMPACT OBESITY
AND CANCER RISK AND THERE'S A
SYSTEM SCIENCE APPROACH TO
UNDERSTAND FOOD INSECURITY AND
OBESITY RISK FOR RACIAL-ETHNIC
COMMUNITIES AND FROM THAT EFFORT
ESTABLISHED BUILDING ACCESS TO
FOOD THROUGH SYSTEMS OF
SOLIDARITY AND PILOTED THAT WORK
IN CHINESE AMERICANS.
WORKING WITH COMMUNITY PARTNERS,
IDENTIFYING SOLUTIONS AND
CO-CREATED STRATEGIES.
LEADING TO A MULTI PRONGED
APPROACH TO IMPROVING FOOD
ACCESS AND CULTURALLY RELEVANT
NUTRITION INFORMATION AND
PROCUREMENT PRACTICES CENTERED
ON COMMUNITY PREFERENCES AND
OPPORTUNITIES FOR LEARNING AND
SOCIAL ENGAGEMENT.
A QUICK SUMMARY OF RECOMMENDED
STRATEGIES TO ADVANCE EQUITY AND
WELL BEING.
WE NEED TO DISMANTLE POLICIES
ROOTED IN RACISM AND XENOPHOBIA
AND ENCOURAGE COMMUNITY PARTNERS
AND MEMBERS TO ENCOURAGE
SOLUTIONS FOR THEIR COMMUNITIES
AND SUPPORT DATA EQUITY THROUGH
RESEARCH FUNDING AND A HEALTH
APPROACH IS KEY TO ADDRESSING
SOCIAL FACTORS THAT INFLUENCE
WELL BEING, ACCESS, ENGAGEMENT,
ADOPTION AND ADHERENCE.
THE USE OF FRAMEWORKS ARE
IMPORTANT FOR SUCCESSFUL AND FOR
MINORITIZED FRAMEWORKS SHOULD BE
PART OF THAT.
COMMUNITY HEALTH WORKERS AND
STRATEGIES ARE NECESSARY IN
REACHING MINORITIZED COMMUNITIES
AND BRIDGING THE GAPS IN TRUST
AND AS MENTIONED BEFORE WE NEED
TO INTEGRATE TRAUMA-INFORMED AND
MENTAL HEALTH STRATEGIES FOR ALL
DISEASE CONDITIONS IN HEALTH
OUTCOMES AND FINALLY, I WOULD
ALSO RECOMMEND FOSTERING
WORKFORCE DEVELOPMENT AND
DIVERSITY THAT INCLUDE ASIAN
AMERICANS, NATIVE HAWAIIAN AND
PACIFIC ISLANDERS OFTEN LEFT OUT
IN THE DISCOURSE AND PROGRAMS ON
DIVERSITY AND CRIN COLLUSION AND
NEED A WORKFORCE TRAINED IN
HEALTH EQUITY RESEARCH AND WHO
ARE REPRESENTATIVE OF THOSE
COMMUNITIES.
IT'S CRITICAL TO ADVANCING
HEALTH EQUITY AND STRENGTHENING
THE RESEARCH WORKFORCE
REFLECTIVE OF THE COMMUNITY'S
EXPERIENCING HEALTH DISPARITIES.
I'M PLEASED SOME OF THESE
STRATEGIES ARE ALIGNED TO THE
NIH ROAD MAP DESCRIBED EARLIER
TODAY.
AND FINALLY THIS IS THE STUDY
FOR THE CENTER OF ASIAN AMERICAN
HEALTH AND REFLECTS THE WORK
THEY DO FOR MORE INFORMATION I
URGE YOU TO LOOK AT THE RECENTLY
PUBLISHED TEXTBOOK ON APPLIED
HEALTH APPROACHES FOR ASIAN
AMERICAN COMMUNITIES.
THANK YOU.
>>OKAY.
AS IRRITATING AS IT MIGHT BE TO
OVERCOME TECHNOLOGY, SERENDIPITY
HAS MANAGED AND HAPPY TO ROUND
OUT THE SESSION WHICH HAS BEEN
INFORMATIVE AND DATA DRIVEN.
THANK YOU FOR SHARING THE DATA
AND TO MY COLLEAGUES,
DR. PEREZ-STABLE AND DR. CHANG
AND YOU INSPIRE ME EVERY TIME I
HEAR YOU TALK.
I'LL TAKE A DIFFERENT TWIST ON
THIS BECAUSE A LOT OF THE POINTS
I HAD HAVE BEEN COVERED AND I'LL
BE GOING FASTER THAN USUAL AND
STARTING OUT FIRST BY BRINGING
WARM GREETHS FROM -- WARM
GREETINGS.
WE HAVE ONE OF THE MOST DIVERSE
LEADERSHIP TEAMS ON THE CAMPUS.
A SHOUT OUT TO MANY AND WE HAVE
A YOGA CLASS LATER AND
ACTIVITIES THAT IS ENRICHED BY
THE PRESENCE OF COMMUNITIES SUCH AS THIS
SO MY THEME IS A BIT EXTENDED
FROM WHAT YOU HAVE ALREADY
HEARD.
IMPROVING THE HEALTH, WELL BEING
AND EQUITY OF OUR COMMUNITIES IS
A MULTI-PRONGED CHALLENGE AND
I'M DELIGHTED THE EMPHASIS IS ON
THE SCIENCE.
YOU LOOK AT RISK FACTORS,
GENETIC, ANCESTRY DISEASE
MECHANISMS, ETCETERA.
I WANT TO GLOSS OVER NIDCRs
COMMITMENTS AND APPRECIATE WHY I
CAN GO INTO DEPTH AND PERHAPS
WILL ASK FOR THE COMMUNITY TO
SHARE THE ISSUES, CHALLENGES
THAT WE DEAL WITH IN ORAL
HEALTH.
I WANT TO ALSO CONTINUE TO TALK
ABOUT THE MIX THAT CONTRIBUTE TO
HEALTH DISPARITIES AND ALL OF
YOU HAVE COVERED THAT
BEAUTIFULLY.
AND IT'S NOT SO MUCH OF WHAT
HAVE YOU ALL GET TO KNOW ME
THOROUGHLY AND FOR ME TO SHARE
THE LESSONS LEARNED AND THE
LESSONS I WISH TO SIMPLY OPEN UP
FOR DISCUSSION AS WE CONTINUE
ON.
THE ORAL CAVITY, ENTIRE COMPLEX
WE CALL DENTAL CRANIOCOMPLEX IS
ESSENTIAL FOR HEALTH AND
WELL-BEING.
WE'RE WORKING HARD TO ESTABLISH
THE MOLECULAR MECHANISM THE
FACTORS THAT CONTRIBUTE TO THESE
CONNECTIONS AND MANY IN
ALZHEIMER'S AND COGNITIVE
DECLINE AND ASIAN AMERICAN
COMMUNITIES AND NATIVE HAWAIIAN
AND PACIFIC ISLANDERS ARE
SUBJECT TO EFFECTS OF THESE
CONNECTIONS.
THE PORTAL OF ENTRY FOR THE
COMMON RISK FACTORS,
CARDIOVASCULAR DISEASE AND
METABOLIC SYNDROME WE ARE
CONNECTED AND OUR SOCIETY AND
HEALTH POLICIES AND COVERAGE
PROVIDERS ARE NOT QUITE
INCLUSIVE OF THIS COMPLEX.
THAT APPLIES TO VISION AND
DEAFNESS AND MENTAL HEALTH AS
WELL.
IN RECOGNIZING THIS IMPORTANCE
NIDRR ESTABLISHED A HEALTH
STATUS OF THE NATION AFTER THE
FIRST SURGEON GENERAL'S REPORT
THAT BROUGHT TO LIGHT THE
IMPORTANCE OF ORAL HEALTH.
AS WE SPEARHEADED THIS THROUGH
THE PANDEMIC TO GET TO
COMPLETION WHAT STOOD OUT TO ME
WAS THE ONE CONCLUSION THAT IN
FACT POPULATIONS IN THE
U.S. EXPERIENCE ORAL HEALTH
DIFFERENTLY.
FOR THAT REASON OUR STRATEGIC
PLAN SURPRISINGLY DEVELOPED
INDEPENDENTLY FROM THE REPORT
FOCUSES ON THE HIGH LEVEL THEMES
OF TRANSLATING IMPLEMENTATION
SCIENCES IN A BIG WAY TO MAKE
SURE OR WORKFORCE THAT WE TRAIN
AND PREPARE FOR THE FUTURE
REPRESENT THE DEMOGRAPHICS OF
OUR NATION AND WILL CONTINUALLY
BE EVOLVING AND EVALUATING THE
OUTCOMES OF OUR PROGRAMS.
SO WE HAVE A STRATEGIC PLAN WITH
THE PATIENT IN THE CENTER AS YOU
SEE WITH ONE CLEAR GOALS WHICH
IS TO MAKE SURE THAT OUR SCIENCE
PROVIDES THE EVIDENCE THAT CAN
GUIDE SYSTEMS, POLICIES, SOCIETY
SO ORAL HEALTH IS AVAILABLE FOR
ALL AND HAVE IN PLACE A ROBUST
PROGRAM INCLUSIVE AND BRINGING
TO THE FORE THE SENSE OF
BELONGING THAT EVERYONE ON OUR
CAMPUS FEELS THAT SENSE OF
BELONGING.
AND WE KNOW VERY WELL STRUCTURAL
RACISM IN OUR SOCIETY IS THE BED
ROCK OF HEALTH INEQUITIES AND
DISPARITIES.
LOOKING FROM A HOLISTIC VIEW,
WHAT IS THAT CEILING?
YOU HEARD ABOUT IT.
OUR LAST SPEAKER ELOQUENTLY
DESCRIBED THAT AND THE FEELING
DOES NOT IMPLY IT'S A WEAK
BARRIER.
AS YOU KNOW THERE ARE BUILDINGS
MADE OF BAMBOO.
IT CAN BE A RESILIENT FIBER AND
INTERTWINED IN THE COMPLEXITY OF
WHAT WE FACE AS ASIAN AMERICAN
NATIVE HAWAIIAN PACIFIC
ISLANDERS IT'S A DETRIMENT
RIGHT.
SO THE MINORITY MYTH YOU HEARD
ABOUT IS THAT IN FACT OUR
POPULATIONS ARE QUITE
INDUSTRIOUS AND THERE'S A
CULTURE UNIQUENESS THAT
SOMETIMES DIVIDE US AND WITH
LANGUAGES AND RELIGIONS AFFECT
THE DIETS WE EAT AND SOCIAL
CONNECTIONS WE MAKE AND THIS
APPLIES TO THE PACIFIC
ISLANDERS.
YOU SEE THE VARIATION IN THE
DIVERSITY WITHIN THE
POPULATIONS.
FOR US IN ORAL HEALTH AND
LOOKING AT THE WORKFORCE ITSELF
YOU SEE THE UNDER REPRESENTATION
AND LEADERS IN ACADEMIA ARE
POORLY REPRESENTED AND WE HAVE
STUDENTS COMING IN BUT THOSE AT
THE TABLE MAKING DECISIONS AND
EMPOWERED TO DO SO THERE'S ROOM
THERE TO GROW.
AND THE CEILING ITSELF IS
DEFINED AS GENERAL POPULATIONS
THAT SUFFER FROM THE SAME
INEQUITIES AND BARRIERS AND MANY
ARE CULTURALLY DERIVED.
I'M PLEASED THIS MONTH WE CAN
HIGHLIGHT OUR UNIQUENESS AND
CULTURE.
COLLECTIVISM AND TRYING TO BE
PEACE MAKERS AND PUTTING THE
NEEDS IN FRONT OF US IS THE WAY
WE WERE RAISED.
DEFERENCE FOR AUTHORITY AND
OCCUPATION ACHIEVEMENTS AND THE
POWERFUL SENSE OF FAMILY VALUES
AND TRUE RESPECT FOR AUTHORITY
AND WHO WE ARE AND THIS I THINK
IS UNIQUE CULTURAL THEMES THAT
CONNECT US AND CONSIDERED AS BIG
STRENGTHS IN SOCIETY.
THE PROBLEMS WE REALIZED WITH
THE BAMBOO CEILING IS MANY OF US
LIVE UNFULFILLED POTENTIAL WITH
FRUSTRATIONS.
WE TURNOVER OFTEN BECAUSE
THERE'S NO ONE'S PATH WHO IS
PATH WE CAN SHAPE OUR CAREERS
WITH AND ROLE MODELS AND MENTORS
ARE LACK IN GENERAL AND THE OVER
ALL LACK OF DIVERSITY AFFECTS
HOW DECISIONS ARE MADE AND WE
HAVE SEEN THAT EVIDENCE IN OUR
CAMPUS.
AND WE'RE PLEASED THE POSITION
NIH IS TAKING THAT IS FUTURISTIC
AND PROGRESSIVE.
NOW, HOW DID I GET IN THIS
POSITION?
WHAT WAS MY JOURNEY LIKE?
THAT SENSE OF CURIOSITY OF A
CHILD TRYING TO UNDERSTAND WHY
THINGS WERE SO ANECDOTAL AND WHY
DON'T WE HAVE A MORE
SCIENCE-BASED TRUST IN DENTISTRY
AND CRANIOFACIAL HEALTH HOWEVER,
THAT WAS ALWAYS BALANCED WITH
THE NEED TO GIVE BACK WITH
MENTORING AND THE SHARING OF
KNOWLEDGE.
FOR ME AND I'M HOPING FOR MOST
OF YOU THE BALANCE IS EQUALLY
WEIGHTED.
OUR OWN SUCCESSES ARE REALLY
GOING TO BE BUILT ON THE NUMBER
WE TRAIN OR INSPIRE FOR THE
FUTURE.
THE COMMITMENT TO DIVERSITY HAS
ALWAYS BEEN WITH ME.
I WAS IN TEXAS AND UTAH, VERY
CONSERVATIVE STATES AND DIDN'T
SEE MANY PEOPLE WHO LOOKED LIKE
ME IN POSITIONS OF DECISION
MAKING.
THAT CALLED ME TO THE POSITION
AND DROVE ME TO MAKE A
DIFFERENCE AND I WAS IN DALLAS
IN MY APARTMENT BECAUSE I
COMMUTED FOR A WHILE AS A CHAIR
AND RAN INTO AN ASTROLOGER WHO
TOLD ME SATURN TAKES PO 30
YEARS TO REVOLVE AROUND THE
EARTH AND OUR LIFE SPANS ARE
MOSTLY ON 30 YEAR CYCLES AND I'M
NOT A FIRM BELIEVER BUT LISTENED
TO HER AND I LOOKED AT MY LIFE
AND THAT IS TRUE PLUS FOR MINUS
FIVE YEARS AND A CAME IN TO THE
COUNTRY LIKE MANY OF YOU AS A
FIRST GENERATION AND RAISED
CATHOLIC IN A PREDOMINANT MUSLIM
AND HINDU SOCIETY AND I TRAVELED
TO THE U.S. IN 1978 AND MY
SIBLINGS AND MY MOM WITH ME.
THE FAMILY UPBRINGING CAME THE
LESSON WHERE WE COME FROM DOES
MATTER AND OUR ROOTS ARE
IMPORTANT AND THEY'RE VALUABLE
AND WE SHOULD NEVER HIDE THEM
AND BE PROUD OF THEM BECAUSE OUR
FAMILY VALUES ARE STRONG AND FOR
ME IT WAS ABOUT WORKING HARD AND
ALWAYS HELPING THE LESS
FORTUNATE.
I TOOK THAT WITH ME THROUGHOUT
MY CAREER NO MATTER HOW LONG
STRUGGLES I FACED I ALWAYS FELT
I NEEDED TO HELP SOMEONE WHO
DIDN'T HAVE THE POSITION OR
RESOURCES I HAD.
I LEARNED THAT WHEN YOU LOOK AT
PREJUDICES AND BIASES IT TOOK ME
TO A HIGHER LEVEL OF THINKING
THESE BELONG TO A GROUP OF HUMAN
FRAILTIES AND IT'S PART OF THE
PROCESS TO DIFFERENTIATE FROM
EACH OTHER AND FROM THE ANIMAL
KINGDOM AND FOR ME INTERPRETING
NEGATIVE EVENTS IN THE PROPER
CONTEXT WAS PAYING ATTENTION TO
ENVIRONMENTAL CUES BECAME A
LESSON I LEARNED AS A STUMBLED
THROUGH LIFE.
AND NOW 25 OR SO I COME TO THE
U.S. AND SETTING UP MY CAREER
AND MOVED TO HOUSTON BECAUSE MY
FUTURE HUSBAND WAS FACED THERE
AND THE ENERGY INDUSTRY KEPT ME
TRAPPED IN TEXAS AND BECAME A
U.S. CITIZEN AND MOTHERED TWO
BEAUTIFUL CHILDREN AND BEGAN MY
ACADEMIC CAREER AND THAT'S WHEN
THE WORLD WAS CHANGING FOR ME IN
MY SECOND CYCLE.
AND IN THE THIRD CYCLE I WAS
GATHERING ALL THESE EXPERIENCES
AND STRUGGLING THROUGH ACADEMIC
LIFE TENURE, ALL THAT DESPITE A
PRODUCTIVE C.V. BUT I HAD THE
OPPORTUNITY TO SERVE IN
IMPORTANT POSITIONS THAT TOOK ME
OUTSIDE THE WORLD THAT HELPED ME
VALUE THE BEAUTY OF THE HUMAN
SOUL.
HERE I AM IN SOUTH AFRICA LOVING
MY TIME THERE FOCUSSING ON CLEFT
PALATE RESEARCH AND MY
CLUELESSNESS LED ME TO RESHAPE
MY OWN THINKING TO BECOME FAR
MORE CLUED IN ABOUT WHERE WAS
AND WHAT I WAS TO DO AND LEARN
FROM THE SECOND CYCLE HERE I AM
IN JAPAN IN A REAL KIMONO AND
NEVER GIVE UP WHEN ALL SEEMS TO
FAIL.
IN FACT SUCCESS IS DETERMINED BY
NOT THE NUMBER OF TIMES YOU FALL
BUT THE TIMES YOU RISE.
UNDERSTANDING VALUES LIKE HERE
AT NIH, ENVIRONMENTAL CUES,
DEVELOPING EXCELLENCE AND
EXPERTISE AND MAKING SURE THAT
IS IN FACT RECOGNIZED BY THE
INDIVIDUALS WHO WORK WITH YOU,
SUPERVISORS AND YOUR PEERS AND
ALWAYS BALANCING THAT LONG-TERM
VISION AND I'M SO MUCH IN THAT
CATEGORY WITH MORE IMMEDIATE
GOAL SETTING GIVING BACK AND
MENTORING SERVICE MAKES FOR A
LIFE-LONG JOURNEY OF LEARNING.
NOW THAT I'M HERE I THOUGHT MY
CUMULATIVE EXPERIENCES HAD A
PURPOSE.
I DIDN'T KNOW THAT AND KNOW
EVERY CHALLENGE I FACED WAS
PREPARING ME FOR ANOTHER ROLE
BUT THE POSITION BECAME
AVAILABLE AND I FELT I HAD A
STEP UP BUT THAT DEEP SENSE OF
CALLING TO MAKE A DIFFERENCE TO
THE ORAL HEALTH PROFESSION AND
INEQUITIES.
NOW, AS I GO THROUGH MY
EXPERIENCES HERE AND BRINGING
ALL THAT I HAVE ENCOUNTERED IN
THE PAST I LEARNED LESSONS THAT
AS THE IMPORTANT TO STUDY
CONFLICTS USING MULTIPLE LENSES
WHICH MEANS WE LISTEN TO THE
OTHER PERSON ON THE OTHER SIDE
OF THE DIVIDE.
IT'S VERY EASY AND I AM AND I'M
SURE MY ASIAN AMERICAN
COLLEAGUES ARE SIMILAR.
WE QUICKLY DRAW CONCLUSIONS AND
OFTEN THEY'RE NOT REALLY RIGHT.
TESTING THOSE ASSUMPTIONS IS
IMPORTANT AND FOLLOWING MY
ABSOLUTE MODEL OF REFLECTION AND
THOUGHT UNDERSTANDING RUTH BADER
GINSBURG REMAINED SOLID AS SHE
ELEVATED WOMEN IN OUR SOCIETY
THROUGH SUPREME COURT RULINGS
WHEN YOU HAVE -- WHEN YOU
EXPERIENCE DISCRIMINATION AND
HARASSMENT ON OUR CAMPUS HERE OR
ANYWHERE ELSE IT'S IMPORTANT TO
CALL IT OUT IN A PROFESSIONAL
AND RESPECTFUL WAY BUT COMES
ONLY WHEN IN FACT OUR INNER
SWITCH IS TURNED ON AND HAVE THE
POSITION OF CONFIDENCE, NOT
ARROGANCE BUT CONFIDENCE TO CALL
THINGS OUT HAPPENING TO YOU OR
MORE IMPORTANTLY TO OTHERS
AROUND YOU.
STAYING DIAGNOSTIC AND BUILDING
THAT CIRCLE OF ADVOCATES OF
MENTORS, ADVISORS ALL WHO PLAY
DIFFERENT ROLES IS IMPORTANT TO
GUIDE YOU TO DOING THE RIGHT
THING FOR THE RIGHT PERSON AT
THE RIGHT TIME AND FOR THE RIGHT
REASON.
THAT IS IN FACT THE OATH THAT
GUIDES OUR PRACTICES AS HEALTH
PROFESSIONALS.
I WANTED TO OFFER FOR YOU THIS
WONDERFUL RESOURCE BY DAVID
BROOKS WHO IS A CONSERVATIVE
WRITER FOR THE NEW YORK TIMES.
I READ AN EXCERPT OF HIS BOOK
AND SO TAKEN BY THE PRINCIPLES
THAT SO APPLIED TO ME I READ THE
BOOK HOW WE WANT TO CLIMB UP THE
FIRST MOUNTAIN AND MAKE OUR MARK
ON THE FIELDS, ALL OF HAVE BEEN
THERE AND ARE THERE AND STRIVE
TO BE HAPPY BECAUSE THAT'S HOW
YOU FEEL ABOUT WHAT YOU DO FOR
YOURSELF.
AND WHEN WE GET TO THE TOP OF
THAT FIRST MOUNTAIN AND YOU
SUDDENLY STRUCK WITH SOMETHING
THAT YOU DIDN'T EXPECT, IT COULD
BE THE UNFORTUNATE DEATH OF A
PARENTS, SPOUSE OR CHILD, IT
TAKES YOU INTO THE DEEPEST
VALLEY OF DESPERATION AND GLOOM
AND OFTEN IT'S JOB RELATED.
YOU LOSE A JOB OR GET A POOR
RATING AND YOU HAVE TO BE IN
THAT VALLEY TO RECOGNIZE YOUR
TRUE CHARACTER EMERGE.
THE STRENGTH AND HOPE AND
PROMISE YOU HOLD FOR YOURSELF
AND THEN YOU BECOME JOYFUL WHICH
IS THAT JOY FROM THE SUCCESS OF
WHAT YOU DO OR WHAT YOU CREATE
IN SOMEONE ELSE'S LIFE.
AND AS A SCIENTIST AND TRAINEES,
WE ARE MOTIVATED BY THAT HERE.
SO I WANTED TO END THERE BUT
SAYING THAT GOOD CHARACTER
FORMATION IS NOT ABOUT
INDIVIDUALS BUT GIVING ONE SELF
AWAY AND MOVING FROM A
SELF-DIRECTED CAREER -- AND I
KNOW THAT'S DIFFICULT FOR US AS
A COMMUNITY TO ACCEPT BUT MOVING
ON TO FROM AN INDEPENDENT TO
INTERDEPENDENCE STATE WHERE
ACROSS THE HETEROGENEITY OF OUR
COMMUNITIES WE FIND THAT COMMON
BOND OF UNITY AND IF WE HAVE
OVERDONE SOMETHING THAT'S A
PURPOSE BECAUSE IT HELPS TRAN --
TRANSCEND YOURSELF AND BECOME
THE PERSON YOU ARE MEANT TO BE
AND AT 30 YOU MAY BE A
SUCCESSFUL AND AT 40 YOU OPENED
UP SCHOOLS IN AFRICA TRAINING
YOUNG WOMEN TO BE LEADERS AND
NOW THAT YOU'RE 50 AND SHE HAD A
SIMPLE PHRASE THAT LINGERS IN MY
MIND AND THIS IS FROM 15 YEARS
AGO THAT SAID I JUST WANT TO BE
THE PERSON I WAS MEANT TO BE.
I WANTED TO END THAT.
IT SOUNDS VERY MOTIVATIONAL BUT
THOUGHT IT WOULD ADD A BALANCE
TO THE DISCUSSIONS WE'LL HAVE IN
THE TWO DAYS.
I WANT TO THANK YOU FOR ALLOWING
ME THE OPPORTUNITY.
SORRY ABOUT THE GLITCHES AND I
HOPE THAT MY MESSAGE RESONATES
WITH YOU.
I AM PRIVILEGED TO MENTOR
SEVERAL IN THE COMMUNITY AND I
CAN TELL YOU I LEARNED FAR MORE
THAN I EVER HOPED I CAN TEACH.
THANK YOU FOR YOUR ATTENTION AND
I HOPE WE CAN ENTERTAIN
QUESTIONS AT SOME POINT.
>>OKAY.
THANK YOU VERY MUCH AND FOR YOUR
EXCELLENT TALK.
FOR THE MORNING SESSION PEOPLE
CAN PUT THE QUESTION IN THE CHAT
BOX.
NOW, I WILL TURN THE PODIUM TO
THE CDC STAFF IN THE CONFERENCE
PLANNING COMMITTEE TO INTRODUCE
CDC CANCER SPEAKERS.
>>GOOD MORNING.
I'M PLEASED TO ATTEND THIS
WONDERFUL CONFERENCE AND VERY
PLEASED TO INTRODUCE MY
COLLEAGUE LIEUTENANT CHEN AN
EPIDEMIOLOGIST AND LEARN MORE IN
THE CONFERENCE MATERIALS AND
I'LL TURN OVER THE PODIUM TO
LIEUTENANT CHEN.
THANK YOU.
>>GOOD MORNING, GOOD AFTERNOON,
EVERYBODY DEPENDING ON WHERE YOU
ARE.
I'M HAPPY AND GLAD TO JOIN ALL
OF YOU TODAY.
A TRANSLATION FROM A WONDERFUL
WISDOM SHARED FROM DR. D'SOUZA
ABOUT HER PROFESSION AND LIFE
AND LETS DELVE MORE INTO CANCER
AND HEALTH DISPARITIES IN ASIAN
AMERICANS AND PACIFIC ISLANDERS
AND LOOK AT SOME OF THE DATA AND
I'M ALSO GOING TO SHARE SOME OF
OUR WORK FROM THE CDC CANCER
PREVENTION AND CONTROL AND I'LL
USE AAPI TO REFER TO ASIAN
AMERICAN PACIFIC ISLANDER
POPULATIONS.
FIRST I'LL DESCRIBE THE CANCER
BURDEN AND THEN DISCUSS CANCER
SCREENING AND LASTLY PROVIDE AN
EXAMPLE OF IMPLEMENTATION
PROJECT TO BUILD CAPACITY OF
CERVICAL CANCER SCREENING IN
U.S. AFFILIATED PACIFIC ISLANDS.
CANCER HAS BEEN THE LEADING
CAUSE OF DEATH FOR ASIAN
AMERICANS SINCE 2000.
IN THE FIGURE OF TOP THREE
LEADING CAUSES OF DEATH IN 2021
BY RACE AND ETHNICITY THE BARS
REPRESENT THE DEATHS AND CANCER
WAS THE FIRST LEADING CAUSE OF
DEATH FOR NON-HISPANIC ASIAN
POPULATIONS AND IT WAS THE
SECOND OR THE THIRD FOR NATIVE
HAWAIIAN OR PACIFIC ISLANDER
POPULATIONS AND THE SECOND OR
THIRD CAUSE OF DEATH FOR OTHER
RACE AND ETHNICITY GROUPS.
THE PERCENTAGE OF CANCER DEATHS
AMONG ALL DEATHS WAS ALSO THE
HIGHEST IN NON-HISPANIC ASIAN
POPULATION AT 21% IN 2021.
THE U.S. CANCER STATISTICS ARE
THE OFFICIAL FEDERAL CANCER
STATISTICS COMBINING CANCER
REGISTRY DATA FROM CDC'S
NATIONAL PROGRAM OF CANCER
REGISTRIES AND THE NATIONAL
CANCER INSTITUTE'S SURVEILLANCE
AND EPIDEMIOLOGY RESULTS FOR
100% OF THE POPULATION.
THEY COLLECT DEMOGRAPHIC AND
CLINICAL AND DIAGNOSTIC DISEASE
DATA.
I ENCOURAGE YOU TO LOOK AT OUR
WEBSITE WHICH INCLUDES GREAT
INFORMATION ABOUT THE DATABASE
INCLUDING A DATA VISUALIZATION
TOOL AND LOOK AT CANCER OUTCOMES
BY VARIOUS METRICS.
THE DATABASES REPORT STATISTIC
FOR API BUT THE DISAGGREGATED
INFORMATION HAS BEEN COLLECTED
AND MY COLLEAGUES HAVE JUST
PUBLISHED A MORBIDITY REPORT
LOOKS AT INCIDENTS AMONGST 23
ASIAN AMERICAN NATIVE HAWAIIAN
PACIFIC ISLANDER SUB GROUPS
USING 2015 THROUGH 2019 DATA.
I'LL SHOW YOU STATISTICS FROM
THE CANCER VISUALIZATION TOOLS
AND SHOWS THE TOP TEN CANCERS
PER INCIDENTS RATES.
AND THE LEFT IS FOR WOMEN OF ALL
RACE AND ETHNICITY AND THE RIGHT
PANEL IS FOR AAPI WOMEN.
THE TOP THREE WERE BREAST,
OVARIAN AND COLON AND THERE WERE
OVARIAN AND STOMACH AND LIVER
CANCERS THAT WERE NOT IN THE TOP
TEN IN WOMEN OVER ALL.
I ALSO WANT TO POINT OUT THAT
BREAST CANCER INCIDENTS
INCREASED AMONGST AAPI WOMEN
FROM 2005 TO 2018 AND DECREASED
OR NO CHANGE IN OTHER RACE AND
ETHNICITY GROUPS IN THE SAME
TIME PERIOD BASED ON THE 2022
MMWR.
THIS SLIDE SHOWS THE TOP TEN
CANCERS BY MORTALITY RATES FOR
100,000 WOMEN AND LUNG CANCER IS
THE LEADING RATE OF CANCER
MORTALITY FOLLOWED BY BREAST AND
COLORECTAL CANCERS.
STOMACH CANCER WAS IN THE TOP
TEN FOR AAPI WOMEN BUT NOT WOMEN
OVER ALL.
AAPI WOMEN HAD HIGHER MORTALITY
RATE OF LIVER CANCER COMPARED TO
OTHER GROUPS.
THIS SLIDE SHOWS THE TOP 10
CANCERS BY INCIDENT RATES PER
MEN AND PROSTATE, LUNG AND
COLORECTAL CANCERS.
SIMILAR TO WOMEN, LIVER AND
STOMACH CANCERS WERE IN THE TOP
10 FOR AAPI MEN BUT NOT IN MEN
OVER ALL.
THE SLIDE SHOWS THE TOP TEN
CANCERS BY MORTALITY RATES IN
MEN.
AGAIN, LUNG CANCER RANK THE
HIGHEST IN TERMS OF MORTALITY
STOMACH AND AAPI MEN HAD HIGHER
MORTALITY RATE OF LIVER CANCER
COMPARED TO OTHER GROUPS.
HERE'S ANOTHER DATA QUERY WHICH
SHOWS LUNG CANCER IN BOTH MEN
AND WOMEN WAS DIAGNOSED AT A
LATER STAGE IN AAPI PERSONS
COMPARED WITH NON-HISPANIC WHITE
PERSONS.
IT REFERS TO THE EXTENT OF THE
CANCER SUCH AS HOW LARGE IT IS
AND IF IT SPREAD AND THE LUNG
CANCER DIAGNOSED AT DIFFERENT
STAGES, CANCER SPREADING TO
DISTANT PARTS OR UNSTAGED.
WE SEE 53.9% OF LUNG CANCER IN
AAPI PERSONS WERE DIAGNOSED
COMPARED TO THIS PERCENT IN
NON-HISPANIC WHITE PERSONS.
THE PURPOSE OF THIS FIGURE IS TO
DEMONSTRATE THE HETEROGENEOUS
CANCER RATES AMONG THE AAPI SUB
GROUPS.
THIS EXAMINED CANCER-RELATED
DEATHS FROM 2003 TO 2010 TO 2011
IN SIX MAJOR AAPI SUBGROUPS.
HERE'S TRENDS IN STOMACH AND
LIVER CANCER AND AGE ADJUSTED
MORTALITY RATE PER 100,000 MEN
AND SEE VARIATIONS HIGHLIGHTING
THE NEED FOR DISAGGREGATION IN
REPORTING.
CANCER BURDEN STATISTICS HAVE
SHOWN AAPI POPULATIONS ARE
DISPROPORTIONATELY AFFECTED IN
CANCERS WITH INFECTIOUS
ETIOLOGY.
FOR EXAMPLE, LIVER CANCER IS
ASSOCIATED WITH CHRONIC
HEPATITIS B INFECTION WHICH
COULD BE CONTRIBUTED TO COUNTRY
OF ORIGIN, RECENT IMMIGRATION
AND VERTICAL TRANSMISSION.
AND THE LIVER CANCER INCIDENTS
IS CONTRIBUTED TO LIVER DISEASE
AND RISK FACTORS INCLUDE H.
PYLORI INFECTION AND SMOKING AND
INGESTION OF SOFT PRESERVED
FOODS.
CERTAIN GROUPS INCLUDING WOMEN
IN PACIFIC ISLANDS EXPERIENCE
THE HIGHEST RATES OF CERVICAL
CANCER IN THE U.S.
LINKED TO A HIGH PREVALENCE OF
THE HUMAN PAPILLOMA VIRUS.
SOUTHEAST ASIAN INDIVIDUALS HAVE
A HIGHER RISK OF CANCER
ASSOCIATED WITH THE EPSTEIN BARR
VIRUS.
VACCINATION IS HIGHLY EFFECTIVE
TO PREVENT HEPATITIS B AND H.
PYLORI CAN BE TESTED AND
ERADICATED USING ANTIBIOTICS.
AND ANOTHER CANCER IS LUNG
CANCER AMONG NON-SMOKERS
ESPECIALLY AMONG FEMALES AND
HALF OF ASIAN AMERICAN WOMEN
DIAGNOSED WITH LUNG CANCER NEVER
SMOKED.
NEXT, I'LL DISCUSS CANCER
SCREENING IN AAPI POPULATIONS.
SCREENING FOR BEST, CERVICAL AND
RECTAL CANCERS HELP FIND
DISEASES AT AN EARLY STAGE AND
TREATMENT WORKS BEST AND REDUCE
THE CHANCE OF DYING.
MANY STUDIES SHOWING SCREENING
RATES IN ASIAN AMERICAN WOMEN
AND COLORECTAL CANCER IN ASIAN
AMERICAN WOMEN AND MEN ARE BELOW
THOSE OF OTHER ETHNIC GROUPS.
THIS HEALTH CARE DISPARITY
PERSISTS AFTER ADJUSTING FOR
ACCESS TO HEALTH THROUGH CARE.
THIS IS BASED ON RECOMMENDATIONS
USING THE DATA FROM THE 2018
NATIONAL HEALTH SURVEY WHICH
PROVIDES NATIONALLY
REPRESENTATIVE ESTIMATES.
AS WE SEE ASIAN POPULATION HAD A
LOWER PREVALENCE OF UP TO DATE
SCREENING OF BREAST, CERVICAL
AND COLORECTAL CANCERS AND HAD
LOWER PREVALENCE THAN HISPANIC
POPULATION FOR CERVICAL CANCER
SCREENING.
THIS LOOKS AT HETEROGENEITY IN
SCREENING RATES.
THIS INCLUDED WOMEN IN THE SAME
HEALTH CARE UTILIZATION AND HAD
INSURANCE AND THE AUTHORS FOUND
SUBSTANTIAL VARIATIONS IN CANCER
SCREENING RATES AND SUBGROUPS
FOR EXAMPLE THERE WAS A 23%
DIFFERENCE BETWEEN ASIAN INDIAN
AND JAPANESE WOMEN IN COLORECTAL
CANCER SCREENING RATE.
AS MANY SPEAKERS HAVE TALKED
ABOUT AND SHOWN IN OTHER
STUDIES, THERE'S A NEED FOR BOTH
NATIONAL AS WELL AS COMMUNITY
LEVEL HEALTH DATA COLLECTION.
THE INCREDIBLE HETEROGENEITYTOWN
THE AAPI POPULATION IS EX
EXEMPLIFIED WE THE
CHARACTERISTICS.
TWO-THIRDS OF ALL ASIAN
AMERICANS SPEAK A LANGUAGE OTHER
THAN ENGLISH AT HOME AND MANY
ARE HAVE LIMITED ENGLISH
PROFICIENCY AND AN IMPORTANT
VARIATION AMONG ASIAN AMERICANS
IB CONTRAST TO OTHER CULTURES IS
THE ATTITUDE TOWARDS HEALTH
CARE.
FOR EXAMPLE, THE WORD CANCER
CARRIES A STIGMA IN MANY ASIAN
CULTURES VIEWS AND BARRIERS TO
BREAST AND CERVICAL CANCER
SCREENING PLAY BE INFLUENCED BY
CULTURAL PERCEPTIONS OF MODESTY
AMONG WOMEN AND THE MINORITY
LABEL CONTRIBUTE TO THE BIAS
ASIAN AMERICANS HAVE SIMILAR
DISEASE RISK PROFILES FOR THE
MAJORITY OF WHITE AMERICAN
POPULATION AND MAY CAUSE API
INDIVIDUALS TO EMBODY THE MYTH
OF THE DOCILE HARD-WORKING
CITIZENS WHO WILL NOT COMPLAIN
OR ADD BURDEN TO OTHERS.
THIS ACCEPTANCE BY PATIENTS AND
PROVIDERS OF THE STEREOTYPE IS
TO LESS ADVOCACY AND LESS
INFORMATION OF DIFFERENT DISEASE
RISK PROFILES AND LESS
SCREENING.
THIS IS ALSO MANIFESTED IN
HEALTH-SEEKING BEHAVIORS IT'S
BEEN SHOWN AAPI INDIVIDUALS ARE
LESS FORTHCOMING ABOUT SYMPTOMS
AND CONCERNS INCLUDING MENTAL
HEALTH CONCERNS AND LESS
ACCEPTANCE OF SCREENING FOR
SYMPTOMS AND LESS LIKELY TO HAVE
SEEN A PHYSICIAN IN THE PRIOR 12
MONTHS.
AAPI PERSONS ARE UNDER
REPRESENTED IN CLINICAL TRIALS.
ACCORDING TO CLINICAL TRIAL.gov
THE PROPORTION WITH ETHNIC AND
MINORITY POPULATION TRIALS AS
THE PRIMARY FOCUS IS
APPROXIMATELY 1% OF ALL CLINICAL
TRIALS.
ONLY FIVE SUCH TRIALS FOCUSSED
ON AAPI COMPARED WITH 83 FOR
AFRICAN AMERICANS AND 32 FOR
HISPANICS AND WE CAN SEE MANY
OPPORTUNITIES FOR CANCER
PREVENTION CONTROL IN THESE
POPULATIONS FROM PRIME PRI
PREVENTION TARGETING CANCERS
WITH INFECTIOUS ETIOLOGIES AND
OTHER RISK FACTORS TO INCREASE
SCREENING AMONG AAPI POPULATIONS
FOR EARLY DETECTION TO INCLUSION
IN CLINICAL TRIALS AND RESEARCH.
ACCESS TO INFORMATION AND
SERVICES IS CRITICAL THROUGHOUT
THE CANCER CARE CONTINUUM.
IT'S ALSO IMPORTANT TO EDUCATE
BOTH AAPI COMMUNITIES AND THEIR
HEALTH CARE PROVIDERS ABOUT
SPECIFIC CANCER RISK AND
PREVENTION IN CONTROL MEASURES.
LASTLY I'D LIKE TO TALK ABOUT
THE PROJECT FUNDED BY CDC
DIVISION OF CANCER PREVENTION
AND CONTROL.
THE OBJECTIVE OF THE PROJECT IS
TO ESTABLISH INFRASTRUCTURE TO
PROMOTE CERVICAL CANCER
SCREENING AND MANAGEMENT IN
U.S. AFFILIATED PACIFIC ISLANDS.
THE APPROACH TO IMPLEMENT
TESTING INCLUDING THE POTENTIAL
TO REACH MORE HARD TO REACH
WOMEN WE PILOTED THIS PROJECT IN
TWO SITES.
GUAM AND FEDERATED STATES AND
THIS IS BIGGER THAN THE AREA OF
THE CONTINENTAL U.S.
THE BURDEN OF CERVICAL CANCER IN
PACIFIC ISLANDS IS HIGH AND PART
OF THE NATIONAL PROGRAM OF
CANCER REGISTRY THE CENTRAL
CANCER REGISTRY IS AT THE
UNIVERSITY OF HAWAI'I DESIGNATED
TO OVERSEE THE PROGRAM ON BEHALF
OF THE JURISDICTIONS.
I WANT TO POINT OUT CURRENTLY
THE CANCER REGISTRY DATA FROM
U.S. PACIFIC ISLANDERS ARE NOT
IN THE U.S. PUBLIC DATABASES DUE
TO THE CHALLENGES MEETING THE
REPORTING CRITERIA AND QUALITY.
NONETHELESS THE TABLE REPRESENTS
CANCER INCIDENTS RATE AMONG
WOMEN 20 YEARS OR OLDER DURING
2007 TO 2018.
THE INCIDENCE OF SERVING CAL
CANCER IN U.S. API IS TWICE THAT
OF THE CONTINENTAL U.S. THE
DIFFERENCE IN GUAM TO 68.8 PER
100,000 WOMEN IN MARSHALL
ISLAND.
CERVICAL CANCER SCREEN COVERAGE
IS LOW IN AFFILIATED ISLANDS AND
THE WOMEN 21 TO 65 YEARS NOT
SCREENED USING THE SURVEILLANCE
SYSTEM AND THE SURVEY CONDUCTED
AROUND THE TIME 2016 TO 2018.
COMPARED TO THE REST OF
U.S. AROUND 20% NEVER SCREEN THE
PROPORTION OF WOMEN NOT SCREENED
WAS HIGHER IN THE API AS HIGH AS
70%.
THE SCREENING RATES ARE
ASSOCIATED WITH BARRIERS SUCH AS
LACK OF AWARENESS OF IMPORTANCE
OF CERVICAL CANCER SCREENING AND
LOW CAPACITY OF HEALTH CARE
SYSTEM AND WORKFORCE.
FOR EXAMPLE, CURRENTLY GUAM AND
YAP CURRENTLY ONLY HAVE ONE
OB-GYN AND HAVE TO SHIP TO FOR
LAB TESTING BECAUSE THERE'S NOT
STRUCTURE ON SITE AND MANY LIVE
IN REMOTE AREAS WITH LIMITED
TRANSPORTATION TO HEALTH
CENTERS.
THERE ARE ALSO UNIQUE CULTURAL
SAMPLES AND THE STIGMA OF HPV
AND BEING EXAMINED.
AND THERE'S JURISDICTION
PARTNERS AND WE ASSEMBLED
EXPERTS WITH EXTENSIVE
EXPERIENCE IN CANCER PREVENTION
IN LOW-RESOURCE SETTINGS WITH
MEDICAL EXPERTS, HEALTH
ECONOMISTS AND PUBLIC HEALTH
OFFICERS FROM VARIOUS
ORGANIZAT
ORGANIZATIONS A TEAM DEVELOPED A
FRAMEWORK TO GUIDE OUR
ACTIVITIES AND CONSISTS OF
COMMUNITY ENGAGEMENT, MEDICAL
AND LABORATORY AND DATA SYSTEM
AND MODELLING.
THE COMMUNITY ENGAGEMENT PIECE
FOCUSES ON ACTIVITIES TO
INCREASE AWARENESS, PROVIDE
EDUCATION THROUGH COMMUNITY
HEALTH WORKERS AND OUTREACH
ACTIVITIES.
MEDICAL AND LABORATORY PIECE
FOCUSES ON ACTIVITIES TO BUILD
CERVICAL CANCER SCREENING AND
MANAGEMENT CAPACITY THROUGH
LOCAL HEALTH CARE PROVIDER AND
SYSTEMS AS WELL AS LABORATORY
INFRASTRUCTURE.
WE ALSO WORK ON DATA SYSTEMS AND
CONDUCT ANALYSIS TO LOOK AT
EFFECTIVE CERVICAL CANCER
PREVENTION AND SCREENING
STRATEGIES FOR EACH
JURISDICTION.
A BETTER UNDERSTANDING OF
DISPARITIES AND BARRIERS IN AAPI
POPULATION HELP US DESIGN AND
IMPLEMENT INTERVENTIONS TO
ADDRESS THEM.
FIRST WE NEED TO ENHANCE
AVAILABILITY AND QUALITY AND USE
OF THE DATA ON AAPI POPULATIONS.
THERE'S A LOT WE CAN DO WITH
PRIMARY AND SECONDARY PREVENTION
AS DISCUSSED EARLIER.
INTERPRETATION SERVICES ARE
CRITICAL FOR THOSE WITH LIMITED
ENGLISH PROFICIENCY WHICH IS
ONE-THIRD OF THE AAPI
POPULATIONS.
AND CARE NAVIGATION CAN IMPROVE
AWARENESS OF ISSUES AND ACCESS
TO CARE AND CANCER SCREENING IN
A SKULL
CULTURALLY SENSITIVE WAY AND
SPEND TIME TO APPROPRIATELY
DISCUSS CANCER SCREENING AND
PRIMARY PREVENTION.
CULTURALLY APPROPRIATE
COMMUNITY-BASED INTERVENTIONS
THAT MEET THE AAPI POPULATIONS
WHERE THEY LIVE ARE LIKELY TO BE
THE MOST EFFECTIVE AND INCLUDING
ACCESS TO EDUCATION ABOUT HEALTH
CARE.
IT'S LIKELY THEY NOT ONLY
ADDRESS DISPARITIES IN CANCER
HEALTH BUT OTHER HEALTH
CONDITIONS.
THANK YOU VERY MUCH FOR YOUR
ATTENTION.
THAT CONCLUDES MY PRESENTATION.
>>THANK YOU, DR. CHEN FOR YOUR
EXCELLENT TALK.
WE ALL LEARNED A LOT.
THIS MORNING'S SESSION IS
CONCLUDED.