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Courtesy of Asian Counselling and Referral Sources	More NurseWeek Features   Smoke-Free Zone   Nurses and patients tackle nicotine addiction   Bloodless Survival     Surgical techniques to use when transfusion drops out of the equation
Because they deal with various ethnicities at the Asian Counseling and Referral Service in Seattle, Vietnamese-American nurses Jeannie-Trang Nguyen, RN, (left) and Hanh Lai, RN, know the special health problems related to some.

Elizabeth Burton, RN, has been forced to rethink her approach when caring for foreign-born Korean Americans, who now make up more than one-quarter of her patients.

Especially in less-acculturated families, female patients aren't always the ones to make decisions about their own health, said Burton, program coordinator for cancer education and early detection at the Bergen County Department of Health Services in New Jersey. Sometimes, Burton said, that role goes to the woman's husband or her firstborn son.

"That's one of the things we have learned, we have to be sensitive to who makes the decision," she said.

It's been a challenge for Burton, who usually wants patients to feel empowered to make their own decisions. But she's learned a crucial lesson. Without that cultural sensitivity, sometimes women won't show up for their tests or follow-up appointments.

Activists and health workers who care for people of Asian and Pacific Islander descent point out that the myth of the "model minority" is just that-a myth. [This phrase has become a stereotype to describe Asian Americans as the hard-working, well-educated, successful minority race.] Asians have specific health needs that nurses and other health care providers need to be aware of, they say.

Population boom

In coming decades, that knowledge will be increasingly necessary as the number of Americans of Asian and Pacific Islander descent continues its rapid growth. From 1990 to 2000, the Asian American and Pacific Islander population grew at least 48 percent, according to the U.S. Census. The number of Americans of Asian and Pacific Islander descent aged 65 and older is projected to increase even more dramatically: 285 percent between 1999 and 2030, compared to 81 percent for the Caucasian population, according to a 2000 report from the U.S. Administration on Aging.

Medical professionals say Asian Americans and Pacific Islanders, especially recent immigrants, may need different care than patients of other ethnicities. Some suffer from diseases endemic to their countries of origin, like hepatitis B and tuberculosis. Others who have had little contact with Western medicine may rely on traditional medicine or have different social or cultural values that must be taken into account in treatment.

Many recent immigrants don't speak English or understand how to access health care. Asian Americans are exceptionally diverse, coming from many different countries and speaking hundreds of languages. Health problems can vary dramatically among people from different subgroups, like Indian, Japanese and Vietnamese.

In the past few years, medical research and cultural competency have improved, especially in areas with large Asian and Pacific Islander populations. But as the populations continue to grow, so too will the need for culturally competent health care. In coming decades, more and more nurses will need to learn how best to care for Asian Americans.

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