Page 53 - Cultural Competence in Health Education

Disparities in Health Among Racial and Ethnic Groups 31

Tuberculosis was 13 times more common among such Asian subgroups as Cambodi-
ans, Chinese, Laotians, Koreans, Indians, Vietnamese, and Filipinos than it was among
the total U.S. population. In 2001, Asians and Pacific Islanders aged 40 and older were

2.5 times more likely to have hepatitis B (14.2 per 100,000) than were non - Hispanic
whites. Of the 12.5 million Americans living with chronic hepatitis B infection, approx-
imately half are Asians. In 2002, the hepatitis B – related death rate among Asians was
six times higher than the rate among whites (OMHD, 2006). In 2002, the AIDS rate

among Asians and Pacific Islanders was 4.0 cases per 100,000 people. During 2003,
497 new AIDS cases were reported among this population, an increase of 9.9 percent
over 2002, and 34.7 percent over the 1999 level (OMHD, 2006).
In terms of preventive services, Asians have the lowest utilization rate of any
group for aspirin use, as well as for breast, cervical, and colorectal cancer screening.

The report Preventive Care: A National Profile on Use, Disparities and Health Bene-
fi ts, found that Asian men aged 40 and older and Asian women aged 50 and older are
40 percent less likely than their non - Hispanic white counterparts to use aspirin as part
of a heart healthy regimen. When it comes to cancer screening, Asian adults aged 50
and older are 40 percent less likely than whites to be current on screening for colorec-
tal cancer, Asian women aged 18 to 54 are 25 percent less likely than white women to
have been screened for cervical cancer, and Asian women aged 40 and over are 21 per-
cent less likely than white women to have been screened for breast cancer in the past
two years (Partnership for Prevention, 2007).

Native Americans and Alaska Natives
American Indians and Alaska Natives are a heterogeneous population, with approxi-
mately 560 federally recognized tribes living in both the rural and urban areas of thirty -
five states (U.S. Census Bureau, 2007). The 2004 American Community Survey estimated

the number of American Indians and Alaska Natives to be about 4 million, or 1.4 percent
of the U.S. households. The number of individuals who reported American Indian and
Alaska Native as their only race was about 2.2 million, or 0.8 percent of the population.
About another 1.9 million reported their race as American Indian and Alaska Native and
one or more other races, including about 1.4 million people who reported their race
as American Indian and Alaska Native and white. The American Indian and Alaska
Native alone - or - in - combination population included about 561,000 Hispanics, and the
American Indian and Alaska Native alone population included about 299,000 Hispanics
(U.S. Census Bureau, 2007).
What is common to all tribal groups, both rural and urban, is a high rate of pov-
erty; American Indians and Alaska Natives have the highest poverty rates of any racial
or ethnic group. From 2001 to 2004, the three - year - average poverty rate for American
Indians and Alaska Natives was 25.3 percent. The three - year - average poverty rate for

Native Hawaiians and other Pacific Islanders was 12.2 percent. (The Census Bureau
uses three - year - average medians for these groups because of their relatively small
populations.) Although each tribal group has a unique history, culture, and economic

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