Community Health Digest vertical bar

Health Digest Image

Physicians Together -

A Commitment to
Health & Well Being


horizontal bar

By: Dr. Nanci Yuan

Once again, it is the beginning of the cold and flu season. To keep yourself and your loved ones healthy during the upcoming season, it is important to consider updating your and your loved ones vaccinations. We always recommend annual influenza vaccinations for children. This year in particular, it is important to remember that the recommendation for influenza vaccination is for universal use, that is for everyone 6 months of age and older, including older adults.

In general, influenza vaccines are dosed differently for children 9 years of age and younger versus those over 9 years of age. Additionally, for children under 9 years of age, there also are differences in whether a child should receive one or two doses of vaccine if they are under 9 years of age based on whether or not they received one or two doses of H1N1 vaccine or seasonal flu vaccine last winter. The reason is that children under 9 may not have a complete immune response to the new H1N1 strain after just one dose.

Parents of children 6 months to 9 years of age are encouraged to talk to their medical providers who will help them make the decision to get one or two doses of this year's seasonal flu vaccine.

Parents also need to consider pertussis or whooping cough vaccination. It is a routine immunization and is always recommended for children:

list circleDTaP if age 6 weeks through 6 years; or
list circleTdap if age 7 years and older.
Pertussis is a highly contagious bacterial infection of the respiratory system that caused many deaths before the availability of the childhood pertussis vaccines (DTaP). Recent statistics show that pertussis is on the rise again. In California, thousands of people have become infected, notably causing several infant deaths.

This increase is due to an epidemic of pertussis in adolescents and adults who have lost their immunity from their childhood vaccines and need a booster vaccine. While this population has less severe consequences from the infection, they may spread pertussis to infants who are too young to have received DTaP vaccine at 2, 4 and 6 months of age.

Young infants have a higher rate of pertussis than any other age group and 87-100% of all deaths from pertussis occur in infants less than 6 months of age. Even when not fatal, two thirds of young infants with pertussis need to be hospitalized because they may have serious complications such as pneumonia, seizures and brain damage. Three quarters of infants who get pertussis most often get it from people who live in their home, one third from their mother, who often do not realize they have the infection.

Experts are recommending "cocooning," a strategy that protects infants who are too young to be immunized, by having parents, siblings, and caretakers vaccinated against this disease. The "cocoon strategy" protects newborn infants from being infected by administering Tdap booster vaccines to mothers and family members of newborn infants. In this way, mothers and family members are protected from getting pertussis and passing it on to their young infants. People over 11 years of age (and those over 7 in some states with outbreaks) should receive 1 dose of Tdap vaccine if they have not already.


horizontal bar

By: Dr. William Hsu, Joslin Asian American Diabetes Initiative

Did you know...?

list circle1 out of 6 Asian American adults in NYC has diabetes (2007, NHANES)
list circleGestational diabetes (GDM) prevalence was higher among Asians compared to non-Hispanic white women (Kaiser Permanente Study)
list circleAmong children in a population-based study, 71% of Asians and 100% of Pacific Islanders with diabetes were obese (SEARCH for Diabetes in Youth Study)
list circleAsian Americans develop diabetes at a lower weight
Diabetes is a rapidly growing epidemic among Asians and Pacific Islanders affecting about 10 percent of Asian Americans; about 90 to 95 percent of Asians with diabetes have Type 2 diabetes.* The higher rate of Type 2 diabetes in people of Asian descent stems from a combination of genetic and environmental influences.

*The major Types of diabetes are Type 1, Type 2, Gestational and Pre-Diabetes.

Despite having a lower body weight, Asian Americans are more likely than Whites to develop diabetes. Asian Americans have a higher percentage of abdominal fat relative to weight in addition to having a higher percentage of body fat per pound of body weight, suggesting physiological differences between Asian and Whites. Common symptoms of diabetes can often be overlooked and Asian Americans are often not identified as a high-risk group. Therefore, discussion between patients and their healthcare providers about diabetes and routine screenings are critical to prevention, early detection and better outcomes.

Symptoms of Diabetes
-    Excessive thirst
-    Increased urinary frequency
-    Unusual weight loss
-    Blurry vision
-    Increased hunger
-    Increased skin, bladder or gum infections
-    Irritability
-    Tingling or numbness in hands or feet
-    Slow to heal wounds
-    Increased unexplained fatigue
If you are experiencing any of these symptoms, fear that you are at high risk for diabetes, or have a family history with diabetes, please consult your primary care physician for more information. During your regular annual check up, make sure that you ask for screening for diabetes.

There are disparities in diabetes care, control and outcomes in the Asian American Pacific Islander (API) community. National data suggests that Asian-White differences in diabetes care exist in the frequency of physiological measurements, eye examinations and self-care instruction received. Another study shows that Asian Americans have more diabetes related kidney diseases but less cardiovascular diseases compared with Whites. Also, Asian Americans were less likely than Whites to report that their doctors talked to them about lifestyle and more likely to report that their doctors do not understand their background values. Both have important implications for diabetes care.

We need more research studies on disparities in diabetes care, control and outcomes in the API community in order to better understand, and develop and implement culturally appropriate care and educational programs for Asian Americans, Native Hawaiians and Pacific Islanders.

Joslin Asian American Diabetes Initiative (AADI) was founded in 2000 in response to the rising rates of diabetes and the lack of awareness, resources, and research devoted to Asian American diabetes. Through research, clinic, education, and outreach, AADI continues to make an impact on patients and their families as well as healthcare professionals. You can visit (Chinese/Japanese/English) or call 617-732-2606 to speak with the multilingual staff.

You can also check out free resources available on the AADI website including:
-    Diabetes Risk Assessment tool
-    BMI calculator designed specifically for Asian Americans
-    "Ask the Experts" - direct connection with Joslin professionals
-    Downloadable educational materials
-    Interactive nutrition learning applications "Joslin online Wok and "Joslin online Dim Sum"

horizontal bar

NCAPIP Community Health Digest - the foremost source of information on the latest issues concerning your health and well-being that can keep you and your family healthy and happy.