Culturally Competent Education on Pediatric Health Care Issues

One way I know that I was able to help my community was to be able to give a culturally competent in my elementary rudimentary Mandarin mix of English presentation to the local Asian Pacific Islander Native Hawaiian population on pediatric pulmonary health care issues related to their children that they should be aware of.

Disaster Preparedness for At Risk Families

Just over the last two years, I worked with a group of UCSF Pharmacy, Medical, Nursing, and Dental students that includes a partnership to bring disaster preparedness skills to families living in single room occupancy buildings in San Francisco's Chinatown. That partnership actually also includes high school students from the San Francisco school district, UC Berkeley undergraduates serving as interpreters, and the UCSF inter-professional students serving as the trainers. This partnership really has improved the personal resiliency skills for many of these families living in the most vulnerable residential areas.

In-Language Culturally Competent Care

My name is Son Do and I am a member of the board of the NCAPIP. I have been involved with our community for many years even before NCAPIP, mostly in medicinal health care but particularly in Hepatitis. I think it・s great to be able to go from medical school to training to practicing in the community and one of the biggest things is being able to converse with some of my patients in learning about my own language but also to help them understand even though sometimes it can be stressful, so I would strongly encourage that all Asian American medical students learn how to converse with other patients in their own language or at least one or two other languages if possible and that would help them to reach out to the community.


Research and Data Analysis

Hi, I am a physician and health economist and my focus is research and evaluation. I work on things that hopefully improve the health and well being of Asian Americans, Native Hawaiians, and Pacific Islanders. One project that I worked on with interns was actually to develop a data chart that looks at the demographic profile of these communities. One of the community based organizations that I worked with in Utah actually circled Utah's data, which has only "white and other" and took it to their Congressman's office and showed the staffers and told them, we don't know how to efficiently allocate our resources because we don't have any data and the staffers were very surprised that there was no data. They said we didn't know that this was happening and now that we know, we are going to work at the state level and connect with you people so that we can have data in Utah so you can work more efficiently about you using whatever resources you have. So that's one example of how I think the research and data analysis I do impacted the health and well being of communities.

Culturally Sensitive Research and Advocacy in Community Health Centers

My name is Arthur Chen. I am a practicing family physician at Asian Health Services, which is a community health center located in Oakland Chinatown in California. I've been there for about the last 27 years and have continued to establish a practice both in outpatient and inpatient sites.

One of the things that I focused on earlier in my career was doing research, in which we conducted a neighborhood survey of behaviors and knowledge of Chinese community members regarding such things as high blood pressure, high cholesterol, and preventive screenings like mammograms and pap smears because we didn't know what the community awareness was regarding these early interventions of things that they could do to lead more healthy lives. As a result of that, we got our results analyzed and discovered that there were actually big knowledge gaps about mammograms, about high blood pressure and the association of salt intake where a number of people didn't realize that salt contributed to high blood pressure, certain foods contributing to high cholesterol, and failure to really get mammograms and other preventive tests that are very helpful in early detection of cancer. So as a result of that, we were able to get it published in the CDC publication, the Center for Disease Control publication, which is called Morbidity and Mortality in Weekly Report, and we were able to get a lot of attention to these issues because it was real data that had been compiled.

This began us on a course of doing a lot of compiling of information and surveying at the local level of what was happening within different segments of the Asian and Pacific islander community. We did this in collaboration with UCSF and working with the Vietnamese community, and also did an additional survey looking at the same kinds of knowledge and behavior and attitudes within the Korean community.

Overall, from conducting this type of survey, we learned that we, as a community based organization, a community health center, could actually carry out research in our communities and do it in a very sensitive way that was very respectful of the population and that, just as importantly, we would use the information that we learned to get the word out and to understand more of what was going on with them so that we could build stronger ways of which we could address some of the knowledge gaps and also enhance more preventive behaviors among the population. So it was a really wonderful experience to have.

A second area that I feel was really important was working in a community health center that provides excellent services and models that, so that people know that they have access to culturally competent services, the right language whenever they see a health care provider. While at the same time, we conducted advocacy and engaged our patients in sharing their stories and testifying to the media, or in Sacramento, or in the state capital about the issues that they are facing that are very challenging to their living circumstances, whether it・s access to care or other types of barriers that they are facing, financial or cultural barriers, and helping them figure out ways in which they can speak up for themselves and actually influence health policy. That is something of a principle and dual mission at Asian Health Services and we continue to do that today.

Medical Research: Increasing Knowledge and Creating New Platforms for Advocacy

I guess where I・ve been able to contribute is through research. Since there is such limited information on Native Hawaiians and Pacific Islanders, right now the charge is to get that type of information out there. I've been able to do it by partnering with the community, but in doing so, I get feedback from them as to what health concerns they have and I・ve been able to communicate that on a larger level when I do advocacy. So, the two main things, once more, that I do to help my community is 1 - do research on heath disparities, on diabetes and obesity; and 2 - to advocate for their health concerns in venues where we're not adequately represented.

The last thing that I think I do is I do some community work in regards to trying to improve the representation of NHPIs in the medical professions and through mentoring and trying to reach out to prospective students. The other thing that I do is, I work with community based organizations to try and get work done in regards to my research but also to try to reach the objectives of these groups to improve health care. So that's the approach I use to help improve the health of my people.


Improving Care through Community Health Clinics and Medical Societies

My involvement with community health way back when I was a medical student, I was at Columbia Presbyterian Medical Center. I witnessed a Chinese American patient who was basically dropped off in our emergency room with no prior referral or any history. It turned out, in fact, that the patient had been treated in Chinatown. However, the treating physician did not provide any information about the patient. Subsequently, in my investigations, I found out that the physician was not even licensed. With that memory in mind, later in life when I became a full fledged physician, I organized a group with grant support from Columbia University. I organized a group called Columbia Chinatown Associates in Chinatown, New York, with the idea of bringing a group of highly qualified physicians to organize a clinic but in the form of a private office in the center of Chinatown. And the group consists of one professor of OBGYN, one pediatrician, and two internists. By doing so, I believe that nuclear physicians did a lot to upgrade the standard of the medical practice in Chinatown and it would continue to function - in fact, changing form and name, but the fact is it is still in existence today. I think this was one of the earliest involvements that I had with the community care of the Chinese community in New York.

Later on, I also devoted myself to organize, to reform, and to reorganize a medical organization at that time that was called American Chinese Medical Society. Once I became a part of the organization, I proceeded to reorganize it so that it would be an American Chinese organization that we named the Chinese American Medical Societies, also known as CAMS. We rewrite the constitutions, bylaws, restructured the whole board structure so that it was more open and focused on recruiting the young Chinese American physicians. I must say since 1996 when I first joined the group and led the group for a couple of years, now the CAMS has matured and has developed into a very robust medical society with membership of over 1000 people. In that group, we devoted ourselves to upgrading the care of our community, to upgrade the standard of medical practice. I think we went a long way to upgrade the overall health care delivery of the Chinese American community of New York. As part of the legacy of CAMS, there was a group called CAIPA, which is based on the membership of CAMS, that proved to be one of the most successful IPOs in existence. Beyond that, I also devoted myself in educating young generations of Chinese Americans through my involvement as Program Director in plastic surgery and Director of the Fellowship in hand surgery and microsurgery, I trained generations of Chinese American plastic surgeons, hand surgeons, even Chinese Canadian hand surgeons and plastic surgeons.

Beyond that, I consider that it is also part of my devotion to the community in helping to organize the Federation of Chinese American and Chinese Canadian Medical Societies. The whole idea of creating such an umbrella organization is to create a representative voice for Chinese American and Chinese Canadians in Northern America. I remember since its inauguration in 1994, up to now, we have established an organization with a membership close to 4000 people. I think that's quite a formidable voice, I believe we also have created a meaningful critical mass that we can actually claim some kind of effective moderation of overall education as well as health care delivery to not only to Chinese Americans and Chinese Canadians but to the community of North America as a whole.

Medical Societies

I・m Daisy Saw, pathologist. As president of the Chinese American Medical Societies and also the chairman of the Federation of Chinese American and Chinese Canadian Medical Societies, we have addressed the health problems of the Chinese in the community and we also hold conferences for our health care providers that mostly address the problems of health in the Chinese in North America.

Engaging the Next Generation of Physicians

One thing I've done is I helped start the Asian Pacific American Medical Student Association, and 15 years later, it's still here. It・s been a terrific way that Asian American medical students have learned about Asian American health issues and engaged the community.


From Community Health to Advocacy

I'm Dexter Louie, I'm an ENT physician. I practice in Chinatown San Francisco for over 33 years. My training was really quite traditional and my practice has been one on one with patients for over 25 years, but then I became interested in more of the community health and more of the public health and more population health. Then I became involved in NCAPIP, the National Council of Asian Pacific Islander Physicians. Here, we are able to address disease and illness as it affects many people and affects many populations and I've found this to be very fulfilling and very gratifying. For me, having been brought up on traditional care, one on one, it's now a way for me to round out my career and really be happy with what I've been able to accomplish in a career of medicine.

Language Access

I've done a lot of work around language access, so ensuring that people who don't speak English well have equal access to quality health care. In the past I've worked for a health care foundation, the California Endowment, where I oversaw their language access grant making program and then I worked with the APIAHF for 2 years trying to improve provider and group knowledge about the impact of language barriers and working with government agencies to try to improve the regulations and try to find financing for interpreter services. And now I・m at San Francisco General Hospital at UCSF and I work very closely with interpreter services department to improve access to interpreter services for our patients.

National Advocacy Efforts

I'm a cardiac surgeon from New York. I came to the United States at an early age and went to medical school never thinking that I would be working in the Chinese American community, but having done my training in New York and subsequently taking up a practice there, I think I couldn・t help but to be involved in the Chinese American community. As it turns out, it has been a very gratifying part of my career. I started off by joining the board of the Chinese American Medical Societies and over the ensuing years I became the President. We were involved in a lot of community services and education efforts with medical students and college students.

One thing led to another and I was asked to serve on the board of NCAPIP. I think this has been an equally gratifying part of my work as we are taking community service to a higher level, to a national level. I think NCAPIP is a very essential part of what we need to accomplish in serving the Asian American communities in the country.

Primary Care to Policy Development

From the start of my career I was dedicated towards providing primary care to underserved communities by working at Asian Health Services, a federally qualified health center in Oakland Chinatown. But, in addition to that, I've been spending a lot of time trying to develop and improve policies for culturally competent care at the national policy level.