Research project rough draft
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
Knowledge of Cardiovascular Health Among Asian American College Students
San Francisco State University
Last Name, First Name
Professor Dr. Mai-Nhung Le
AAS 591: Community Health
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
INTRODUCTION
According to the New York State Vital Records Death Statistics and the Bureau of Vital Statistic
heart disease has the highest rates of mortality among Americans. According to the Journal of The
American College of Cardiology, Asian Americans are twice as likely to contract heart disease
over White Americans. The growth of Asians coming to the United States and settling has
expanded profoundly over the past couple of years. According to the Journal of American College
of Cardiology, “Asian Americans are the fastest growing racial/ethnic group in the United States,
with a population of more than 18 million that is projected to reach nearly 34 million by 2050”
(Powell, 2014). As the number of Asian Americans increase in the United States, so should the
knowledge within the medical field of health problems and diseases that might affect this
community. It has been proven that the rates of people coming is increasing faster than the
knowledge doctors have on cardiovascular disease and the effect it has within the Asian American
community. Therefore, this study will be used to analyze and prove the importance of expanding
the knowledge of health care professionals on cardiovascular disease, America’s leading killer, in
order to prevent and reduce mortality rates. This study will be conducted among Asian American
college students to test their knowledge of heart disease and their awareness of them being at risk
as well as
LITERATURE ANALYSIS
The College of American Cardiology performed research on the mortality rates of Asian
Americans with cardiovascular disease. After performing autopsies, they recorded that almost all
of the 6 largest Asian sub group: Chinese, Japanese, Korean, Filipino, Vietnamese and Asian
Indian that Vietnamese were the only sub group to NOT be twice as likely than an American to
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
have such a high risk of heart disease. All groups, specifically Filipinos at 41% were at a high risk
of contracting heart disease in their lifetime (Powell, 2014). Thus, all Asian Americans,
specifically Filipinos must take extra care when promoting a healthy lifestyle and attending the
doctors more regularly. Another study done recorded that after further investigating autopsies more
women were recorded to have passed from a heart attack or stroke according to the Applied
Nursing Research Journal (Ancheta,2015). I found this particularly interesting because most
people I know diagnosed with heart disease were male however the body mass of a women tends
to be smaller thus I can only assume that it could possibly have a greater impact if not treated on
a woman. In order to figure out how heart disease begins we must dive into the health history of
patients who tend to most frequently become diagnosed with the issue. Heart Disease can become
contracted if cholesterol is too high, someone has diabetes or obesity as well as high stress levels
and smokers. Another study was conducted measuring the effects of smoking, high stress obesity
etc. on Asian Americans compared to White Americans. After the study was conducted the
following results were discovered Asian Americans had higher rates of diabetes and smoking
depending on the length of them living in the United States. (Echeverria, 2015). Asians born or
living in America were at higher risk than those who were foreign born but why? Income can play
a large role. After settling in America resources available at a certain income are not always the
healthiest causing a decrease in health for many Asian Americans This research will investigate
other ways Asian Americans are affected in regards to cardiovascular health.
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
METHODOLOGY
In this study I decided to conduct in depth interviews in order to gain a large understanding of the
topic cardio vascular health. A total of 6 Asian American college students were recruited to
participate in 6 in depths interviews that tested their knowledge on cardiovascular health.
Participants were not selected randomly, but were friends and fellow students that also attend San
Francisco State University. I reached out to 10 people via text asking whether they would mind
engaging in a quick 10-15-minute interview regarding their knowledge of cardiovascular health.
Out of the 8 that agreed I choose to interview 3 male and 3 female so that one gender would not
be more prevalent than another. Before engaging in the interviews all participants were informed
that participation was voluntary, and all responses would be confidential. I began interviewing
participants at school mid-October in person however due to time constraints I interviewed two of
the male participants over the phone. I completed my last interview early November and recorded
all my interviewees responses via google docs that I way I can access the data readily wherever
decide to work on my investigation. I decided to arrange my questions into four types of categories,
each with a set of questions. The categories include: Demographics, Knowledge of Cardiovascular
Health, Health Experience, and Family Heart History.
Demographics
I began each interview with a set of 4 questions regarding them to state their age, which gender
they identify with (male, female etc.), which Asian American ethnicity they identify with and if
they were a US born citizen.
Knowledge of Cardiovascular Health
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
Following demographics, the next 5 questions asked participants to test their knowledge, without
researching, on cardiovascular health. Questions were introduced as “Name the first three things
that come to mind when mentioning cardiovascular.” , “Can you explain what heart disease is?”
as well as “Describe hypertension and its effect…”. These questions were used to test both
knowledge and awareness of the issue.
Family Heart History
The following 4 questions were introduced asking if any of the participants had a history of
cardiovascular diseases in any form to their knowledge. Participants were asked to describe
situations in their personal family health history. Participants were also asked if they had any
knowledge to how the disease may have occurred and if they were taking steps in their lives to
prevent it.
Personal Health Experience
The last set of 4 questions regarded the participants personal healthcare history and experience
within the past couple of years. Questions included, “how often do you attend the doctors?’, “Do
you feel confident or well informed once leaving” etc.
RESULTS/ DICUSSION
The following are the results I received after completing all six in depth interviews. The following
is an analysis that I hope can demonstrate the current knowledge Asian American college students
have on cardiovascular disease.
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
Demographics Out of the 6
participants, 50% were male
(n=3) and 50% female (n=3).
I purposefully chose to evenly
interview on gender that way
the information would not
seem more specific or bias to a certain group. The mean age of these participants was 23, with
participants ranging from the ages
20-33. I was not surprised that the
age group was so young because I
knew before hand that most college
students are in their early 20s. A
majority of the students identified
themselves as Chinese 50% (n=3),
while Filipino came in second at
33.33% (n=2), and one participant
identified as Japanese 16.67%
(n=1). All participants were born in
the United States and were either
first, second or third generation in
this country.
2 2 2 4
3 3
2 0 2
3
2 1
P A R T I C I P A N T 1
P A R T I C I P A N T 2
P A R T I C I P A N T 3
P A R T I C I P A N T 4
P A R T I C I P A N T 5
P A R T I C I A N T 6
AG ES
Age
Female 50%
Male 50%
Gender
Female Male
50%
33%
17%
ETHNICITY
Chinese American Filipino American Japanese
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
Knowledge of Cardiovascular Health
The next series of my questions focused on the knowledge of cardiovascular health regarding the
general term and/or hypertension amongst the participants and the risks/ preventions of the disease.
83% (n=5) participants were unclear of the term cardiovascular disease in general, however many
knew the relation to hypertension and high blood pressure. Many associated cardiovascular disease
as being a fancy word for heart disease, which it is, however 66% (n=4) could not identify what
heart disease actually was. When asked what the first words that came to mind when cardiovascular
disease was mentioned 100% of the participants mentioned heart, 83% mentioned blood and 33%
mention pain. All these definitions were very vague and proved that there was either no knowledge
of the disease amongst the participants or very little. Midway responding to questions, a participant
asked, “Can I use my phone or google it? That’s what I always do when I am unsure of a medical
term.” I feel like most of us use Web MD as a faulty go to when trying to research an unknown
term. I tried to dig deeper on why so many of the participants were unclear of the disease. 33%
(n=2) stated that they have not taken any science classes in a while causing them to forget about
the disease, while 66%(n=4) stated that since the disease did not apply to them they did not pay
too much attention to it. I was somewhat surprised to learn how unimportant the disease was to
many especially after finding out that heart disease ran in the families of the 83% of the
participants.
Family Heart History
This section was crucial in exploring the history of heart disease among Asian American families
and how common the disease is. This section was also beneficial for the participants to notify them
on the importance of attending the doctors and getting checked if heart disease runs in the family.
Out of the 6 participants 5 noted that heart disease ran in their immediate family. Only one
participant noted that they heart no knowledge of heart disease in their family history. Out of the
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
83% (n=5) that responded to have heart disease in their family or early stage of heart disease, 60%
(n=3) that it came from their parent, while the other 30% (n=2) noted it was from a grandparent.
One participant said, “Heart disease is not uncommon in my family both my dad and step dad have
it, as well as my grandmother, the risk of me getting it are extremely high.” I then proceeded to
ask, “are you doing anything to prevent it?”, the participant responded, “no, I’m not sure how to
prevent it, I feel like if it happens it’s out of my control.” Aside from family health history I asked
participants on actions they could take to prevent on stage occurrences of heart disease. When
asking on ways the participants thought they could prevent hypertension or cardiovascular disease
many responded similarly in: eating healthy, exercising regularly and no smoking. While this is
true, it is hard to say if participants answered this because they knew the disease and were aware
of preventions or if they just thought the answers sounded right.
Personal Health History
I found this section to be important in uncovering Asian Americans perceptions of visiting the
doctors and figuring out how to increase attendance. After reviewing the results 66% (n=4) of the
male participants responded with going to the doctor at least once a year and 83% (n=5) of females
stated going 2-3 times a year. 66% (n=4) of the participants also mentioned that their physician
changes with each visit and is not consistent. I used this question to analyze the possible trust the
participants may have with their doctor in discussing more serious health topics. I also asked to
note if there was any correlation with having a constant physician to asking more questions and
vice versa. After analyzing I noticed that 33% (n=2) of participants who went to the doctors more
regularly and had a constant physician ranked their health experience as being confident. However,
the 66% (n=4) who went less often were less knowledgeable and more skeptical with their doctor
visits. 83% (n=4) of participants also noted that they had never received or asked about possible
risks they could have because of their race/ethnicity or family background and how they should be
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
cautious. I believe this could be because I had interviewed participants in the millennial age range,
which might be quite “too young” in doctor’s mind to start worrying about Cardiovascular Disease.
However, I did find this extremely odd since most participants mentioned immediate family
members having heart complications, which would thus mean they’re at some sort of risk. One
participant told me, “I am very skeptical about attending the doctors, they are uncomfortably too
quick to prescribe a drug before listening to the whole problem.” I would have to agree in that
most doctors prescribe way too fast.
CONCLUSION
Cardiovascular disease within the Asian American community is a broad topic that is not focused
in education enough. Families that are affected or at risk rarely take preventative steps until it
becomes to late. Increasing knowledge and stressing the importance of attending the doctors are
just a few measures that can be taken in order to decrease the mortality rates of this disease. Health
care professionals must inform their patients of possible risks they may be at and form a diet plan
that suites their client’s lifestyles. Asian Americans need to step up and ask questions as this
disease is becoming more prevalent amongst their groups however there needs to be more exposure
of resources readily available to them. Without easy access to resources people are more likely to
procrastinate becoming educated on the disease. Finally, college students need to become more
engaged with their health and family health and be more eager to informing their family on
measures they must take in order to maintain a healthy lifestyle.
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
Annotated Bibliography
Echeverria, S. E., Mustafa, M., Pentakota, S. R., Kim, S., Hastings, K. G., Amadi, C., &
Palaniappan, L. (2017). Social and clinically-relevant cardiovascular risk factors in Asian
Americans adults: NHANES 2011–2014. Preventive Medicine, 99
The purpose of the journal is to publicize awareness of cardiovascular disease and factors which
can cause it amongst Asian American Communities. As citied in the article, Asian Americans are
the fastest growing racial groups in the United States. Research from this article was conducted in
2010 resulted in a difference of health among American born Asians and US Born Americans as
well as non-Hispanic White. Studies proved that since obesity and diabetes prove to be high within
Asian Americans, the heart is effected which as well is almost nearly talked about. Bringing to
people’s attention that their heart could be at risk when relaying the news that they have diabetes,
might urge them to be more careful. This journal touches base on ways that medical personals can
become more strict on preventatives.
Echeverria, S. E., Mustafa, M., Pentakota, S. R., Kim, S., Hastings, K. G., Amadi, C., &
Palaniappan, L. (2017). Social and clinically-relevant cardiovascular risk factors in Asian
Americans adults: NHANES 2011–2014. Preventive Medicine, 99, 222-227.
doi:10.1016/j.ypmed.2017.02.016
The purpose of the journal is to fully analyze and access the statistics among cardiovascular health
in Asian American adult communities and how they compare to Hispanic Whites and non-Hispanic
White adults. The demographics surveyed within the Asian American Communities are Chinese,
Asian Indian and Filipino. The goal this survey had was to find similar characteristics or qualities
within each community to see their risks of Cardiovascular Disease, Hypertension, and Diabetes.
Powell O. Jose, Ariel T.H. Frank, Kristopher I .Kapphahn, Benjamin A. Goldstein , Karen
Eggleston, Mark R.Cullen, Latha P.Palaniappan L. (2017) Cardiovascular Disease Mortality in
Asian Americans. Journal of the American College of Cardiology, 64, 2486-2494
The objective of the journal is to access the mortality rates in Asian Americans who have any heart
conditions, diseases etc. The study is conducted among the 6 largest Asian groups with are
Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese. In order to conduct the study
death records were traced within these 6 subgroups from 2003-2010. According to the research
10,442,034 records were analyzed and the highest death rates with disease were women. The
research then goes on explaining what could have caused this and how it can be prevented.
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
Ancheta, I. B., Carlson, J. M., Battie, C. A., Borja-Hart, N., Cobb, S., & Ancheta, C. V. (2015).
One size does not fit all: cardiovascular health disparities as a function of ethnicity in Asian -
American women. Applied Nursing Research, 28(2), 99-105. doi:10.1016
While only so much research is conducted about heart disease to begin with, the most research
tends to be off male Asian Americans and disregarding females. This articles focuses on the
difference women may have over men when dealing with cardiovascular diseases, stroke, attacks
etc. This journal also annotates the importance of figuring out the statistics and demographics
behind why certain communities are more affected with this disease than others.
Mehta, R. H., Parsons, L., & Peterson, E. D. (2012). Comparison of Bleeding and In-Hospital
Mortality in Asian-Americans Versus Caucasian-Americans With ST-Elevation Myocardial
Infarction Receiving Reperfusion Therapy. The American Journal of Cardiology, 109(7), 925-931.
doi:10.1016/j.amjcard.2011.11.019
The Mortality in Asian-Americans Versus Caucasian-Americans proves to be important because
the factors can be many. Are white Americans be given better health care and guidance, thus
having lower mortality rates than Asian Americans? Is there a difference within their ancestor’s
health history that contributes to the major differences? This article goes in depth on how women
in particular are more susceptible to heart disease, strokes high blood pressure etc. and how it
affects their lifespan if it is not taken care of properly.
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
Knowledge of Cardiovascular Disease & Hypertension
Interview Results
QUESTIONS:
1.) How old are you?
2.) How do you identify yourself (gender)? 3.) What ethnicity or race do you identify most with? 4.) How often do you go to the doctors or clinic? 5.) Is your healthcare physician constant or do you receive a different physician each time
you go to get checked up?
6.) What are the first three things that come to mind when cardiovascular disease is mentioned?
7.) Do you know which most common disease is related to hypertension and cardiovascular problems?
8.) Can you describe what hypertension is and the effect it has on the body? 9.) Name three ways you believe you can prevent cardiovascular disease or hypertension. 10.) Does anyone in your immediate family suffer from any heart related conditions and
have they received proper help?
11.) Follow up: If so, are you aware that some of these can be genetic and are you taking
steps necessary to prevent it?
12.) Do you ever feel that you are not receiving proper care or awareness of diseases that are
more prominent amongst your ethnic group?
13.) On a scale of 1-10 (10 being best) how confident do you feel once leaving the doctor’s
office that you have received and are fully aware of how you should maintain a healthy
lifestyle?
RESPONSES/ DATA COLLECTED:
Participant 1 : Male, 22
1.) 22
2.) Male
3.) Half Chinese American, also Mexican and White
4.) I try to visit the doctors about once a year before the school year begins, normally in the
summer
5.) My physician has been constant for a couple of years, my family has been going to the
same doctors since I was younger
6.) Three words that come to mind: Hemophilia, infarctions, and cardiac arrest. There’s no
reason they came to mind other than impulse.
7.) The subject was unaware of what the most common disease is related to hypertension and
had almost no knowledge to cardiovascular disease
8.) They could also not define what hypertension was and the effect has on the body. Once
they were informed it made more sense and was able to answer question 9
9.) Don’t Smoke, Don’t Drink and Exercise
10.) No one in their immediate family was suffering of cardiovascular disease to their
knowledge.
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
11.) They are aware that some of the traits of cardiovascular disease are genetic
however since it has not happened in their family they are not taking the time to receive
proper education on how to prevent it.
12.) They had never thought about being informed about certain health risks by their
doctors that are more prominent in their culture, however feel like they should’ve been.
13.) 8
Participant 2: Female, 24
1.) 24
2.) Female
3.) Chinese and Filipina American
4.) I try to visit the doctors around 0-3 times a year, I think its important to go especially
because I am a female and require multiple checkups/ tests
5.) My physician is constant, I feel more comfortable going to see a doctor that already
knows my health history
6.) Three words that come to mind: Heart disease, heart attack, blood pressure
7.) The subject was unaware of what the most common disease is related to hypertension and
had almost no knowledge to cardiovascular disease
8.) When describing hypertension they referred to it as: when blood pressure becomes too
high it causes pain
9.) Not consuming salty foods, being physically active, not smoking
10.) Someone in her immediate family has a history of cardiovascular disease possibly
high cholesterol
11.) She is aware that it can be passed on to her so she tries to exercise regularly, eat
healthier and not smoke
12.) She feels that her doctors are not properly informing her about possible health
risks
13.) 7, Doctors are uncomfortably quick to prescribe medications for everything.
Participant 3: Male, 33
1.) 33
2.) Male
3.) Asian American, Japanese mostly some Chinese ancestors
4.) I do not go to the doctors often a year, it’s rare that I go unless I have to
5.) My doctor used to be constant but then I switched healthcare and it is different each time
6.) Three words that come to mind: mother, heart, red blood
7.) Described cardiovascular disease as having hypertension, high cholesterol, or high blood
pressure. Says it is caused by stress
8.) Described hypertension as having high blood pressure or high cholesterol
9.) Staying healthier, active, not smoking
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
10.) Both of his parents were affected with some aspect of cardiovascular disease. His
dad had high cholesterol all the time and mom had heart disease.
11.) Is not aware that it could be passed down genetically and will begin to look out
for symptoms
12.) He feels well educated by his doctors on risks, however is surprised that they
haven’t mentioned the likelihood of him receiving cardiovascular disease especially since
his parents are affected.
13.) 8 or 9
Participant 4: Female, 23
1.) 23
2.) Female
3.) Filipino Chinese American, but mainly identify as Filipino
4.) I don’t go to the doctors often, probably around 2 to 3 times a year depending on
whenever I go home to visit
5.) After attending college, I have received a different physician each time I go in
6.) Three words that come to mind: Heart disease, stroke, +high blood pressure
7.) Described hypertension to stem from cardiovascular disease,
8.) Described hypertension as basically the same thing as high blood pressure. She also
described that hypertension could lead to heart disease and may cause damage to other
parts of the body
9.) Lessen your sodium intake, eat a healthy diet, and exercise
10.) To her knowledge no one in her immediate family suffers from any
cardiovascular diseases or symptoms
11.) She knows it can be genetic however since it is not currently affecting her family
now she is not taking the steps necessary to research ways to prevent the disease overall
12.) She feels well educated about the risks she could be at by her physicians
13.) 7
Participant 5: Female, 21
1.) 21
2.) Female
3.) Chinese American, White
4.) I try to go to the doctors at least once a year, but end up going more if I get sick or need a
refill on prescription
5.) I used to have a constant health physician, but now I just go to the clinic on campus and it
is normally random/ whoever is available
6.) Three words that come to mind: Heart disease, bad, diet
7.) She said that high blood pressure was the most common thing linked to hypertension, as
they are practically the same thing
8.) She described hypertension as being something her dad has that has to do with your blood and heart
9.) Less stress, better diet, more exercise
KNOWLEDGE OF CARDIOVASCULAR HEALTH AMONG ASIAN AMERICAN COLLEGE
STUDENTS
10.) Her immediate family was affected with cardiovascular disease, she mentioned that her dad, and grandmother- take medication for it, didn’t like how it affected him so is
changing diet
11.) She is aware that it could be passed on to her genetically however she is not being
as health conscious as she should be, she did admit to using less salt.
12.) She doesn’t pay too much attention to whether she is receiving proper care or not
when going to the doctors.
13.) I haven’t asked about it explicitly, I always make sure to check my blood pressure. 8