South Asian Health: From Research to Practice and Policy: Working Group Themes

The South Asian Health working group themes will be examined in the context of reducing risk for cardiovascular disease (CVD) and cancer. Each review presents the available epidemiologic and behavioral research data, and identifies research gaps. The reviews were elaborated  to facilitate the development  of research programs to address these gaps, and brainstorming about related health services, health advocacy and health policy actions.

Theme 1: Genetics, Epigenetics, Epidemiology, and Pathophysiology

Research has shown disparities in CVD, diabetes, and obesity to be partially determined by underlying biological factors. This working group will catalogue the available research on the intersection of environment, genetics, biomarkers, and pathophysiology to identify gaps and develop research priorities to address these gaps.

Theme 2: Lifestyle & Behaviors

Lifestyle behaviors have a significant role in CVD and cancer risk. This working group will examine the impact of behaviors common in the South Asian population (related to diet, fasting, physical activity, and circular migration) on CVD, diabetes, and cancer. The role of complementary and alternative medicine,, including traditional South Asian medicine such as ayurvedic medicine,  in the treatment of chronic conditions will also be covered in this thematic area.

Theme 3: Inflammation, Infection, Exposure, and the Human Microbiome

Infection and chronic inflammation can elevate CVD and cancer risk. Environmental exposures among South Asians, such as to arsenic, also pose risk. This working group will examine the effects of exposure to arsenic and particulate matter, HPV and Hepatitis B/C infection on shared CVD and cancer risks. The group will also assess emerging research on the human microbiome, and the effect of microbiome changes on obesity and diabetes risk among South Asians.

Theme 4: Alternative Tobacco Products

Alternative tobacco products, including paan with tobacco, gutka, bidi, and kretek, are widely used among the South Asian community. These products have been linked to increased rates of oral, pancreatic, and liver cancers, cardiovascular effects, periodontal disease, and adverse pregnancy outcomes. This working group will summarize the current literature on these products, including on prevalence of use, product toxicology, and associated risk for disease. Behavioral and pharmacological quit strategies, and the impact of current and potential regulatory policies on use and cessation will also be addressed. Literature gaps will be identified and strategies for future research discussed.

Theme 5: Healthcare Access & Patient-Provider Readiness

Poor healthcare access has a detrimental impact on the health of a community. This working group will discuss the current state of healthcare access for South Asians. The role of cultural issues, institutional barriers, and the ongoing impact of health care reform (Affordable Care Act) on the community will be explored. This group will also examine patient and provider readiness to address healthcare access barriers.

Theme 6: Stress and Mental Health

Stress and poor mental health are risk factors for CVD and cancer. Among South Asian immigrants, the stress of acculturating to the American lifestyle while retaining certain cultural values and traditions, limited social support, occupational stress, and financial strain may contribute to high stress levels and poor mental health. This working group will assess the current literature, and gaps that need to be addressed.