By Thaddeus Pham, Adult Viral Hepatitis Prevention Coordinator, Hawaii Department of Health
In addition to observing Hepatitis Awareness Month and Asian and Pacific Islander Heritage Month in May, this week we also recognize the second annual Hepatitis Testing Day. As I look at all these important events for the month, I am reminded about why I do the work that I do. I invest my time and energy and passion in combating viral hepatitis not only because I believe in public health, not only because I am an Asian American, but also because it affects people I know and love.
The Face of the Hepatitis B Epidemic
Chronic hepatitis B is a major health burden that affects up to 2.2 million people in the U.S. We also know that the majority of those living with chronic hepatitis B in the U.S. are from regions of the world where hepatitis B is highly endemic, especially Asia and the Pacific Islands. Even though Asians and Pacific Islanders (API) make up less than 5% of the general U.S. population, APIs account for more than 50% of Americans living with chronic hepatitis B. Most of these APIs (approximately two-thirds) currently living with hepatitis B are unaware of their status. We know that hepatitis B is the greatest health disparity among API and that we therefore should be addressing it within the API communities.
Drivers of Hepatitis B Infection
There are many social, economic, cultural, and linguistic challenges to ensuring appropriate, evidence-based education, prevention interventions, testing and comprehensive care are available to all API communities. Addressing these barriers in a culturally sensitive and linguistically appropriate way must be an ongoing priority, especially in the context of achieving the goals of the U.S. Department of Health and Human Services’ (HHS) Viral Hepatitis Action Plan and advancing culturally and linguistically appropriate services in health and health care.
For me, as a public health official and as a community member, it all comes back to ‘ohana (family). I think of my relatives who passed away from liver cancer because they were too poor, too unaware, or too ashamed to address their hepatitis B. Unfortunately, my situation is not an uncommon one, especially in Hawaii.
In Hawaii, more than half of our communities identify as Asian or Pacific Islander, and almost 1 out of 5 people are foreign-born. We are a state that is proud of our cultural diversity, and we recognize the need to keep all of our diverse communities healthy. When people in our state think about hepatitis B, they are not thinking about percentages or numbers. Instead, they are visualizing friends and coworkers, friends and family, aunties and uncles: people they know and love.
Responding to Hepatitis B in API Communities
In addressing hepatitis B, we have had to tailor our interactions for each API community so as to make meaningful and sustainable impacts on the community. We engage communities in Talking Circles that allow them to create their own “intra-ventions” on how they would like to address health issues within their own culture. Across these various intraventions, there are some consistent messages that have been developed around hepatitis B among all the cultures:
- Learn about it
- Get tested
- Get vaccinated
- Talk to your doctor
These are simple messages, but they are messages that can save lives and keep families healthy. Ultimately, public health “work” in hepatitis B (as well as hepatitis C) goes beyond medical models and numbers. We, as public health officials, are empowering diverse communities to stay healthy and take care of each other. In the same way, I hope that we, as public health officials, can continue to work together to support communities to combat viral hepatitis to the benefit of our communities, our families, and ourselves.
Learn more about hepatitis and Hepatitis Test Day resources and events in your area here.
We want to hear from you! Tell us how your state is responding to hepatitis B by leaving a comment below.