Many Asian and Pacific Islander cultures have highly evolved health practices. Examples include acupuncture, Chinese herbal remedies, yoga, meditation, and Ayurvedic medicine, all of which are gaining increasing acceptance into mainstream America and being incorporated into Western medical practices. Whereas many Asian and Pacific Islander women are well informed about the offerings of Western medicine, many elderly and recent immigrants may not understand Western medical concepts, or find them confusing. For example, a study of Southeast Asians in Ohio found that 94% did not know what blood pressure is. A survey of Vietnamese women in San Francisco revealed that 52% believed “there is little one can do to prevent cancer.” In fact, traditional Chinese medical texts have no concept of cancer. Beliefs such as these can interfere with preventive mammograms and Pap smears that screen for cancer. Chinese medical doctors, prevalent throughout Asia, largely rely on examinations of the pulse and the tongue, and Asian and Pacific Islanders accustomed to seeing these physicians may find the extensive questioning and physical examinations of Western doctors intrusive. Western and Asian cultures have many dissimilar concepts and interpreters must therefore not only translate language, but culture as well, a difficult task during today’s time-limited medical visits.
Many surveys have shown that Asian Americans are likely to use traditional Asian remedies even when they seek help from Western doctors. A 1992 study found that 69% of Asian American women and 39% of Asian American men used traditional Asian remedies. Often, this concomitant usage remains unknown to their Western physicians.
Many Asians believe that they are more sensitive to drugs than Caucasians and may therefore intentionally take lower doses of medicines than prescribed. A growing number of studies now support the validity of what has been considered to be an “old wives’ tale.” In a 1989 study, Zhou found that Asians respond more profoundly to propranolol, experiencing lower blood pressures and heart rates than Caucasians. The liver enzyme cytochrome P450-2D6, responsible for degrading numerous psychiatric medicines, exists in at least nine variations, with a less active form found in 33-50% of Asians and Africans. Several studies show that Asians experience higher plasma levels and more severe side effects than Caucasians in response to Haldol, an antipsychotic medication metabolized by P450-2D6. Similarly, studies confirm that Asians have higher plasma levels of the antidepressant desipramine (P450-2D6 metabolized) than Caucasians.