Menopause often comes with its own set of emotional and physical challenges, but it’s also an opportunity to embrace a new chapter in your health journey. The transition into menopause, which usually happens between ages 45 and 55, marks the end of menstruation and a significant shift in hormone levels. While it’s natural and expected, it can also bring symptoms like hot flashes, night sweats, weight gain and mood changes.

The good news is that there are ways to navigate these changes and continue to thrive. Hormone replacement therapy (HRT), lifestyle changes, and yes, even some birth control methods can play a role in managing menopausal symptoms. Whether it's through natural supplements, hormone-balancing food choices, or medical treatments, there are solutions tailored to your body’s unique needs.

One of the key takeaways is that menopause is not the end—it's a transition to a different stage of vitality. You can still feel energized, healthy, and in control by taking a proactive approach to managing your symptoms and staying in tune with your body’s needs.

Join Our Tea Talk: Learn More About Navigating Menopause -- For those who want to dive deeper into this topic, we invite you to join us at our Tea Talk of the season on Thursday, October 17th, from 12-1 PM EST. Our expert speaker, Dr.Yen will cover everything you need to know about navigating menopause, including practical advice, symptom management, and how to make choices that support your overall wellness.

Parkinson’s disease (PD) is a complex and progressive neurodegenerative disorder that affects nearly one million people in the United States. However, despite the availability of treatments that can manage symptoms and improve quality of life, Asian Americans living with Parkinson’s often face significant barriers to accessing the care they need.

Cultural and Language Barriers

One of the primary challenges Asian Americans encounter is the cultural stigma surrounding illness and aging. In many Asian cultures, there is a strong emphasis on maintaining family privacy, which can lead to hesitation in discussing health issues openly. This cultural norm can prevent individuals from seeking medical help early, often delaying diagnosis and treatment. Additionally, language barriers can further complicate the situation. While most hospitals offer translation services, the quality of these services varies, and digital translations may not capture the nuances of medical terminology. This can result in miscommunication and misunderstanding between patients and healthcare providers.

The Reluctance to Speak Up

Many Asian Americans also experience a reluctance to question or challenge their doctors, driven by a desire to be perceived as “good patients.” This cultural inclination can lead to underreporting of symptoms or side effects, which are crucial for effective disease management. As a result, patients may not receive the full spectrum of care available to them, further exacerbating the progression of the disease.

Underrepresentation in Research

Another significant barrier is the underrepresentation of Asian Americans in Parkinson’s disease research. Despite the high prevalence of Parkinson’s, Asian Americans have been largely excluded from clinical studies, which means that the unique challenges they face are not adequately addressed. This lack of representation contributes to a knowledge gap that can delay diagnosis and result in less effective care for Asian American patients.
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Addressing the Gaps: The ACCESS-PD Initiative

To tackle these challenges, Tufts University and Asian Women for Health launched the ACCESS-PD (Advancing Comprehensive Care & Enhancing Service Standards in Parkinson’s Disease among Asian Americans) study in 2022. Funded by the Michael J. Fox Foundation, this groundbreaking initiative aims to identify and address the cultural and systemic barriers that prevent Asian Americans from accessing the care they need.

The study is recruiting family care partners to participate in a national online survey that explores their experiences with diagnosis, treatment, and caregiving. The goal is to gather insights that will inform the development of culturally appropriate resources and care strategies tailored to the needs of the Asian American community.

Building a Better Future

As we continue to learn more about the unique challenges faced by Asian Americans with Parkinson’s, it’s clear that addressing these barriers is not just about improving individual outcomes—it’s about fostering a healthcare system that is equitable and inclusive for all! 

A news story that delves deeper into the experiences and challenges of individuals living with PD, based on the responses through the study will appear next week in SAMPAN newspaper. Stay Tuned for more updates! 

For more information on how to participate in the ACCESS-PD study, visit asianwomenforhealth.org/accessPD.  Together, we can make a difference! ​

​Meet Naheed Esar: 

Q1. Can you share your personal journey and what led you to become the Executive Director of Asian Women for Health? How has your background and experiences shaped your vision for the organization?

I am originally from Afghanistan and first came to the United States as a Fulbright scholar to pursue a master's degree in Cultural Anthropology. After completing my studies, I returned to Afghanistan and founded a nonprofit organization dedicated to helping women and children lead healthier lives. During this time, I utilized a book titled “Where There Is No Doctor” to teach health literacy to small groups of women, empowering them to disseminate this knowledge within their communities. 

​I have also worked with United Nations Development Organization (UNDP) as gender consultant and then pivoted to government sector. 

These diverse experiences, both professional and personal, have profoundly shaped my vision for Asian Women for Health (AWFH). They have equipped me with a holistic understanding of health gaps and the importance of community-driven solutions, which are central to our mission at AWFH.  

Amidst the electrifying hum of the violinist, the atmosphere at the Exchange Center overlooking the Seaport waterfront was electric on May 30th, 2024 as Asian Women for Health (AWFH) held their annual but first of its kind CelebrAsians Gala. The event was a vibrant showcase of diverse Asian heritage, with guests donning a wide array of traditional garments from flowing lehnga cholis, saris and intricate kimonos to striking hanboks and shalwar kameez.

Naheed Esar, executive director of AWFH opened the evening with a powerful message, “We are gathered here as a community with a shared vision- a healthcare system that truly understands and embraces the rich diversity within our Asian communities," her words resonating deeply with the crowd.

Jean Yang, President and CEO of Vinfen who was also the keynote speaker at the event addressed the urgent need to tackle mental health issues within the Asian American community. "Barriers to mental health are complex, and we need to fight for a better, socially, and culturally aware mental healthcare system for all, especially our youth," she stated, highlighting that suicide was the leading cause of death for Asian Americans aged between 15 to 24.

Asian Women for Health has made remarkable strides in addressing these issues. For the past 10 years, the organization has held numerous workshops and awareness campaigns including organizing the Asian American Mental Health Forum. This forum brings together health practitioners, policymakers, researchers, and individuals with lived experience to combat stigmas and concerns related to mental health within Asian communities. AWFH has also been at the forefront of creating safe spaces where community members can openly discuss and seek help for mental health concerns.

In the past year alone, the organization has successfully completed three cohorts of community health workers, with an impressive 95% of participants coming from underrepresented communities and majority securing employment. During the COVID-19 pandemic, the team’s effort in promoting vaccine equity has been instrumental in ensuring broader access and awareness.

"I am honored to be part of the CelebrAsians Gala tonight," said Adam Thomas, Co-Chair of the Board of Directors. "I am inspired by the strides AWFH has made and am excited to see how we will continue to close the health gap for Asian women, ensuring they receive the culturally sensitive care and support they deserve."

The gala also featured a mesmerizing Kathak performance by Anjali Nath, which captivated everyone in attendance. The traditional Indian dance, characterized by its intricate footwork and expressive storytelling, added a magical touch to the evening, leaving the audience in awe.

Adding to the significance of the occasion, Mayor Michelle Wu sent a heartfelt video message, expressing her gratitude and support for the invaluable work of AWFH, "We know that access to quality healthcare is a challenge in this country, and even if services exist, Asian Women for Health has helped highlight that our residents face additional challenges in accessing them," she commended, acknowledging the organization's dedication to the health and well-being of the Asian American community.

As the night came to a close, the sense of unity and shared purpose was palpable. The CelebrAsians Gala was not just a celebration of cultural heritage, but a testament to the collective power of a community striving for a healthcare system that embraces and understands its rich diversity.

For many queer AAPI individuals, discrimination is a multifaceted issue. They often find themselves at the intersection of racial and sexual minority statuses, facing prejudice and bias on both fronts. This dual discrimination can manifest in various forms, including micro-aggressions, exclusion, and overt hostility in both personal and professional settings.
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Cultural Stigma and Family Dynamics

​One of the most poignant challenges is the cultural stigma within their own communities. Many AAPI cultures place a high value on family honor, respect for elders, and adherence to traditional roles and expectations. As a result, over 40% of queer AAPI individuals report hiding their sexual orientation or gender identity from their families. The fear of rejection, shame, or being disowned can create a significant emotional burden, leading to a sense of isolation and internal conflict.

Mental Health Implications

The stress of navigating these dual identities can take a toll on mental health. Studies have shown that LGBTQ+ AAPI individuals are at a higher risk for depression, anxiety, and other mental health issues compared to their heterosexual or non-AAPI counterparts. The lack of culturally competent mental health services exacerbates this issue, leaving many without the support they need.
Representation MattersRepresentation in media and public life plays a crucial role in shaping societal attitudes and providing role models for young queer AAPI individuals. Unfortunately, positive and accurate representation of this group is still limited. Increasing visibility and representation can help reduce stigma and provide a sense of validation and acceptance.

Building Supportive Communities

Organizations like NAAAP Queer Asian Supper Club and MAP for Health are vital in creating safe and supportive spaces for queer AAPI individuals. These communities offer a place to share experiences, find support, and build connections with others who understand the unique challenges they face. Events such as the AWFH upcoming discussion at CIC Boston are essential for fostering dialogue, understanding, and solidarity.

Advocacy and Progress

Activism and advocacy by and for queer AAPI individuals have been instrumental in pushing for greater inclusivity and equity. From grassroots movements to policy changes, these efforts work towards dismantling systemic barriers and creating a more accepting society.

Conclusion

The journey of navigating the world as a queer AAPI individual is fraught with challenges but also marked by resilience and strength. By acknowledging the dual discrimination they face, providing supportive communities, and increasing representation, we can work towards a future where all individuals are free to embrace their true selves without fear of stigma or discrimination.

Join us on June 27th, 2024, from 6:00 PM to 8:00 PM EST at CIC Boston for an insightful discussion on these topics. Together, let's celebrate our identities, share our stories, and support each other on this journey. See you there!

As we celebrate Asian American and Pacific Islander (AAPI) Heritage Month, it's crucial to spotlight not just cultural achievements, but also pressing health disparities within these communities.

​​Despite being one of the fastest growing populations in the U.S., Asian Americans are often underrepresented in health research, which can obscure critical disparities. The National Health Interview Survey indicates that Filipino Americans exhibit a diabetes prevalence rate nearly twice that of non-Hispanic whites. Similarly, Vietnamese and Korean Americans report significantly higher rates of hepatitis B, underscoring the diverse and often hidden health challenges faced by these groups.

​The notion of a "model minority" often masks the stark health disparities that exist within the Asian American community. These disparities are not just broad strokes of data but are significantly pronounced when disaggregated by ethnicity. For instance, while overall cancer rates among Asian Americans are lower, Vietnamese American women have the highest cervical cancer rate of any ethnic group in the United States. This discrepancy illustrates the danger of aggregating data, as it can obscure critical health issues specific to subgroups.
 
Further complicating the picture, language barriers, cultural nuances, and limited access to culturally competent healthcare contribute to these disparities. Many Asian Americans are less likely to seek regular medical examinations and mental health services due to cultural stigmas and a lack of resources tailored to their linguistic or cultural needs.

Addressing these issues requires a nuanced approach that considers the cultural, economic, and social factors influencing the health within these communities. Initiatives like the FILLED Project and The SEA US HEAR US Study are pivotal, as they provide insights and stories derived directly from the Southeast Asian communities. These community-driven projects help identify specific needs and tailor public health interventions that are culturally appropriate and effective.
 
These projects highlight a critical truth: effective public health interventions must be rooted in the understanding of cultural uniqueness and specific health needs. By spotlighting disparities from local communities to broader societal contexts, they pave the way for enacting effective strategies and empower further community-driven projects.

​ACCESS PD - Advancing Comprehensive Care & Enhancing Service Standards in Parkinson's Disease among Asian Americans, funded by the Michael J. Fox Foundation, investigates cultural and systemic barriers that hinder access to care and participation in research studies for Parkinson’s disease among Chinese and Vietnamese Americans in the Greater Boston Area. As a community partner, Asian Women for Health ensures that this study engages and informs the Asian American community in a culturally appropriate manner. This project not only aims to understand barriers but also to create culturally appropriate resources for patients, care partners, and clinicians, enhancing Parkinson’s disease literacy and service standards among Asian Americans.
 
Similarly, the All of Us Research Program (AoURP) is an NIH-funded program to involve people in research and clinical studies that are representative of the diversity within the United States. This initiative is building one of the largest biomedical data resources of its kind, representative of everyone in the United States. By encouraging participation from a broad cross-section of the U.S. population, the All of Us Research Program aims to facilitate research that can lead to more personalized healthcare solutions based on individual differences in lifestyle, environment, and biological makeup. This program not only advances medical research but also ensures that participants are engaged ethically and respectfully, emphasizing inclusivity and the protection of their rights and privacy.

In the United States, senior care and the role of caregivers has become increasingly prominent with the increasing population of seniors. The demand for eldercare will  increase with the US senior population projected to grow by nearly 40% between 2020 and 2035, according to the Census Bureau. Caregivers, often unsung heroes, play a crucial role in ensuring the well-being and best quality of life for seniors, often offering physical assistance and emotional support.

Why is Caregiving so Prominent in AANHPI Communities? 

In a study conducted by AARP, researchers found that 73% of AANHPIs believe that they are expected to care for their parents. Within many AANHPI households, the cycle of caregiving is often revered, as the young take on the caregiving status when elders reach a point where they need to be cared for. There are several major reasons why many members of the AANHPI communities becomes caregivers for their loved ones:

• Filial Piety: Within many AANHPI cultures, filial piety – a Confucian value emphasizing respect for one’s parents and elders– is often expected of children. 
• Stigma Against Institutional Care:  Many AANHPI individuals often feel guilty and consider it disrespectful to send their parents or loved ones to senior homes or assisted living. Often, many care facilities also aren't culturally tailored for AAHIPI seniors as language and cultural barriers persist.
• Living in multi-generational households: This core cultural value often manifests itself in the form of multi-generational households, where seniors are cared for by their children and extended family members. In this position, caregivers often assume a pivotal role of not only providing physical assistance but also in advocating for their loved ones in situations when they cannot advocate for themselves. 

It is also important to recognize that under the AANHPI umbrella, there are many cultures and differences in family structure that can effect caregiving dynamics. 

Caregiver’s Experiences

Caregiving in the AANHPI community is not without its challenges. Cultural stigmas surrounding mental health issues may prevent seniors from seeking the care they need, placing additional strains on caregivers. Moreover, the demands of caregiving can take a toll on caregivers’ own well-being, leading to stress, burnout, and feelings of isolation. Some unique challenges AANHPI family caregivers face include: 

• Language Barriers: Language and communication also play a vital role in caregiving within the AAPI community. We see that many seniors may be more comfortable speaking their native language, presenting a unique challenge for caregivers who must navigate linguistic barriers while providing care. Caregivers often have the responsibility to facilitate clear communication between seniors and healthcare providers, all while ensuring that cultural nuances are respected throughout the caregiving process.
• Mental Health Struggles: Caring for loved ones can be immensely rewarding, but it can also come with its own set of challenges. One of the major challenges include burnout and isolation. The demand of caregiving, household chores, and personal tasks, can take a huge toll on caregivers. This can often lead to feelings of overwhelm and exhaustion. Caregivers may also experience heightened levels of stress, anxiety, and depression as they navigate the challenges and destress of seeing a loved on struggle with illness.
• Lack of Self Care: Caregivers often neglect their own physical and emotional well-being and needs in favor of prioritizing the health of their loved ones.  This can lead to a cycle of self-neglect and emotional suppression.

It's essential for caregivers to recognize the importance of self-care and prioritize their own mental health and well-being. This includes setting boundaries, seeking respite care, practicing stress-reduction techniques such as mindfulness or meditation, maintaining social connections, and seeking support from friends, family, or support groups. Additionally, caregivers should not hesitate to seek professional help if they are struggling with their mental health. Therapy, counseling, and support services tailored to caregivers can provide valuable resources and coping strategies to navigate the challenges of caregiving while safeguarding their own mental health.

Period Poverty, a community health issue that has been often overlooked and neglected  throughout the world. According to the American Medical Women’s Association, period poverty is defined as the lack of accessibility or affordability of menstrual hygiene tools and educational materials. Period Poverty can take different forms and has emotional, physical, and mental tolls on individuals who menstruate. It is essential for everyone openly discuss this pertinent issue to reduce period stigma, and increase access to period products for all people who menstruate. 

Effects of COVID-19 on Menstrual Health
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Throughout the COVID-19 pandemic, period poverty became a widespread health issue as economic strains and home quarantine limited individuals to access to menstrual products. Amid widespread job losses, reduced working hours, and home quarantine, many women and AAPI individuals found themselves struggling to afford basic necessities such as menstrual products. 

• Financial Burdens: As households tightened their budgets to accommodate essential expenses such as food, rent, and medical bills, menstrual hygiene products were often relegated to the bottom of the list. According to a 2021 study by U by Kotex, period supplies has grown to become less affordable over the past fire years with a 35% increase in people struggling to afford period products. Due to the loss of cotton crops and drought, the New York Times reported that the pice of tampons has risen 13% over a year in 2022.
• Lack of community support: During the pandemic, many individuals felt isolated and lonely when trying to seek support in menstrual hygiene education as schools and community support groups were closed due to lockdown. Studies also found that individuals had difficulty expressing their feelings around periods, especially with their parents, leaving them feeling further isolated.
• Impact on Mental Health and Well-being: ​A study highlighted the mental health implications of period poverty among college-aged women in the United States. The study found that 14.2% of women had experienced period poverty in the past year, and this experience was associated with moderate or severe depression. The lack of access to menstrual products, coupled with heightened economic uncertainty and social isolation, contributed to worsened mental health outcomes among menstruating individuals.

Stigmas & Barriers of Menstrual Health in the AAPI Community.
 
Period poverty, a global issue affecting millions, has been exacerbated by the COVID-19 pandemic. Within the AAPI communities, this challenge is not only about access to menstrual products but also combating deep-rooted stigmas surrounding menstrual health. Despite that half of the world's female population experience menstruation each month, talking about menstruation and menstrual health is still stigmatized within various communities. 

• Shame & Cultural Taboos: Shame often prevents people from discussing menstrual health issues such as access to pads, how to use certain menstrual products, and even ingredients used in products. In many AAPI households, discussions about menstruation are considered taboo, preventing open dialogue and education about menstrual hygiene. Consequently, individuals may feel ashamed to seek help or support, exacerbating their vulnerability to period poverty.
• Gaps in education: Limited access to comprehensive menstrual health education perpetuates misconceptions and myths about menstruation within the AAPI community. Many individuals grow up with inadequate knowledge about menstrual hygiene, leading to unhygienic practices and increased vulnerability to health risks. Language barriers further exacerbate the issue, making it difficult for non-English-speaking individuals to access culturally appropriate information about menstrual health.
• Lack of research: Despite that Asian Americans are one of the fastest growing minority groups in the United States, our community are often overlooked by researchers in areas including issues related to sex, STIs, and menstrual health. 

It is imperative to center the voices and experiences of AAPI individuals in conversations about menstrual health and period poverty. By elevating diverse perspectives and experiences, we can develop more inclusive and culturally relevant solutions that address the specific needs of AAPI communities. Given the lack of specific studies on AANHPI women and girls, it's crucial to recognize the broader implications of period poverty and the need for targeted research and interventions that address the unique challenges faced by different communities, including AANHPI populations. The importance of providing access to affordable menstrual products, education around menstrual health, and support systems can result in great positive impacts within our communities!

Sources:
1. Period The Menstrual Movement: Period Poverty
2. Period poverty and mental health of menstruators during COVID-19 pandemic
3. Editorial: Period Poverty
4. Harvard Public Health: "Inside the movement tackling period poverty in the U.S."

Eating disorders are complex mental health conditions that affect people from all walks of life, regardless of age, gender, or ethnicity. However, within the AAPI community, these disorders often go unnoticed or unaddressed due to cultural stigma and lack of awareness. Despite this silence, eating disorders are a significant issue within the AAPI population, with profound impacts on physical health, emotional well-being, and familial dynamics.

What are eating disorders?

According to the American Psychiatric Association, eating disorders are behavioral conditions characterized by disturbance in eating behaviors and associated distressing thoughts and emotions. 

Type of eating disorders include:

• Anorexia nervosa: Characterized by self-starvation and weight loss
• Bulimia nervosa: Alternate dieting, or eating only low calorie safe foods and binge eating on higher calorie foods
• Binge eating disorder: Characterized with having episodes of binge eating, in which individuals consume large quantities of food in a brief period
• Avoidant Restrictive food intake disorder: Involves a disturbance in eating resulting in persistent failure to meet nutritional needs and extreme picky eating
• Other specified feeding and eating disorder: Individuals with OSFED may have many of the symptoms of anorexia nervosa, bulimia nervosa or binge eating disorder but do not meet the full criteria to be diagnosed with these conditions.
• Pica and Rumination Disorder: Eating things that are not food with no nutritional value

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COVID-19 Effects on Mental and Physical Health 

As the world grappled with challenges brought by COVID-19, the effects on both mental and physical health became increasingly apparent. With widespread lockdowns and social restrictions, many found themselves grappling with heightened levels of stress while also experiencing difficulty to cope and seek help.

• Isolation: During lockdown, disruptions of daily routines negatively impacted eating, exercise, and sleeping patterns that may have increased ED risk and symptoms. Social restrictions also deprived individuals of traditional coping strategies and social support from their networks. A study showed that there was a significant increase in adolescents and young adults seeking care for an eating disorder after the onset of the pandemic and that the pandemic likely led to an increase of eating disorders and disordered eating behaviors.
• Social Media: As individuals began to confide in online spaces to connect with the world around them, social media platforms grew stronger in shaping societal norms and perceptions of body image, particularly among younger generations. Research indicates that the number of teens with eating disorders at least doubled during the pandemic, as individuals began to compare themselves to unrealistic portrayals of beauty influencers online.

Eating Disorders within the AAPI Community 

Eating disorders can impact people regardless of their race, age, sexual orientation, gender identity, or socioeconomic status. There is often a misconception that eating disorders affect only upper-middle-class white female patients. However, the rates of disordered eating in AAPI women are comparable to rates seen in European American women and often higher rates than other women of color.

Statistics reveal the prevalence and severity of eating disorders within the AAPI community. ​

• Research indicates that Asian American women are less likely to seek treatment for eating disorders compared to their Caucasian counterparts, highlighting disparities in access to care and support services.
• Asian girls and Asian American college students report significantly greater body dissatisfaction due to Western beauty standards but still receive inadequate treatment for ED due to cultural stigmas associated with mental illness.

Eating Disorders are a significant but often overlooked issue within our community due to cultural stigmas, lack of awareness, and limited access to culturally appropriate resources that lead to under diagnosis and under treatment. By de-stigmatizing conversations about mental health and promoting culturally competent resources and support services, we can empower individuals to seek help and support early intervention and recovery. We hope that by raising awareness, fostering supporting communities, and bridging access to resources can provide individuals in our community they need to heal and thrive.

Sources:
1. https://www.mhanational.org/issues/asian-american-pacific-islander-communities-and-mental-health 
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737071/​
3. https://www.umassmed.edu/news/news-archives/2023/03/eating-disorders-in-teens-more-than-doubled-during-pandemic/ 
4. https://jamanetwork.com/journals/jamapediatrics/fullarticle/2798255 
5. https://onlinelibrary.wiley.com/doi/abs/10.1002/eat.23318
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10032524/

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