I am interviewing a 32-year-old male (X) from the India who has been a resident of the San Jose in the US state of California since the last 10 years. He is employed as a Software engineer in one of the software MNCs in urban parts of California. Regarding, the Asian and Pacific Islander Americans (APIA) population in the US, they are one of the fastest growing population in the US. In the year 1999, the population was about 11 million and it is expected to grow to about 20 million by 2020. In 1999, 4 % of the US population was APIA, 12 % Hispanics and 11 % African-Americans.
The APIA come from several parts of the world including India, China, Pakistan, Polynesia, Micronesia, Papua New Guinea, Hawaii, Japan, Philippines, Indonesia, Korea, Vietnam, etc. One of the favorite locations in the US, the APIA population would like to settle is in the state of California. The APIA make up for about 12 % of the California population in 1999. They come from various cultural backgrounds and have diverse needs. They are one of the most diverse groups in the US, and it is difficult to fulfill their health problems due to diverse healthcare needs. Let us now go through the entire interview process: –
Socio-economic factors – Mr. X earns about 45, 000 US dollars every month. He is employed in a software-MNC. None of his other family members are working. He is married and has one child. Although he came to the US in 1997, he brought his family down to the US about a year back. Mr. X feels happy that he is able to earn a good income in the US and is more or less settled. He feels that many of the Indians in the US are earning far less and are belonging to the poverty groups. However, he also feels that the organization he is working in is a small organization and the income provided is less compared to other organizations. Lifestyle – MR.
X is not leading a very healthy lifestyle. Earlier as his family was not with him, he used to eat his food in eat-outs and restaurants. Due to this, he is unable to lead a healthy life. However, once his family has come home, he is able to eat a traditional Indian meal and due to this, his nutritional status has improved. He is now able to consume a balanced diet. Mr. X and his family members consume a vegetarian diet. Mr. X smokes about 5 cigarettes a day and consumes about 2 servings of alcohol (especially whisky and rum) on Saturdays and Sundays. He is able to sleep only for about 6 to 7 hours a day. This is due to excessive workload.
Although his duty timings are only 8 hours, he puts in an extra 5 hours work at home. During the weekend, he has to work from home at least for 5 hours on Saturdays and Sundays. He usually gets together in family meeting and religious ceremonies on Saturdays and Sundays. Family Values – Mr. X has not had much of a family life in the US. This is because his wife and child were staying back in India, as they were unable to come to the US earlier. However, in the last one-year his wife and child have come down to California and are staying with him. His son is an 8-year-old kid, who has just joined a US Elementary school.
The child goes to school for about 4 hours in a day, from Monday to Friday. Prior to this one-year, the only members of his family in the US were his cousins, uncles and aunts, who reside about 20 miles from his home. Mr. X feels that in India, family values are given a great amount of importance. Down in India, people stay in a common house with the family members. This is especially seen in villages and small towns. Family meetings are conducted every day and usually food is consumed and prayers are said in a family. During the earlier days when he had just come to the US, Mr.
X had stayed with one of his maternal aunt in California. However, as his condition began to improve and his job was settled, he shifted to a separate residence. However, he continues to meet his family members during weekends. Mr. X also makes important decisions after taking the advice of the elders in the family. This is also the case in India, where elders are given a lot of respect and value. In case of any personal problem, he would first call up his uncle, a man of 67 years, and explain his problem to him. Religious preferences – Mr. X belong to a high caste Hindu family in India, and actively practice his religion.
During the weekends, he attends for prayers in a temple in California. He usually makes a trip along with family members. He does follow intricate religious practices at home and at his workplace. He consumes a vegetarian diet and would take care especially whilst eating out. During the morning and before starting work, Mr. X chants a few short prayers. This he also does after he finishes work and before going to bed. His wife and child are also religious like him. He accompanies his family members during the weekends for a trip to their local temple. The local temple is about 25 miles away from their home.
They also consume a vegetarian diet. In California, the number of vegetarian restaurants and eat-outs are less, due to which he has experienced problems. Health and practices – Mr. X enjoys a good state of health compared to the other APIA’s in the US. It is also important to note that the APIA’s enjoy a much better health status compared to the Whites, African-Americans and the Hispanics. In the year 1999, Mr. X suffered a bout of malaria. He suffered from the illness for about 15 days, and required admission in the Hospital. During his earlier days in the US, Mr. X did not have health insurance. Hence, he had to pay for his hospital bills.
In the year 2000, the organization he was working with provided him with health insurance, which helps him to meet with his health expenditure. As Mr. X smokes excessively and due to his work-related habits, he suffers from asthmatic attacks frequently. He uses a small pump that provides Broncho-dilators. He has to consume two puffs twice a day as suggested by the physician. He also follows the advice on food and exercises suggested by the physician. Sometimes during winter months, Mr. X requires hospitalization for difficulty in breathing. This has occurred frequently in the last 4 years. His hospital bill is now covered by health insurance.
The physician has repeatedly suggested to give up smoking and to follow better work-related practices, which Mr. X has ignored. The access to health is good, as Mr. X resides in an urban area. He has a hospital providing ultra-modern facilities located about 1 mile from his residence. The hospital also has physicians, specialists and nurses who are from an Indian background. This makes him a special patient at the hospital. He does feel that his physician is able to communicate with him appropriately and understand his health problem. As Mr. X has his family come in newly into the US, they do not have health insurance.
However, he plans to subscribe to health insurance for them within the next six months. So far his wife and child did not require hospitalization. However, MR. X frequently takes his son for health checkups and immunizations to the pediatrician. His wife visits a female gynecologist frequently, to ensure that problems with her periods are addressed properly. She does prefer going to an Indian female gynecologist, but is unable to do so as there is a shortage of medical staff from other cultures in the US. Due to problems with financing (uninsured), she is unable to afford seeing an Indian gynecologist from another hospital.
MR. X’s physician and pediatrician both belong to the Indian community. Child-bearing/parenting practices – Mr. X has just one son, and he plan to have one more child in the near future. However, he says that during the pregnancy period, he plans to send his wife and son back home to India, as he may be unable to take appropriate care of his wife. As family values are give great importance in India, Mr. X wishes that his son stays with him even after crossing the age of 16 or 18. He wants his soon to mix about with other children in the US, but at the same time follow Indian traditions regarding religion, diet and customs.
Other issues – Mr. X and is family members do understand English and do not have any problem communicating with the people in the US. Mr. X may not consider preventive medical care. However, he does visit the local physician frequently to take medical advice and go in for routine checkups. Mr. X feels that more physicians, nurses and specialists from the Indian communities should be available to fulfill the need of the Indians in California. Mr. X also feels that the local government and the Federal government have not addressed several of the problems faced by the APIA communities in the US.
This is with regards to health insurance, health access, education, working conditions, immigration status, etc. References: Ro, M. “Overview of Asian and Pacific Islanders in the United States and California. ” Center for Alternative Policies. 1999. 9 Nov 2007. http://www. communityvoices. org/Uploads/om3gfk55hhzyvrn00n4nerbf_20020828090003. pdf Srinivasa, S. “Toward Improved Health: Disaggregating Asian American and Native Hawaiian Pacific Islander Data. ” American Journal of Public Health 90. 11 (2000): 1731-1734. http://www. ajph. org/cgi/reprint/90/11/1731. pdf