The Filipino American identity comprises principles from both the Philippines and the United States. Although the meaning of identity differs from one individual to another, the fundamental factors are the same. History, genetics, socio-economic status, culture, and education are all indirect factors that influences the identity of an ethnic group; thus, they are also reflective of a group's health beliefs and practices.
The ethnic differences between the Philippines and the United States are influential on the health practices and behaviors of Filipino Americans; however, these differences can also be regarded as being on opposite ends of a spectrum. While it is apparent that the United States exhibits a greater Western approach to health care than Eastern medicine, the health care practices in the Philippines reflect both traditional medicine as well as Western medicine. Due to the historical ties between the United States and the Philippines and societal progression, the healthcare practices of the Philippines also have an allopathic influence.
In reference to the different healthcare approaches of the United States and the Philippines, it is evident that both healthcare strategies and indirect factors are reflected in the health lifestyle of Filipino Americans. Socio-cultural factors such as established medical systems, religion, and superstitious belief are influential indirect factors of Filipino American health.
Measurement of health of the Filipino American population Health indicators are key in analyzing the overall public health of the Filipino American population. Main health indicators of a particular population include mortality and morbidity. By analyzing these statistics, the effect of certain health practices of the Filipino American population can be determined. Other important health indicators include leading cause of death, life expectancy, neo-natal mortality rate, and the maternal mortality ratio. It is noted that unlike many other Asian Americans, a lot of Filipino Americans suffer from a founder effect due to the Philippine islands being isolated from much of the world until Spanish discovery. This is very similar to the founder effect issues of Ashkenazi Jews, French Canadians, Cajuns, Irish, and Finnish.
Hypertension Based on reports of Filipino American communities throughout the United States, specifically in higher population areas of Filipinos, there is a history of a higher prevalence of hypertension exhibited among Filipino American men and women than in other ethnic communities within the United States second to African Americans. In addition, the prevalence of hypertension was greater within Filipino American communities than Filipinos living in the Philippines. There are behavior-related risk factors related with hypertension. These factors include reduced physical activity levels and excess dietary sodium intake from foods. In addition to hypertension, Filipino Americans have a genetic risk of cardiovascular disease and diabetes due to similar founder effect genetic bottlenecks in Philippine island populations.
Cancer In general, cardiovascular disease, cancer, and strokes are the leading cause of death for Filipino Americans. For Filipino men, the greatest health concern is cardiovascular disease and diabetes, whereas breast cancer is the leading cause of death among female Filipino Americans. Filipino Americans have also high prevalence of the BRCA1 gene mutation, nearly on the same level of prevalence as Ashkenazi Jews, and is a predisposition to early breast and ovarian cancer. This is due to a founder effect among several populations in the Philippines. The prevalence of cancer is higher among Filipino Americans in comparison to other ethnic groups of the United States, which is reflective in their associated low cancer screening rates. Westernized diets and behaviors are considerably influential on the high cancer risk of the Filipino American community. Other factors such as acculturation, lack of targeted educational programs, and socio-economic status influence the morbidity and mortality rates of Filipino Americans.
Depression
It is common among immigrant groups to experience difficulties with acculturation upon arrival. and Filipino Americans share similar mental health effects to other Asian American groups. In this case, Filipino Americans struggle with cultural alienation, stress from separation, and societal discrimination. Filipinos may struggle with assimilation due to separation from family and financial struggles, which contributes to clinical depression. It is found that Filipino men commit suicide more than Filipino women.
Tuberculosis Tuberculosis cases are highly prevalent among Filipino Americans. The Philippines is ranked the ninth on the list of top countries with high incidence and prevalence of tuberculosis. Poverty and health care disparities are major contributors of the tuberculosis epidemic within the Philippines. Filipino immigrants have the highest amount of tuberculosis diagnoses among all Asian immigrant groups. The difference between the tuberculosis incidence rate of Filipino Americans and United States born citizens is more than tenfold.
Influence of socio-cultural factors It is important to consider both the Filipino and American cultural influences on Filipino Americans to understand the root of Filipino American health practices and behaviors. Addressing culture in healthcare is complicated because of the possibility of feeding stereotypes.
Different cultural values held by an American physician may become a barrier in providing proper care to a Filipino American patient, especially for those who are recent immigrants. Filipino values of sensitivity and concern for an individual's limitations may clash with American values which tend to side on openness and frankness. Health providers whose values may not align with that of the Filipino American patient may not trust the physician and consider them as "ibang tao" (not one of us). This may create a disconnect with the patient who may respond at a superficial level.
Integration of the Filipino culture in the health care interventions of Filipino Americans can be useful in improving participation and health outcomes. Tailoring health screening recruitment strategies, educational materials that build on existing values, and employing Filipino staff who reflect the population have been seen to improve outcomes for Filipino American communities.
Although most Filipinos are familiar with prevention practices, such as health screenings, its importance is usually not well understood so it is not applied as common practice. Elderly Filipinos may choose rather to self-monitor and assess their own illness especially in its early stages. Encouraging prevention practices such as health screenings may be difficult as some adult family members may discourage participation as a means of trying to protect their loved one from external forces.
Family and community dynamics Like many immigrant groups, Filipino elderly and recent immigrants may already feel like a burden to their families after having gone through the process of immigrating; thus they tend to hide their health concerns to prevent imposing more stress and a greater financial burden amongst their families. Filipino families are hierarchal in that family members of a younger age are taught to obey and follow their elders, including their older siblings. Thus when patients seek care, may look to a family member to make a decision for them regarding their health options.
On the other hand, family and community relationships can be useful as a means of promoting health: engaging Filipino American communities as a whole on certain health projects can help advance health related initiatives, such as preventative care. Research shows that, in providing a sense of community and a place for different generations of immigrants to meet and learn from each other, community centers provide effective spaces for addressing preventative health.
Language Although most Filipinos are proficient in English, language continues to be a barrier in providing proper healthcare. Filipinos take pride in being able to speak English which is perceived as a sign of higher social status, thus they may refuse the need for an interpreter. However, communicating in English may still prove to be challenging in high-stress situations.
Dietary acculturation
Dietary acculturation is the change in eating patterns due to adopting new diets that occurs when members of the minority group adopt eating patterns of mainstream society. High degree of dietary acculturation is associated with poorer dietary habits. Immigration to the US is associated with increased consumption of fats, sweets, dairy products but decreased consumption of meats and vegetables.
As Filipino Americans acculturate in terms of their diets, they practice bicultural patterns that reflect both a preference for food that is American and traditionally Filipino. The Western dietary acculturation scale, which measures Western eating patterns that include a high intake of fat and sugar, was a significant predictor of the increase in body mass index (BMI) and weight in Filipino Americans. High salt intake is a feature of both the Filipino and Western diet; Filipino Americans are typically aware that their traditional cultural foods have high levels of sodium and fat, which is associated with an increased risk for hypertension.
Medical system Medical beliefs and practices are constructed based on an individual's perspective of the world. Socio-cultural influences are considerable factors that determine an individual's belief about disease and treatment. Based on this understanding, ethnic groups (typically groups of Third World countries), follow a holistic approach to health care; thus, encompassing physical, psychological, and spiritual practices that are differentiated from Western medicine.
Folk medicine is not the only medical system used by Filipinos. In general, Filipino health practices are based on biological, spiritual, and personal understandings. In particular, Filipinos support two contrasting medical systems of western medicine and alternative medicine, otherwise referred to as holistic healing. It is a blended health belief system of both biological and supernatural causes to illnesses. Generally, Filipinos consider multiple factors that contribute a particular illness and rarely believe in a sole cause of disease. An individual may consider a natural over a non-natural cause for an illness depending on their socio-cultural influences.
Alternative prevention and healing practices
Religion