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Boston is home to over 63,000 Asian residents, representing 9.5% of the city’s population, and constituting one of the fastest-growing groups in the city. Asian immigrants tend to underutilize health care services, and often lack the information, time, or resources necessary to practice preventive health maintenance. This can be attributed in part to cultural differences and linguistic barriers, as well as financial concerns, such as lack of health insurance.
In response to the health needs of Boston’s Asian community, Tufts Medical Center, in consultation with the South Cove/Chinatown Neighborhood Council, established the Asian Health Initiative (AHI) and its advisory committee in 1995. The AHI identifies public health issues of particular prevalence or concern to the local Asian community and seeks to work collaboratively with community-based organizations to help address those health issues in a culturally and linguistically appropriate setting.
Since its inception, funded programs and projects have addressed: tuberculosis, hypertension, hepatitis B, chronic disease prevention, domestic and family violence, smoking cessation and prevention, and the importance of primary care and understanding the American health care system, among other health issues. Because of the diversity of the programs and organizations supported, the AHI has been able to reach a broad segment of the Asian community, from toddlers to senior citizens.
As of 2015, the Asian/Pacific Islander community is the fastest growing group nationally. It now comprises 5.8% of the total population nationally, 5.3% of the total population in Massachusetts, and 9.5% in the city of Boston.
Boston Public Health Commission’s Health of Boston report 2016-2017 >
Based on findings from Tufts MC’s 2019 Community Health Needs Assessment (CHNA), the AHI Community Advisory Committee recommended tobacco and nicotine use, and the behavioral health challenges that contribute to it, as a high priority in the Chinatown community. This concern was raised by all the key informants and focus groups that contributed to the 2019 CHNA. Heart disease and lung cancer have remained the top causes of death in Chinatown for more than a decade, and smoking is a significant risk factor for both conditions. Secondhand smoke impacts non-smokers as well, particularly children, leading to high pediatric asthma rates in Chinatown. And chronic stress stemming from poverty, social isolation, immigration status, and family and social expectations make youth more amenable to using tobacco and nicotine when given a chance, while making adult smokers less likely to quit. As a result, current AHI funded programs are addressing the challenging issue of tobacco and nicotine use prevention and cessation in a number of ways.
The Asian American Civic Association (AACA) is developing an evidence-informed anti-smoking Mass Media Campaign by compiling, customizing, and translating existing graphic and compelling tobacco- and nicotine-related content adapted from effective past national mass media campaigns. New content is being created to more specifically cater to Boston’s Chinatown community. AACA leverages its property manager, local business owner, and community organization networks to promote smoke-free areas throughout Chinatown.
Boston Asian: Youth Essential Service (BAYES) engages youth in a range of activities to learn about the risk factors of tobacco and nicotine use, the negative impacts on physical and mental health, the marketing strategies used by the tobacco industries to entice young people, and tips to live tobacco- and nicotine-free. The youth use what they learn to develop and implement a public health education campaign centered on tobacco and nicotine that reaches hundreds of community members per year. The youth also identify, modify, and create new tobacco- and nicotine-related content that specifically resonates with Asian American youth, publishing it on social media and other accessible platforms.
The Boston Chinatown Neighborhood Center (BCNC), through their Smoke Free Chinatown Initiative, aims to mitigate the negative impacts of tobacco use and smoking among Chinese families in Chinatown and Boston. BCNC engages children, youth, parents, and other adults in tobacco education through arts programs, parenting classes, and other workshop presentations. BCNC disseminates information through newsletters and other methods to build community awareness of the health hazards of smoking and tobacco products, secondhand smoke, and resources for smoking cessation. BCNC’s Family Services team also provides individualized case management and counseling to current smokers to support their cessation journey.
The Greater Boston Chinese Golden Age Center (GBCGAC),through their Smoke Free for Healthy Living program, promotes prevention and cessation of tobacco and nicotine use among Chinese adults. The program empowers smokers via outreach events and educational workshops to lead healthier lives by reducing and stopping smoking. GBCGAC also assesses smokers’ health and behavioral needs, creates individualized smoking cessation/reduction plans, and provides one-on-one support with family engagement and regular follow-up to support the quitting process. Smoke Free for Healthy Living engages public and private housing developments to promote the program, recruit participants, and help maintain a smoke-free environment for all residents.
Josiah Quincy Elementary School (JQS) provides a comprehensive tobacco prevention curriculum to all 4th and 5th graders, helping students learn about the health and economic impacts of smoking and vaping, including secondhand smoke, as well as techniques to protect themselves and their families from these impacts. JQS has partnered with the Josiah Quincy Upper School to deliver a similar curriculum to 6th and/or 7th graders, equipping them with knowledge and skills at a time when they may begin to experience peer pressure to try smoking or vaping. JQS is exploring innovative methods of engaging families to support students’ abstention from tobacco, and JQS will work with co-located service providers to promote a fully smoke-free environment on the school’s community campus.
For more information contact:
Sherry Dong, Director
Community Health Improvement Programs
Tufts Medical Center
800 Washington Street, Box 116
Boston, MA 02111