The National Asian Women s Health Organization (NAWHO), a non-profit community-based health advocacy organization located in San Francisco, recently completed a health needs assessment of South Asian women in Northern California.
The South Asian Women s Health Project (SAWHO) consisted of over 85 interviews and invoked more than 150 South Asian women participants. The project was an attempt to build awareness of the unique community health issues and concerns of South Asian women in Northern California.
Despite the fact that South Asians are the third largest Asian community in the United States, with a population estimated at approximately 925,800 (as of 1990, doubling every 10 years), there are very few studies on the health issues facing this population; and none on South Asian women s health and well-being from their own perspective.
South Asian Womens Health Project, the first documentation of South Asian womens health needs in America, has highlighted the diversity found within the South Asian community, and the need for increased and improved advocacy, policies, and programs on South Asian women s health.
The report of this project, Emerging Communities: A Health Needs Assessment of South Asian Women in Three Northern California Counties, provides a background of the population, demography statistics, and a qualitative description of the health needs and concerns from the South Asian women s perspective. The report offers conclusions and recommendations for health advocates, service providers, and policy makers to better address the health needs and concerns of South Asian women in a sensitive and appropriate manner.
The South Asian population has been growing for the last 25 years. Service providers justify the lack of specific health and social services for one of the largest Asian communities in the country by stating that the other communities we at a higher risk, or that South Asians have the resources to obtain health insurance and fee-for-series private care.
However, since health and social service statistical data on South Asians is so minimal, it has not been possible to accurately determine financial and health status and whether or not a significant number are higher risk, based on available information.
The 1990 U.S. Census indicates that there is greater diversity among South Asians in terms of education, language skills, occupation and consequently, income levels than earlier thought.
This diversity is also reflected within families, especially given that women have different access to education, resources, and control within families. For example, South Asian women earn a fraction of what their male counterparts earn, and may have little control over financial decisions because greater percentages of the womens population engage in semiskilled, unskilled and/or homemaking labor force. Female rates of education and English skills are considerably lower, and female poverty rates are higher.
When a South Asian woman is coping with a socially unacceptable issue, such as family violence, depression, anorexia, or HIV/AIDS, it may be very difficult to divulge this information and seek help from the family, community, or the health system. Traditionally seen as caregivers, South Asian women generally place a low priority on their own needs and focus on the needs of their family, which often includes extended family members. As a result, the unique and specific health needs of women are often overlooked and neglected.
The South Asian Womens Health Project focused on three California Counties in which significant numbers of South Asians reside: Alameda, Santa Clara, and Sutter. These counties include South Asian populations with different backgrounds, and therefore different health concerns.
Many South Asians in Sutter County work as farm workers and/or cannery workers, and do not receive health benefits; they must rely on the Sutter County Public Health Department for basic health services.
The overall income level is high for South Asians in Alameda and Santa Clara counties since many are professionals, such as doctors, engineers, or business owners. However South Asian taxi drivers, Silicon valley assembly line workers, factory and technical workers, and those working in other low-wage service industries, such as restaurant labor and care giving, also live in these two high income counties.
Although their individual experiences may differ, the project participants from these three counties mentioned mental health, nutrition, occupational health, violence, and reproductive and sexual health as major health concerns that impacted their lives as South Asian women.
Women discussed depression, a disability to function normally anxiety, stress, isolation, negative body image, low self esteem, and feelings of guilt, pressure, and isolation as mental health problems they faced. These were heightened by socio-economic status, family structure (the pressures of caring for extended family members, gender roles, etc..), occupational conditions, cultural prescriptions, violence in the family, generation gaps and gender discrimination.
Elderly women often felt isolated due to lack of established family and social networks, which served as support systems In South Asia. Younger women also felt isolated because of bicultural dilemmas -- the pressure of living a double life," or following traditional behaviors at home, and trying to assimilate into mainstream American culture outside the home.
Help for mental health problems was usually not sought for due to the stigma attached with mental health problems, fear of shame being brought to the family, and a lack of South Asian mental health providers or providers sensitive to South Asian cultural issues.
In terms of occupational health, the problems that were mentioned varied significantly with the type of occupation the women held. Agricultural workers are exposed to a variety of pesticides and herbicides, which may have serious side effects. Back injuries and damage to the wrist were also common health problems among agricultural workers. Women working in the cannery industry and as asembly line workers experienced a range of long lasting health problems affecting the back, arms, shoulders, head, heart, gastrointestinal, and reproductive systems. "White collar" workers also faced occupational hazards such as toxic substances, poor air quality, poor lighting and chair design, and eye strain and carpal tunnel syndrome from working with computers.
Violence in the South Asian community was discussed in the form of wife abuse, child abuse, and elderly abuse. Domestic violence counselors who were interviewed stressed that South Asian women who are psychologically or physically abused often did not report the abuse because they are in daily and emotionally dependent on their abuser, and may not have any support system to turn to. They may be accused of shaming the family and questioned as to the accuracy of their stories.
NAWHO's report details these and other health issues such as reproductive health and nutrition. The diversity found among South Asians in the three county populations is reflected through the wide range of health issues that arose during this research prospect, and in the diversity of the participants, who include assembly line workers, domestic violence counselors, agricultural workers, homemakers, doctors, and students.