Musculoskeletal Disorders
Asian women, including Asian-Indian women, are at a high risk for osteoporosis. According to the National Osteoporosis Foundation, because of the differences in bone mass and density between these groups Asian and Caucasian women are at higher risk for osteoporosis than African Americans and Hispanics. The musculoskeletal disorder may partly be explained due to widespread prevalence of vitamin D deficiency in the south Asian population.
Vitamin D Deficiency
There is widespread Vitamin D deficiency (VDD) amongst all age groups in India (Goswami et al., 2008). Similar trend has been found in the immigrant South Asian population in the U.S.
Pain
It has noted in a couple of studies in UK that South Asians immigrants (Indians, Pakistanis, and Bangladeshis) had higher prevalence of widespread pain compared to the Europeans (Palmer et al., 2007; Njobvu, 1999). It was mostly musculoskeletal pain, and was more prevalent in women than in men. In addition, there was more of somatization of pain compared to that in Caucasian population.
Although the reason for this occurrence of pain is not clear, the authors suggest culture could play an important factor, however other explanations were Vitamin D deficiency, the level of acculturation, gender, communication barriers (language) or ethnicity of the provider (Palmer, 2007). Elderly patients may be stoic in expression of pain. It is important to observe nonverbal behavior.
Other Health Problems
Other health problems of considerable importance among Asian-Indians immigrants include:
- Cardiovascular disease
- Hypertension
- Diabetes mellitus, Type 2 per se, or as a part of Syndrome X
- Nutritional deficits
- Tuberculosis ( multi-drug resistant variety is not uncommon)
- Malaria—choloroquin resistant P.falciparum
- Filariasis (Wuchereria bancrofti infection)
- Protozoal—Amebiasis ( intestinal and liver)— E. histolytica and Giardiasis ( G. lamblia)
- Other parasitic infestations
- Hepatitis A
- Dental caries and periodontal disease
- Sickle cell disease in selected populations
Cardiovascular Disease
Immigrant Asian Indian men in the U.S.. have a high prevalence of
- coronary heart disease,
- non insulindependent diabetes,
- lower high-density-lipoprotein (HDL) cholesterol levels and hypertriglyceridemia.
All these have “insulin resistance’’ as a common pathogenetic mechanism, which seems to be the most important risk factor.
The prevalence of coronary artery disease (CAD) is three times higher in immigrant Asian-Indian women compared to the white women (Caucasian women).
Diabetes Mellitus
Abate and Chandalia (2006) have compressive reviewed on increasing prevalence of type 2 diabetes and insulin resistance in South Asian Immigrants (Asian Indians). Major contributing factors were found to be urbanization and westernization that include life style factors (dietary practices and inadequate physical activity). In addition, current evidence points towards genetic variants (e.g., ENPP1 121Q) as one susceptibility factors (Abate and Chandalia 2006; Petersen et al, 2006).
