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Finding NEPO

A blog to highlight news, issues and trends on health and ethnic minority physicians.

Diabetes Awareness Month

November is Diabetes Awareness Month!

A Little Bit of Diabetes 

Dr. Monya De

Diabetes disproportionately effects people of color, especially members of the Asian/Pacific Islander community. Dr. Monya De, a internist and health journalist, provides insight and recommendations regarding South East Asian culture and diabetes. 

The Indian party was in full swing. The ladies gossiped in the kitchen and rolled dough, and the men smoked and sipped whiskey in the den. One of our ‘uncles’ popped a second gulab jamun sweet in his mouth, prompting a raised eyebrow from one of the doctors in attendance.

“Oh,” said the Indian ‘uncle,’ “I just have a little bit of diabetes.” Unfortunately, we hear this a lot in the South Asian community. Blame denial, blame blood tests that represent early diabetes as a small-appearing number instead of a scary, high number found in a cholesterol panel, blame a cultural obsession with sugar, but South Asians often minimize this maddening dysregulation of the body. The truth is that, once that little number isn’t normal, it means that the body is already suffering as a result of that dysregulation.

Sadly, we can’t afford to ignore it. There is an entire coterie of genetic variants that promote South Asian Type II diabetes; the cells of brown people too often just start ignoring insulin and allowing sugar molecules to accumulate in the blood stream, like pollution particulates.(1)  The result of these unfortunate genes and, yes, our cultural tendencies and questionable food and portion choices, make our percentage of diabetes cases twice what they should be relative to our population. Diabetics can suffer gangrenous limbs, kidney failure, blindness, and loss of sensation in the hands and feet.

It gets worse; South Asians independently have other risk factors for heart disease, such as a tendency to have the MTHFR mutation that encourages blood clotting. Put all this together, and no wonder South Asians have a higher likelihood of clogged arteries, heart attacks, and strokes.

But as a largely highly educated ethnic group, South Asians have the opportunity to not detonate that ticking time bomb. The bomb can be defused instead, with diet and exercise—real diet and exercise, athlete-style, not “Maybe on Sunday I will take a walk after dinner.”

(1) -


You can read the full article at

For more insights from Dr. De be sure to follow her on twitter at @medjournalist!

To access resources to help physicians and care teams treat prediabetic & diabetic patients visit our Prediabetes & Diabetes page.

Asian Pacific Islander Heritage Month

May is Asian Pacific Islander Heritage Month.

During API (Asian Pacific Islander) Heritage Month, we honor the culture and celebrate the achievements of Asian Americans, Native Hawaiians, and Pacific Islanders. We also recognize API Heritage Month as a time to bring attention to public health programs addressing health disparities in the API community.

Screen at 23

Diabetes is a disease that millions of Americans and people across the globe live with, and that many millions more are at risk of developing. Fortunately, the National Council of Asian Pacific Islander Physicians (NCAPIP) is bringing attention to the diabetes disparity within the API community, which has real potential benefits for alleviating the diabetes burden overall.

According to the World Health Organization, American Diabetes Association, National Institutes of Health and the Centers for Disease Control, APIs are at risk of developing diabetes at a lower body mass index (BMI) than Whites, Blacks, Hispanics, and Native Americans. The community based participatory research and academic studies done on this small but rapidly growing population have provided the literature that has caused these large institutions to change their recommends for screening diabetes in Asian Americans.

Over half of all APIs with diabetes remain undiagnosed. The number of undiagnosed APIs with prediabetes is even higher. Of these, a significant portion of APIs at risk for diabetes or prediabetes appear to be at a "healthy weight", and aren't being tested.

The general rule for some time has been that if you have a body mass index below 25, you aren't at risk for diabetes. Research on Asian Americans, however, proves different.

The American Diabetes Association, National Institutes of Health, and the Centers for Disease Control have all recently acknowledged that Asian Americans should be screened for diabetes at a lower body mass index, and 23 is that number. 23 isn't a redefinition of overweight or obesity, it's a number to keep in mind to get checked by our doctors and live healthier. Learn more at

Resources:        Screen at 23 News and Resources 

Stigma in Mental Health

Asian Americans use mental health services about half as much as the general population, according to a report by the California Asian Pacific Islander Joint Legislative Caucus.

Meanwhile, a report by the National Alliance on Mental Illness found that API women in certain age groups have the highest number of suicide mortality rates of any ethnicity.

Misconceptions about mental illness too often deter members of the API community in California from accessing mental health services. A 2014 study from the RAND Corporation found Asian Americans face among the highest levels of stigma, with 38 percent reporting being unwilling to interact with individuals with schizophrenia.

Asian Americans comprise 15 percent of California’s population, so working to meet the needs of this diverse community is crucial if California is to achieve mental wellness for all. The California Mental Health Services Authority (CalMHSA) is doing just that by implementing innovative stigma reduction and suicide prevention strategies that engage Asian-Americans in breaking down mental health stigma. View more programs at

     Resources:        Fact Sheet: Reducing Stigma

     Documentary: A New State of Mind Ending the Stigma of Mental Illness 

Learn more at the 2016 Building Healthy Communities (BHC) Summit

Diabetes and mental health among Asian Pacific Islander populations and many more issues will be discussed at the 2016 Building Healthy Communities (BHC) Summit in Newport Beach this September. Since its inception in 2002, the BHC Summit has provides physicians, public health professionals, community leaders, and grassroots health advocates with opportunities to learn about emerging health policy issues, best practices for reducing health disparities, and cultural competency in clinical care. For more information, please visit: 


Dexter Louie, M.D., J.D., M.P.A.

Chair, National Council of Asian Pacific Islander Physicians

Committee Member, Network of Ethnic Physician Organization’s 

Building Healthy Communities Summit Planning Committee

Healthy Communities for All

April is National Minority Health Month.

The U.S. Department of Health and Human Services Office of Minority Health has invited the nation to raise awareness of the health disparities that continue to affect racial and ethnic minorities and highlight how we are working together to accelerate health equity.

NEPO’s most recent projects have rallied physicians around a wide range of issues, and we encourage you to get involved!

Climate Change and Health

Communities of color in the United States often reside in neighborhoods with worse air quality, more environmental hazards, and fewer health-promoting environmental amenities such as parks. This unequal distribution of exposures may contribute to racial/ethnic health disparities in environmentally sensitive diseases, such as cancer and asthma.[i]

The CMA Foundation and NEPO have been working on a project in partnership with the Public Health Institute (PHI) and the Golden State Medical Association (GSMA). Climate Change and Health is a two-year statewide initiative focused on increasing physician knowledge about climate change in order to expand the diversity of voices speaking about the impacts of climate change on health. By mobilizing physician champions, especially within communities of color, this initiative aims to increase public understanding that climate change is an important public health issue and to build public support for climate change solutions. Currently, 15 NEPO physicians have pledged to become our Climate Change and Health Champions. To learn more, please visit:

Adult Vaccines

Overall, adult vaccine coverage remains low for many routinely recommended vaccines. CDC reported that just 24.2 percent of people over the age of 60 reported having received the herpes zoster vaccine, which helps prevent shingles in people over the age of 50 who have had the chicken pox. Similarly, reported pneumococcal vaccination coverage among high risk adults aged 19–64 was only 21.2 percent overall.

The “Community Immunity” Adult Vaccine Schedule is an educational resource for California physicians and their patients on adult immunization recommendations. The CMA Foundation guide provides adults with detailed information on vaccine-preventable diseases, their symptoms, and long-term risks, and makes vaccine recommendations for adults based on age, dosage, and vaccine type. To view the Adult Vaccine Schedule in English and Spanish, please visit:

Vaccination rates among some ethnic groups are even lower than other adult populations. Vaccination rates for Latino and African American communities for example are even lower than for Caucasians.

The CMA Foundation and NEPO have also developed public service announcement videos (PSAs) to reach broader audiences. To view the PSAs in English, visit: or in Spanish, visit:

Join us.

In September, NEPO will be hosting the 2016 Building Healthy Communities (BHC) Summit in Newport Beach to help health providers address social determinants of health. Since its inception in 2002, the BHC Summit has been an annual educational event where physicians, public health professionals, community leaders, and grassroots health advocates are presented with opportunities to learn about emerging health policy issues, best practices for reducing health disparities, and cultural competency in clinical care. For more information, please visit:

We hope that you will join us as we continue to find our collective voice with more health advocates in the community. Please be sure to follow us on Twitter, Facebook, and subscribe to our list to get NEPO News and other updates by contacting Kyla Aquino Irving at


 Margaret Juarez, MD
 Dr. Juarez is a Board Certified OB/GYN at San Gabriel Women’s Health in Arcadia and the Chair of the Network  for Ethnic Physician Organizations (NEPO).

[i] Lara Cushing, John Faust, Laura Meehan August, Rose Cendak, Walker Wieland, and George Alexeeff.  Racial/Ethnic Disparities in Cumulative Environmental Health Impacts in California: Evidence from a Statewide Environmental Justice Screening Tool (CalEnviroScreen 1.1) American Journal of Public Health November 2015: Vol. 105, No. 11, pp. 2341-2348.

Finding Our Voice

How far have we come since 2002?

The Network of Ethnic Physician Organizations (NEPO) began as a project of the California Medical Association (CMA) Foundation in 2002 to enable existing networks of ethnic physicians to collectively advocate for improved health in their local communities. NEPO also set forth to provide a united voice and play a critical leadership role, in order to:

·         Identify strategies for building the capacity of ethnic physician organizations (EPOs). 

·         Reduce health disparities by helping EPOs improve access to health care for their communities through increased collaboration with community organizations.

·         Participate in policy-advocacy efforts both in the public sector and within organized medicine.

·         Address diversity and cultural competency in the health care workforce.

Today, NEPO’s network of over 50 EPOs remains passionate, but EPOs now have more tools to reach the communities they serve. In developing this blog, our goal is to provide a forum for our leaders to highlight vital, emerging issues affecting underserved communities.

We hope that you will join us as we continue to find our collective voice with more health advocates in the community. Please be sure to follow us on Twitter, Facebook, and subscribe to our list to get NEPO News and other updates by contacting Kyla Aquino Irving at