Chapter 97: Asian American Pioneers in Dermatology

INTRODUCTION

Due to the increasing numbers of Asian Americans of both Asian and mixed Asian race, the responsibility of Asian American dermatologists to serve and educate this population is considerable. According to the 2010 U.S. Census, the Asian American population grew faster from 2000 to 2010 than any other racial group in the United States.¹ As of 2012, Asian Americans had the highest educational achievement level and median household income of any racial demographic in the country.^2,3 In 2008, Asian Americans held the highest median personal income of any other demographic group in the United States.^4,5 Adjusting for the proportion of the population, Asians and Caucasians had greater numbers of dermatologic encounters than African Americans and Native Americans in 1990. This correlates with the disparity in the median family income that exists between those racial groups.⁶ From 1993 to 2009, the top five dermatologic conditions seen by dermatologists in Asian or Pacific Islander patients were acne, unspecified dermatitis or eczema, benign neoplasms of the skin, psoriasis, and seborrheic keratoses.⁷ A retrospective cohort study of health-plan pediatric patients from 1997 to 2007 showed that the three most common diagnoses for Asian pediatric patients were dermatitis (29.1%), acne (22.2%), and warts (12.6%).⁸ In 2009, a survey of ‘westernized’ Asian Americans in California indicated that they were more likely to view behaviors promoting sun exposure (tanned skin, increased weekend sun exposure, or actively lying out in the sun to get a tan) in a positive way.⁹ This suggests that the Asian American population needs to be targeted by dermatologists for education regarding sun protection and the risks of skin cancer.

According to a census analysis from the American Medical Association in 2010, the percentage of dermatologists in the United States who reported that they were Asian (9.9%) was disproportionately low compared to the overall percentage of Asian physicians (17.4%).¹⁰ The data also showed that this disproportionately low representation of Asian physicians within the field of dermatology was most noticeable among Asian Americans, relative to their African American colleagues or Hispanic American colleagues.¹⁰ It should be noted that according to the 2012 Association of American Medical Colleges survey, 17% of dermatology residents were Asians, compared to 5% African Americans, and 5% Hispanics.

HISTORICAL CONTEXT

In 11,000 b.c., the first Asians came to inhabit the Americas by crossing the Bering Sea land bridge from Asia to Alaska. Evidence of Asian influence is apparent in Native American pottery dating from 800 b.c. From 300 to 750 a.d., Polynesian sailors settled the islands known as Hawaii. From 1565 to 1815, Filipinos were coerced by Spanish rule to serve in the Manila Galleon trade between the Philippines and North America. They are thought to be the first Asians to have traveled the Pacific Ocean to North America. In 1802, a Chinese sugar trader landed in Hawaii ...