Cultural Factors Undermine Asian Health, Experts Say : Conference: The largely immigrant local population faces such threats as tuberculosis and hepatitis B, speakers note, but they are unlikely or unable to seek help.

IRVINE â€”  Tuberculosis, smoking, domestic violence, AIDS--major health and safety issues, to be sure, but not often specifically associated with Asian Americans and Pacific Islanders.

At the Radisson Plaza Hotel Orange County Airport on Tuesday, experts at the first Pan-Asian Health Conference in Orange County told an audience of about 200 health and social service providers that it is time to bring these threats to the Asian community’s well-being “out of the closet� and into the public arena.

Too often, said keynote speaker Audrey Yamagata-Noji, Asians and Pacific Islanders in the United States feel that they must live up to the “model minority� stereotype.

They should not have to be models, and they are not a single minority, said Yamagata-Noji, dean of student development services at Rancho Santiago College-Santa Ana.

She and other speakers at the conference, organized by the Orange County Health Care Agency and a coalition of community groups, said it is time to recognize that these very diverse populations face their share of health problems in this country--and that they must in addition overcome linguistic and cultural barriers to receive treatment.

For example, Yamagata-Noji said, Asians and Pacific Islanders may have a culturally reinforced need to “save face� by keeping ailments secret and may be reluctant to complain or seek assistance.

“It’s ‘bad’ to do anything that might dishonor yourself and your family. So you keep it inside and solve it yourself,� she said.

These cultural factors--often combined with poverty, unemployment, illiteracy or language difficulties--keep Asians and Pacific Islanders from getting the attention they need and deserve from medical service providers and researchers, conference speakers said.

Several said that the recent passage of Proposition 187 has made matters worse.

“Many of our community members are concerned and afraid to use services� in this “anti-immigrant� climate, Yamagata-Noji said.

Because the obstacles to seeking care often are so great and difficult to surmount, conference speakers stressed, health officials must be ready to go to patients instead of expecting patients to flock to them. It is key, they said, to hire health care workers who are familiar with Asian languages and cultures--and to send them out to knock on doors, if necessary.

The need for an aggressive approach was emphasized in cases of tuberculosis, hepatitis B and other infectious diseases. In Orange County, the TB rate increased almost 14% from 1992 to 1993--with Asians and Pacific Islanders, many of them recent immigrants, making up a significant percentage of the caseload.

Smoking was also singled out at the conference as a growing problem among Asian males. One community survey in Los Angeles estimated the smoking rate among Korean males at 75%.

Health Threats Orange County’s largely immigrant Asian community is more vulneable to certain diseases than other ethnic groups. For example, although Asians account for about 10% of the county’s population, last year they suffered more than half the cases f tuberculosis. And about three of every four hepatitis B carriers last year were Asian. The trends: *

Tuberculosis is a communicable bacterial disease typically marked by fever and the formation of lumps, often in the lungs. Asian cases: ‘93: 226 *

Asians a % of all cases: ‘93: 52.4 *

Hepatitis B, the most serious form of hepatitis, persists for years and may lead to chronic hepatitis, cirrhosis and/or liver cancer. It is mainly spread sexually or by exposure to infected blood through needle sharing among drug abusers, razor sharing or ear piercing. Asian carriers: ‘93: 1,291 *

Asians as % of all carriers ‘93: 76.9 Source: Orange County Health Care Agency; Researched by CAROLINE LEMKE / Los Angeles Times