Implicit Racial Attitudes and Associations Among Obstetricians in Hawaiʻi: a Pilot Study

Introduction Pacific Islanders living in Hawai‘i with ancestral ties to islands in the western Pacific region of Micronesia are common targets of uninhibited forms of prejudice in multiple sectors, including healthcare. Whether the explicit societal-level attitudes toward this group are reflected in implicit attitudes among healthcare providers is unknown; therefore, we designed a pilot study to investigate this question. Our study measures implicit racial bias toward Pacific Islanders from Micronesia among Obstetrician-Gynecologists (OB-GYNs) in Hawai‘i. Methods We developed 4 new implicit association tests (IATs) to measure implicit attitudes and associations (i.e., stereotypes) toward Pacific Islanders from Micronesia in 2 conditions: (1) Micronesians vs. Whites and (2) Micronesians vs. Japanese Americans. Participants were practicing OB-GYNs in Hawai‘i. The study was conducted online and included survey questions on demographic and physician practice characteristics in addition to IATs. The primary outcome was the mean IAT D score. Associations between IAT D scores and demographic and practice characteristics were also analyzed. Results Of the 49 OB-GYNs, 38 (77.6%) were female, mean age was 40 years, 29.5% were Japanese, 22.7% were White, and none were from a Micronesian ethnic group. The mean IAT D score in the Micronesian vs. White condition (N = 29) was 0.181, (SD: 0.465, p < 0.05) for the Attitude IAT and 0.197 (SD: 0.427; p < 0.05) for the Stereotype IAT. Conclusion The findings from this pilot suggest a slight degree of implicit bias favoring Whites over Micronesians within this sample of OB-GYNs and warrant a larger investigation into implicit biases toward this unique and understudied Pacific Islander population.

An Insider’s Response to Racism: Abe Fortas and the Japanese Question during the Asia-Pacific War, 1941–1945

Abe Fortas (1910–1982) has been best known for service during his legal career as an Associate Justice on the Supreme Court of the United States for four years from 1965 to 1969. His supporters have characterized his life as a lawyer who supported and defended the American Civil Rights Movement during the tumultuous periods of the 1950s and 1960s in the United States. However, observers of his career have paid little attention to the fact that Fortas was one of the few American bureaucrats who took the stand in defense of those of Japanese ancestry in the official hearings in the 1980sinvestigating the internment of Japanese Americans during World War ii. Fortas, as undersecretary in the Department of the Interior from 1942 to 1946, had a close relationship to key U.S. policies dealing with people of Japanese ancestry during the Asia-Pacific War, including the establishment of martial law in Hawai‘i and the ending of the Japanese internment. Fortas’s responses to and critiques of U.S. policy regarding the Japanese American question reveal the intertwined dynamics of how white racism developed and challenges against it at the governmental level.

The Prison Camp as Pedagogy of Place

Place-based education usually refers to curricular work conducted in PK-12 settings that mobilizes local contexts to teach subject matter content. The education research reviewed here departs from this approach. Less interested in place as a means to transmit content, instead this article describes the often intangible learning that occurs in place. Place is a repository of lived experience, one in which the mind and body are intertwined. Place-based learning involves the knowledge and affective attachments provisioned by architectural arrangements and designs. Grounded in familial experience as Japanese Americans incarcerated in World War II-era prison camps, I research historic concentration camps, prisons, and other confinement spaces and how these sites educate contemporary audiences. Many of these historic prisons are places in which populations deemed security threats to the state were targeted, stripped of certain rights and obligations, forcibly removed, and sequestered. Treating these place-based projects as a kind of “curriculum,” my research also has implications for teaching and learning in K-12 classrooms.

Transnational Caregiving for Older Adults and Caregivers’ Wellness in Japanese Americans during the Pandemic

Global migration has greatly affected intergenerational family support beyond national borders, in particular adult children’s transnational family caregiving for elderly parents. Specifically, the COVID-19 pandemic has largely influenced transnational caregiving due to the travel restrictions. Transnational caregiving for older adults includes adult children’s periodical returning to their home country and/or adult children’s caregiving for their parents in their settled country. The goal of this study was to identify trajectories between adult children’s transnational caregiving for their parents and caregivers’ wellness in Japanese Americans before and during the pandemic. We conducted semi-structured interviews with Japanese Americans 40 to 59 years of age (N=20) in California before the lockdown and during the increasing number of patients infected with the Delta variant. The qualitative data analysis showed some Japanese Americans periodically returned to Japan to provide caregiving for their parents before the pandemic, while others didn’t. However, the former group currently relied on their families in their home country more than before. The limitations led to not only distress over uncertainty but also release from a strong sense of reciprocity and filial responsibility, by changing from physical support to emotional and financial support via online. They also enhanced cultural identity as Japanese Americans, by thriving from discrimination against Asian Americans. Thus, our findings demonstrate important factors that impacted on transnational caregiving and caregivers' wellness, including cultural identity, family norms, beliefs and practices of intergenerational support, social and historical contexts, financial remittance, ICT use, and healthcare policies among the underrepresented populations across the Pacific.

Aging of a Model Minority: A Diachronic Analysis of Two Quantitative Research Studies on Aging of Japanese in New York

This is a diachronic analysis of two quantitative research studies on the aging of Japanese and Japanese Americans living in Greater New York. How have older Japanese individuals, who once have been referred as “model minority,” lived and aged in Greater New York? All the data in this paper are based on the first research study conducted in 2006 and the second in 2018 (Ethical approval reference number 6, 2018). This paper reveals both the social transitoriness and the cultural immutability of the Japanese elderly community in Greater New York. The following is a summary of the findings: (1) a growing Japanese American community with US citizenship, higher academic qualification, and better communication competency has been observed. (2) The allowable range of private expense to hire personal caregivers has been widened. (3) Not only the concerns and anxieties for later lives but also the plans and preparations for aging are much the same. (4) The elderly are provided with culturally specific care (with regard to language, food, and concept of care)—even allowed to live with other Japanese people—and the needs of caregivers who can understand Japanese culture are satiated. (5) Almost half of those in the community find it difficult to eliminate the possibility of returning to Japan, and some of them have already chosen to migrate back to Japan.

I am Chinese: The Politics of Chinese American Lapel Buttons in Los Angeles during World War II

This article examines the history of lapel buttons and stickers used by Chinese Americans to identify their ethnicity during World War II. Most of these buttons and stickers were produced by Chinese Consolidated Benevolent Associations (CCBAs) immediately after the attack on Pearl Harbor to differentiate their members from Japanese Americans. In examining this history, this article focuses in particular on Los Angeles, the city with the largest Japanese American population on the West Coast. In Los Angeles, U.S.-born Chinese American and Japanese American youth attended many of the same schools and often formed close friendships with one another. As a result, the questions that the buttons and stickers posed for this generation of Chinese American youth were particularly fraught. Drawing on oral history interviews, sociological studies of the Southern California Chinese American community from the period, and archival newspaper reportage, this article approaches these lapel pins and stickers as items of cultural contestation through which a variety of historical actors—from Chinese consular representatives, to immigrant leaders in the CCBAs, to Chinese American youth—negotiated questions of ethnic and national identity after the U.S. entry into World War II. I argue that rather than reflecting the complex ways that most Chinese American youth understood their own identity, the buttons and stickers represented the official viewpoints of the Chinese consulates in the United States and their allies in the nation’s CCBAs.

Race/ethnicity-associated blood DNA methylation differences between Japanese and European American women: an exploratory study

Background Racial/ethnic disparities in health reflect a combination of genetic and environmental causes, and DNA methylation may be an important mediator. We compared in an exploratory manner the blood DNA methylome of Japanese Americans (JPA) versus European Americans (EUA). Methods Genome-wide buffy coat DNA methylation was profiled among healthy Multiethnic Cohort participant women who were Japanese (JPA; n = 30) or European (EUA; n = 28) Americans aged 60–65. Differentially methylated CpGs by race/ethnicity (DM-CpGs) were identified by linear regression (Bonferroni-corrected P < 0.1) and analyzed in relation to corresponding gene expression, a priori selected single nucleotide polymorphisms (SNPs), and blood biomarkers of inflammation and metabolism using Pearson or Spearman correlations (FDR < 0.1). Results We identified 174 DM-CpGs with the majority of hypermethylated in JPA compared to EUA (n = 133), often in promoter regions (n = 48). Half (51%) of the genes corresponding to the DM-CpGs were involved in liver function and liver disease, and the methylation in nine genes was significantly correlated with gene expression for DM-CpGs. A total of 156 DM-CpGs were associated with rs7489665 (SH2B1). Methylation of DM-CpGs was correlated with blood levels of the cytokine MIP1B (n = 146). We confirmed some of the DM-CpGs in the TCGA adjacent non-tumor liver tissue of Asians versus EUA. Conclusion We found a number of differentially methylated CpGs in blood DNA between JPA and EUA women with a potential link to liver disease, specific SNPs, and systemic inflammation. These findings may support further research on the role of DNA methylation in mediating some of the higher risk of liver disease among JPA.

Racial and ethnic disparities in nasopharyngeal cancer with an emphasis among Asian Americans.

118 Background: Nasopharyngeal cancer (NPC) is characterized by a distinct geographic distribution which reflects genetic predispositions, with highest incidence in Southeastern Asia and Southern China. It continues to cause a significant health burden among Asian Americans (AAs), which is a fast growing but understudied racial group. Prior studies investigating NPC combined all AA groups which may mask heterogeneities among AA subgroups. We aimed to examine the disparities in NPC by dividing AAs into four major ethnic groups - Chinese, Filipinos, Vietnamese, and Japanese Americans. Methods: NPC cases were identified from the Surveillance, Epidemiology, and End Result (SEER) 18 database from 1975-2016. Information regarding age, sex, race/ethnicity, education, income, % of foreign born, marital status, region of SEER registry, stage, histology, grade, surgery, chemotherapy, and radiation therapy were extracted. Multivariate-adjusted Cox proportional hazard regression and Fine-Gray sub-distribution hazard models were used to calculate overall and cause-specific mortality. SEER*Stat was used to calculated age-adjusted incidence. Results: Among a total of 11,737 NPC patients, 42.2% were non-Hispanic White (NHW), 10.7% non-Hispanic Black (NHB), 7.1% Hispanics, 18.9% Chinese, 7.6% Filipinos, 4.8% Vietnamese, 1.0% Japanese and 7.7% other Asians. AAs continue to have the highest NPC incidence among all racial groups despite of an overall decreasing trend. Japanese were significantly more likely to be diagnosed at localized stage, having low grade tumor and having keratinizing squamous cell carcinoma histology compared to other AAs. Compared to NHW, Filipino Americans had decreased mortality (HR = 0.90; 95%CI:0.84-0.98). Chinese (HR = 0.95; 95%CI: 0.90-1.01), and Vietnamese (HR = 0.94; 95%CI: 0.86-1.03) also observed marginally reduced mortality but not Japanese Americans (HR = 1.09; 95%CI: 0.90-1.32). No differences in NPC-specific mortality by race/ethnicity groups were found. In addition, Chinese, Filipino and Vietnamese Americans with NPC were less likely to die of other cancer and cardiovascular disease than NHW, but no such differences were observed among NHB, Hispanics or Japanese Americans. Conclusions: Asian Americans have been historically studied as one single racial group mostly due to limited sample size, despite that it is consistent of a diverse population with different genetic makeup, socioeconomic status, cultural background, health behaviors, and health care access. Our novel finding that significant disparities exist within AA NPC patients in regard to demographic and clinical features, overall and cause-specific mortality underlines the importance of adequate AA-subgroup specific sample size in future studies in order to understand the prognostic role of ethnicity in NPC, and advocates more ethnically and culturally tailored cancer care delivery.

Association of Dietary Nutrient Intake with Early Age-Related Macular Degeneration in Japanese-Americans

Lifestyle factors may be associated with the development of age-related macular degeneration (AMD), in addition to demographic and genetic factors. The purpose of this cross-sectional study is to elucidate the association between nutrient intake and AMD in the Japanese-American population living in Los Angeles. We conducted a medical survey of Japanese immigrants and their descendants living in Los Angeles, including interviews on dietary habits, fundus photography, and physical examinations. Participants were classified into early AMD and control groups on the basis of fundus photographic findings. Consequently, among the 555 participants, 111 (20.0%) were diagnosed with early AMD. There were no late-stage AMD participants. Multivariate logistic regression analysis showed that the intake of animal fat and saturated fatty acids (SFA) was positively associated with early AMD (p for trend = 0.01 for animal fat, p for trend = 0.02 for SFA), and the intake of vegetable fat, total carbohydrate, simple carbohydrate, sugar, and fructose was inversely associated with early AMD (p for trend = 0.04 for vegetable fat, p for trend = 0.046 for carbohydrate, p for trend = 0.03 for simple carbohydrate, p for trend = 0.046 for sugar, p for trend = 0.02). Our findings suggest that excessive animal fat and SFA intake increases the risk for early AMD in Japanese-Americans whose lifestyles have been westernized.