SNAP Participation Moderates the Association Between Household Food Insecurity and A1c Among Cambodian Americans With Depression

Objectives We tested whether participation in the Supplemental Nutrition Assistance Program (SNAP) moderated the relation between household food security status and HbA1c, the gold standard measure of glycemic control, among Cambodian Americans with depression enrolled in a diabetes prevention trial. Methods Participants had elevated risk factors for type 2 diabetes and elevated depressive symptoms; recruits were excluded for extant diabetes. Community health workers assessed household food security status and SNAP participation via in-person interview. HbA1c levels from venous blood samples were ascertained using direct enzymatic assay. Results Among respondents (n = 189), 19% were food insecure, 41% received SNAP benefits, and mean HbA1c = 5.5%. There was a significant interaction between SNAP and food insecurity. HbA1c was highest among participants without SNAP who were food insecure. Simple effects analysis revealed a significant difference within the no SNAP group [Mean (SD) HbA1c: Secure = 5.38 (0.38), Insecure = 5.78 (0.36)] and no difference within the SNAP group [Secure = 5.61(0.44), Insecure = 5.61(0.55)]. Differences remained significant after controlling for demographic, socioeconomic, and clinical indicators. Conclusions SNAP may protect against the deleterious association between household food insecurity and elevated HbA1c. Funding Sources R01-DK103663 to Dr. Julie Wagner.

Buddhist-Christians in Cambodian America

Former refugees from Cambodia, along with their American-born children, frequently travel between the two countries, thereby blurring the lines between ‘Cambodian’ and ‘American’ identities. At the same time, there exists an almost ubiquitous conception of Cambodian cultural heritage as inseparable from Buddhist religious affiliation. In this context, some Cambodian-Americans who have adopted Christianity maintain both religious identities. Engaging in religious activity at the temple and at the church, these Buddhist-Christians defy the widely held Western view of religions as mutually exclusive of one another. Honouring two or more religious traditions is far from unusual in Cambodia, where the royal coronation ceremony combines Buddhist and Hindu elements, and where Chinese or indigenous Cambodian religious practices often infuse daily Buddhist practice. In this article, I explore dual religious belonging in the Cambodian-American context and call attention to the ways in which it exemplifies a perspective, prevalent in the non-Western world, that religion is hybrid by default; often is driven by a desire to enhance faithfulness vis-à-vis one's primary religion, be it Buddhism or Christianity; and can be characterised by a longing to maintain Khmer cultural identity while also acquiring potential practical and spiritual benefits associated with Christianity.

A Review of the Historical, Criminological, and Theoretical Understandings of the Cambodian American Population: A Call for More Comprehensive Research

The collective view of Asian Americans as model minorities is evident with the extensive amount of statistical data showing support for the academic and socioeconomic success of Asian Americans in the United States. This perception, however, often presents an inaccurate portrayal of Asian Americans, in general, as it overlooks many of the difficulties and hardships experienced by Asian American ethnic groups such as Southeast Asians. Within this group, Cambodian Americans are at the highest risk for experiencing socioeconomic hardships, behavioral health problems, substance use disorders, and contact with the criminal justice system, with deportation also being a prevailing issue. Unfortunately, research in this area is scant and contemporary research on Cambodian Americans has several limitations. To begin to address this issue, the present article merges information from existing research on this population from a sociohistorical, criminological, and theoretical standpoint to call for more comprehensive research on Cambodian Americans.

Hepatitis C Is Poorly Associated With Drug Use in Cambodian Americans in Lowell, Massachusetts

Background. Hepatitis C (HCV) is the most common chronic blood-borne infection in the United States and affects Asian and non-Asian Americans comparably. Injection drug use, the most common national transmission risk, is not as prevalent in Asian-Americans, but prior studies do not include many Cambodian Americans. Lowell, Massachusetts has the second largest population of Cambodian Americans, allowing a direct comparison of HCV-infected Cambodian and non-Cambodian Americans not previously done. Improving our understanding of HCV risks in this unique community may improve their linkage to care. Methods. In this cross-sectional study, medical data were collected regarding HCV risk factors for HCV-infected Cambodian and non-Cambodian Americans seen at Lowell Community Health Center from 2009 to 2012. Results. Cambodian Americans (n = 128) were older (mean age 53 vs 43 years old) and less likely to be male (41% vs 67%, P < .001) compared with non-Cambodians (n = 541). Cambodians had lower rates of injection drug use (1.6% vs 33.6%, P < .001) and any drug use (2.3% vs 82.1%, P < .001). More Cambodians were born between 1945 and 1965 (66.4% vs 44.5%). Within this birth cohort, more Cambodians had no other risk factor (82% vs 69%, P = .02). Fewer Cambodians had chronic HCV (53% vs 74%, P < .001). Conclusions. Birth between 1945 and 1965 was the major HCV risk factor for Cambodian Americans. Cambodians had lower rates of injection drug use or any drug use history. Risk behavior screening fails to describe HCV transmission for Cambodian Americans and creates a barrier to their linkage to care.