May is Asian American Pacific Islander (AAPI) Heritage Month – a time to celebrate and recognize the history, culture, contributions and achievements of the AAPI community in the United States.
The South Asian population is one of the fastest growing ethnic groups within the United States. The community is diverse – comprised of individuals with roots in Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka – and faces a number of health care disparities. Possible contributing factors for these disparities include genetic factors, socioeconomic variables, education, culture, language, health care behaviors, and attitudes.
“There’s limited awareness related to the disparities in heart disease among South Asians, and it has serious implications for this growing population,” said Pritpal Singh, medical director for Cigna Health Care. “That’s why in 2020 we decided to launch an effort to raise awareness of the risk factors, lifestyle changes, and health care interventions that could benefit the South Asian community and help them to live longer, healthier lives.”
For example, South Asians have four times the risk of cardiovascular disease compared with the general population, which makes them far more likely to experience a heart attack before age 50. Additionally, South Asians living with diabetes have a higher mortality rate than other ethnic groups and are more prone to developing cardiovascular disease due to higher levels of fat in and around their internal organs, which is considered a risk factor regardless of ethnicity.
Cigna is committed to help reduce health disparities in the communities we serve. We are working hard to help close the gaps for the South Asian population through cultural competency training for health care providers and community and employee outreach.
Community and Employee Outreach
In 2021, Cigna began to build an awareness campaign that explores the five main areas of health disparities among South Asians in the United States:
- Cardiovascular health
- Mental health
- Maternal and child health
The campaign focuses on the importance of preventive care, screening, and close monitoring.
The multichannel effort featured South Asian Cigna employees sharing their personal experiences with cardiovascular disease and culturally relevant guidance from South Asian Cigna medical directors. With the support of our ASPIRE employee resource group (ERG), the Cigna Health Equity Council, and the Care+ clinical team, we created a digital experience to help educate the South Asian community and their health care providers.
The campaign, which ran in February 2022 during American Heart Month, included brochures, social media outreach, video, email, web experiences, and more. The goal was to surround the community and their providers with educational content on the health disparities that exist, highlighting the cardiovascular risk and need for prevention and early screening.
“There is a lot of research and scientific studies out there that validate the health disparities among South Asians, but we believe there is not enough awareness about the cultural and genetic health risk factors impacting those of South Asian descent. ”Pritpal Singh, medical director for Cigna Health Care
Therefore, Dr. Signh said, the goal was to educate as many people as possible – employees, providers, families, friends, etc. – and make the information easy to understand, relatable, and actionable.
For example, we engaged Cigna employees that identify as South Asian using our employee intranet, panel discussions, events, and social media. Case in point: Hundreds of Cigna employees attended a medical panel hosted by the ASPIRE ERG that discussed cardiovascular disease risks for South Asians.
Additionally, a slew of digital content hosted on our company’s intranet was produced with the goals of empowering our South Asian coworkers to take control of their health and well-being by focusing on prevention and screening.
“This campaign encourages our South Asian colleagues and customers to take the initial step to schedule an appointment with their provider to discuss their individual risk factors and learn how they can work toward self-management in lowering their risks.”Dr. Matthew Keller, medical director for Cigna Health Care
Building Cultural Competency Among Providers
Building cultural competency in health care can help reduce health disparities. Health coaches and health care providers who offer culturally appropriate treatment plans can help make cardiovascular disease management easier for South Asian patients, which can improve their adherence to treatment and lead to better outcomes.
In addition, South Asian patients are more likely to be trusting and receptive of treatment advice from a provider who understands and considers their culture and beliefs, their lifestyle and circumstances, and the issues and challenges they face.
To better educate providers, Cigna's ASPIRE ERG partnered with our health equity team to create a South Asian diabetes training for Cigna physicians and health care practitioners. Physicians who participate in the training gain practical insights on engaging South Asian customers in Cigna’s health and wellness programs. The training shares culturally relevant insights on how clinicians and coaches can assess cultural influencers, environmental factors, and resulting health disparities specific to coronary artery disease within the population. It also suggests their patients to take proactive steps to reduce their individual risk factors, including lifestyle changes and dietary modifications. Click here to learn how to access this training.
“There are a number of factors to consider when working with a South Asian patient. Providers must engage patients to understand their backgrounds and the dietary and lifestyle regimen that is likely to work best for them. Health care providers must treat cultural differences as strengths that can be leveraged to design an effective treatment plan for patients.”Dr. Anil Sipahimalani, medical director at Cigna Health Care
In addition to creating training and resources for providers, Cigna developed culturally competent patient brochures that are available in Hindi, Nepali, and Urdu languages.
While there is always more work to be done to drive better health outcomes for our communities, #TeamCigna is proud of this campaign, which collectively reached more than 800,000 South Asian patients and health care providers. But our work is not done. A customized training for Cigna employees, including coaching and clinical job roles, will be rolled out in the near future. Inspiring customers to understand their unique risk factors and motivate them to take action is the aim of this training effort. We will continue to expand the reach of this campaign via more channels to spread the word, and we will continue our advocacy and our conversations with employees, providers, and communities.
Currently, Cigna is focusing on expanding provider-specific communications and education on this topic to increase relevant culturally responsive care for the South Asian community. Content is posted on Cigna’s provider web page dedicated to South Asian health disparities.
“While additional work continues to help close cardiac disparities, these resources will be an effective tool as part of our targeted educational campaign to help improve health outcomes and measure the success of our efforts,” Dr. Sipahimalani said.
South Asian Health Disparities
Clinical insights and practical tips on how to address health disparities among this diverse population.