Asian Americans have the highest rates of chronic hepatitis B virus (HBV) and liver cancer, but nearly three quarters of this population has never been screened for HBV. What’s worse, structural racism and discrimination may be to blame.

While most research on structural racism and discrimination has focused on Black Americans and Latinos, a new five-year, $4 million grant from the National Institute on Minority Health and Health Disparities of the National Institutes of Health (NIH) will allow researchers at the Center for Asian Health, the Lewis Katz School of Medicine at Temple University and the Fox Chase Cancer Center to expand such research to include Asian Americans.

The grant is the first to be dedicated solely to address the effects of racism and discrimination on liver cancer and liver disease outcomes in high-risk Asian Americans. Specifically, research will center on Chinese, Korean and Vietnamese Americans in Philadelphia and New York City.

“We are very excited to be able to work toward identifying SRD [structural racism and discrimination] issues in health care for Asian Americans and to explore how we can use that information to develop culturally aligned interventions to improve quality of care,” said principal investigator Grace X. Ma, PhD,  a founding director of the Center for Asian Health and a professor in the Department of Urban Health and Population Science at the Katz School of Medicine, in a Temple Health news release.

“Our research essentially will be a deep dive into structural and systemic issues related to liver disease disparities in Asian Americans at three levels: the patient population, the health care system and the community,” Ma said.

Using integrative analyses, researchers will examine factors that contribute to discrimination against Asian Americans in the health care system, such as a lack of culturally and linguistically appropriate services and resources, structural barriers, mistrust of the health system, anti-Asian racism, immigration, poverty and more.

The findings will help support the goal of eliminating hepatitis as a global public health threat by 2030, a target set by the World Health Organization.

“Our hope is that this first multilevel and longitudinal study will not only help us understand how structural racism drives disparities in HBV infection and liver disease in Asian-American populations but also help improve quality of care for those affected by the virus as well as advance hepatitis elimination initiatives,” Ma said.

To learn more, read “’Hep ElimiNATION’ to Assess and Guide U.S. Efforts to End Hepatitis.”