title: Racial disparities in hepatitis B infection in Ohio: screening and immunization are critical for early clinical management.
abstract: OBJECTIVE
  Chronic hepatitis B virus (HBV) infection and liver cancer mortality represent a neglected health disparity among Asian Americans. The purposes of this study were to compare the prevalence of hepatitis B among a diverse group of 1311 Ohioans in Franklin County, OH (85% Asians, 7.5% African Americans, and 6.5% whites) and to improve access to care for high-risk Asian adults through advocacy and policy changes.
  
  
  METHODS
  The Asian subgroups comprised of Chinese, Filipino, Asian Indian, Pakistani, Vietnamese, Korean, Laotian, Indonesian, Japanese, Cambodian, Thai, and Malaysian nationalities. The HBV screening was completed at health fairs, restaurants, churches, and temples from 2006 to 2011.
  
  
  RESULTS
  The prevalence of HBV infection (9.5% vs 5%) and family history of liver cancer was significantly higher among Asians than other racial ethnic groups (P = 0.001). Cambodian, Vietnamese, and Chinese participants were disproportionately infected with the virus compared with other Asian subgroups (P < 0.001). Advocacy and policy changes for resources allowed vaccine-eligible Asians included as "high risk" group to receive free vaccinations at the health department. However, although vouchers were provided to vaccine-eligible Asian adults, compliance in getting vaccinated was very low (11%). Common barriers for compliance were lack of time and knowledge of completing the 3 shot series, low English proficiency, and fear of adverse effects.
  
  
  CONCLUSIONS
  Outreach education may use community liaisons to improve screenings, education, and vaccination/treatment. A hepatitis free clinic was established in 2009 to provide culturally and linguistically appropriate treatment for low-income Asian Americans in Franklin County, OH.
authors.affiliation: From the *Public Health Practice, Social and Behavioral Health Sciences, School of Public Health, West Virginia University, Morgantown, WV; †Health Through Action, Ohio Asian American Health Coalition, Columbus, OH; National Hepatitis B Task Force Board, Miller, NE; ‡Ohio State University (Medical graduates); and §Division of Gastroenterology, Hepatologyand Nutrition, Ohio State University, Columbus, OH.
authors.forename: Ranjita
authors.initials: R
authors.lastname: Misra
authors.forename: Karen
authors.initials: K
authors.lastname: Jiobu
authors.forename: Johnathan
authors.initials: J
authors.lastname: Zhang
authors.forename: Qihui
authors.initials: Q
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Li
authors.forename: Robert
authors.initials: R
authors.lastname: Kirkpatrick
authors.forename: Jason
authors.initials: J
authors.lastname: Ho
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology*; D000368:Aged; D001213:Asian / Q000208:ethnology*; D003430:Cross-Sectional Studies; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D054625:Healthcare Disparities / Q000208:ethnology*; D006509:Hepatitis B / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006801:Humans; D007114:Immunization / Q000379:methods; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009820:Ohio / Q000208:ethnology; D044469:Racial Groups / Q000208:ethnology; D013997:Time Factors; D044465:White People / Q000208:ethnology*
chemical_list: D017325:Hepatitis B Vaccines