Perception of Illness in Asian American Culture

Authored by: Nicole Kim

Art by: Amber Briscoe

“Have these oranges and study harder!” “You’re sick again? Go drink some water.”

Illness in a child deteriorates the quality of life of every member of the family [1]. When a child is sick, parents worry about a number of complications: their children’s symptoms getting worse, the possibility of getting infected by their children, rescheduling work if the sick child must stay at home, and much more. Because illness takes a toll on the patient as well as those with close connections to the patients, illness, especially in children, is stigmatized and even condemned in some cultures.

Oftentimes, parents in Asian households tell their children to drink lots of water, eat well, and sleep well, while constantly pushing them to work harder. This style of parenting known as “tiger parenting” [2] is ironic, because the harder you work, the harder it is to carve out time from your busy day to focus on maintaining good health and well-being. Yet, parents show that it is possible to prioritize both health and work by sacrificing parts of their time to keep us healthy and hardworking. This is manageable until children actually get sick. The guilt in not being able to live up to parents’ health expectations is huge, despite the fact that getting sick is often inevitable given that most children attend school and afterschool activities, where children share crayons and eat lunch together perhaps after forgetting to wash their hands. children from diverse backgrounds congregate. Because of the uneasiness in accepting one’s illness, it is common to ignore early symptoms of a serious illness and avoid seeking care due to past experiences with Asian parents — especially immigrant parents — who complain about the language barrier or the costs of healthcare in the US. This is dangerous since ignorance and avoidance in critical situations may become the norm in these families, as a child grows up in such an environment where these behaviors are encouraged or stimulated by the parents’ perception of illness. Conversely, there are those who excessively worry about illnesses and overreact to even the slightest change in their child’s health. Anxiety, concerns, and phobias such as fever phobias do exist, especially in populations where current medical guidelines are hard to follow or unknown [3]. If the reaction to illness does not align with the “appropriate” reaction, are there problems that arise, and how harmful is it for the patient and their caregivers if they do not react accordingly to the current medical guidelines?

The knowledge, attitudes, and practices toward particular illnesses widely vary among diverse cultural backgrounds and beliefs. Childhood fever management among Southeast and East Asian parents has been studied to identify and fill in the gap between Asian parents and those from the mainstream population, that is, Caucasian parents raising their children in North America [4]. After examining the source of fever information, knowledge level, attitudes, and practices towards childhood fever, it was concluded that Southeast and East Asian parents presented a negative attitude towards childhood fever along with an inadequacy of fever knowledge [3]. Prioritizing fever and body temperature reduction goes along with Asian parents’ efforts to get rid of the illness as rapidly as possible. However, this does not align with the current medical guidelines, which state to allow enough time for rest and appropriate medications to be absorbed by the body. Body temperature reduction will not get rid of the illness, but some Southeast and East Asian parents use alternative medicine to focus on bringing the child’s body temperature down to the normal range. These different perceptions on what healing means and how it looks vary within different cultural groups; thus, Ng’s research recommends unified educational interventions that address parental concerns and fever-related knowledge needs [3].

Additional research conducted by Khuu [5] sheds light on the correlation between parental health literacy — a parent’s ability to find, understand, and use health-related information and services to make decisions and take action for their child — and child health outcomes. The data in this research reflects how Southeast Asian American immigrants and refugees often have relatively low health literacy [5]. This may be due to language barriers that mitigate effective diagnosis or treatment; thus, immigrants who are unfamiliar with the US healthcare system may distance themselves from “proper” treatment. They are often accustomed to using alternative or traditional medicine techniques, but because traditional medicine sometimes greatly diverges from modern medicine, it is discouraged by the mainstream. Since it is harder to access traditional medicine materials and equipment in North America, Asian immigrants occasionally resort to avoiding treatment, especially during the early stages of illness. Self-diagnosis and self-treatment save costs and are less time-consuming, but receiving the correct diagnosis for a proper medical treatment that is proven to allow healing is crucial for every patient.

Children’s well-being and health outlook may vastly differ from one another depending on how their caregivers perceive illness and injuries. Whether the parents focus more on the prevention or treatment of illness, and whether they overreact or dismiss their children’s complaints about symptoms of illnesses, they are, after all, parents who love their children and are trying their best to promote well-being while advocating for the family’s health in what they believe is the best way.

References

1. Golics, C. J., Basra, M. K., Finlay, A. Y., & Salek, S. (2013). The impact of disease on family members: a critical aspect of medical care. Journal of the Royal Society of Medicine, 106(10), 399–407. https://doi.org/10.1177/0141076812472616

2. POON, D. (2024). Parental Influence on Asian Americans’ Educational and Vocational Outcomes. Wp.nyu.edu; Applied Psychology Opus. https://wp.nyu.edu/steinhardt-appsych_opus/parental-influence-on-asian-americans-educational-and-vocational-outcomes/

3. Ng HL, Li H, Jin X, Wong CL. Parental knowledge, attitudes, and practices towards childhood fever among South-East and East Asian parents: A literature review. PLoS One. 2023 Sep 8;18(9):e0290172. doi: 10.1371/journal.pone.0290172. PMID: 37682910; PMCID: PMC10490995. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10490995/

4. Hiller, M. G., Caffery, M. S., & Bégué, R. E. (2019). A Survey About Fever Knowledge, Attitudes, and Practices Among Parents. Clinical Pediatrics, 58(6), 677–680. https://doi.org/10.1177/0009922819834276

5. Khuu, Belle P., et al. "Healthcare providers' perspectives on parental health literacy and child health outcomes among Southeast Asian American immigrants and refugees." Children and Youth Services Review 67 (2016): 220-229. https://www.sciencedirect.com/science/article/pii/S0190740916301839