The degree of utilization is dependent upon acceptance by patient and family, and barriers such as
- Saving face
- Family responsibilities
Additional barriers to the U.S. health system include:
- Lack of language and culturally competent services
- Geographic barriers
- Economic barriers
For example, English ability, conservatism with regards to more traditional Eastern cultural values and lack of knowledge may be partially responsible for lower rates of mammograms in Chinese-American women (Wang JH 2009; Liang 2009). In general, the fact that Asians and Pacific Islander Americans are less likely to see a physician may impact on the success of prevention programs, such as smoking cessation and breast cancer screening (Chen 1994; Fu 2003; Wang JH 2009).