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Health and Diverse Populations

Health and Southeast Asian Canadians

Overview
Mental Health
Breast Cancer
Cervical Cancer
Heart Disease
Diabetes
References, Reports and Websites

Overview

According to the 2001 Census, South Asians were the second largest minority group in Canada, representing approximately 917,000 people (Statistics Canada, 2002). The South Asian community in Canada is a very diverse group, representing a range of ethnic, religious and linguistic groups with varying histories and backgrounds. According to the 2001 Census data, 29% of South Asians reported being born in Canada, while 69% were immigrants. South Asians have resided in many areas of Canada, however, the large majority have settled in Vancouver or Toronto. For clarification purposes, the term “South Asian” can also be referred to as East Indian and can be defined “as any person who reports an ethnicity associated with the southern part of Asia or who self-identifies as part of the South Asian visible minority group” (Statistics Canada, 2005, p. 21).

Canadian research is scarce on the health of South Asian Canadians. However, limited research has indicated that South Asian Canadians are at increased risk for type 2 diabetes (Canadians Diabetes Association, 2006) and heart disease (Heart and Stroke Foundation of Canada, 2006) compared to the general Canadian population. In addition, research has been published that indicates mental health issues, poor breast and cervical cancer prevention knowledge and practice among South Asian refugees and immigrants in Canada (Beiser, & Hou, 2001; Choudhry, Srivastava, & Fitch, 1998; Gupta, Kumar, & Stewart, 2002). Significantly more research is required on the health status of South Asian communities in Canada.

An overview of the characteristics of South Asian individuals in Canada is available in a Statistics Canada (2005) document entitled, “South Asians in Canada: Unity through Diversity”, which is located at the following web link http://www.statcan.ca/english/kits/pdf/social/asian.pdf

A general history of South Asians in Canada is available at the following link http://www.thecanadianencyclopedia.com/index.cfm?PgNm=TCE&Params=A1ARTA0007574

(Top of Page)

Mental Health

A study by Beiser and Hou (2001) investigated the effects of unemployment and language facility on the mental health of Southeast Asian refugees in Canada. Data was gathered on 1348 refugees at three different time points during the first ten years of the refugees stay in Canada. Findings from the study indicated that language proficiency improved as time spent in Canada increased. In addition, employment rates improved among the refugees over the 10 year period. The prevalence of major depressive disorder declined during the 10 year period, from 6.48% when the refugees arrived to 2.27% ten years later. Unemployment rates were found to be high during the early years of resettlement. In addition unemployment was found to be significantly related to depression at the last two time points. Further, fluency in English was associated with increased probability of employment at the later two time points. Of concern however, were the 8% of refugees who reported speaking no English 10 years after arriving in Canada. This study suggests a relationship between mental health and language proficiency and depression among refugees. By the end of the first decade, this study found language proficiency to be a substantial predictor of depression and/ or employment.

A study by Noh, Beiser, Kaspar, Hou and Rummens (1999) investigated the relationship between refugees’ experience of racial discrimination and their level of depression. In addition, they examined the experience of refugees that confront discrimination, and how individual ethnic identity affects the relationship between depression and racial discrimination. A total of 647 South Asian refugees participated in this study and completed personal interviews. Findings indicated that refugees who reported experiencing racial discrimination had increased levels of depression compared to those individuals reporting no racial discrimination. In addition, those individuals who reported confronting the racial discrimination were not significantly associated with depression. This study concluded in suggesting that strong ethnic identification may increase the likelihood of depression in the face of racial discrimination.

Ahmad, Shik, Vanza, Cheung, George, & Stewart (2004) investigated the health experiences and beliefs of South Asian immigrant women after immigration. Focus groups were developed with 24 South Asian women who have settled in Canada for less than five years. Mental health was a major health issue identified among the focus groups. The economic uncertainties, lack of social support, lifestyle, climate and food changes, and barriers in accessing health services were all issues related to poor mental health status among these women. The women indicated inadequate coping strategies and available resources; this suggests that health and social programs are required to actively address the mental health burden among South Asian immigrant women.

(Top of Page)

Breast Cancer

A study by Choudhry, Srivastava, & Fitch (1998) investigated the level of knowledge, attitudes, beliefs and practices in regards to breast cancer detection practices among South Asian women in the Toronto area. A total of 57 South Asian women aged 40 years and over were involved in the study. A general interview guide was developed for this study and conducted via face-to-face interviews with the women. The interview included questions regarding knowledge, attitudes, beliefs and practices about clinical breast examination, breast self-examination, and mammograms. Findings from the study revealed that 47% of study participants had never had a mammogram, 49% reported at least one clinical breast exam during their lifetime and 12% practiced breast self-examinations monthly. In regards to their level of knowledge, 54% of the women reported having little knowledge of breast cancer. A positive correlation was present among the women who had little knowledge of breast cancer and women who practiced breast health practices. In addition, findings indicated that the longer the women had lived in Canada, the more likely they were to participate in breast health practices.

Ahmad & Stewart (2004) investigated the predictors of clinical breast examination among South Asian women in Toronto, Ontario. A total of 54 South Asian women participated in the study and completed a self-administered survey when visiting their family physician. Findings indicated that 38.5% of women had a clinical breast examination at one point in their lives. Women who reported having a clinical examination were significantly older and had resided in Canada for a longer period of time compared to the women who reported never having a clinical breast examination. In addition, women who reported having a clinical breast examination had better knowledge of breast cancer and were more likely to have regular health exams. Language and education were not significant factors between the two groups. This study suggests that there is a need for breast cancer education and screening initiatives among young and immigrant South Asian women in Canada.

(Top of Page)

Cervical Cancer

Cervical Cancer testing via a Pap smear provides a method of early detection of cervical cancer among women, and is a health care prevention measure that should be readily available to all women at risk (Public Health Agency of Canada, 2003).

A study by Gupta, Kumar, & Stewart (2002) examined the knowledge and use of Pap smears among South Asian women in Canada. A total of 124 South Asian women aged 18-60 years completed the self-administered questionnaire. Findings indicated a low level of Pap smear knowledge and prevalence among South Asian women in the study. In addition, the level of knowledge and prevalence was positively correlated with the level of formal education. This study suggested a need for educational and screening interventions in Canada directed specifically towards women of South Asian origin.

(Top of Page)

Diabetes

According to Health Canada and the Canadian Diabetes Association, people of South Asian descent are at increased risk of developing type 2 diabetes (Health Canada, 2004; Canadian Diabetes Association, 2006). Specific prevalence or incidence studies within the Canadian South Asian population were not found in the review.

(Top of Page)

Heart Disease

According to the Heart and Stroke Foundation of Canada, South Asians are considered a high-risk group for heart disease (Heart and Stroke Foundation, 2006).

A 2001 article on the Heart and Stroke Foundation of Canada website outlines a study conducted by Dr. Milan Gupta from the Canadian Cardiovascular Congress in Halifax, Nova Scotia. Gupta examined the medical records of patients with coronary artery disease undergoing angiography over a one-year period. Individuals self-identified their ethnicity. Findings indicated that in South Asian patients, the three major arteries were more seriously diseased compared to the patients of European decent. No significant differences were present in the known risk factors for heart disease such as obesity, high blood pressure, high cholesterol or family history. Smoking was actually found to be at a lower prevalence among the South Asian patients. The prevalence of type 2 diabetes, which is a major risk factor for heart disease, was greater among the South Asian patients. Dr. Gupta concluded that heart disease is on the rise among South Asians in Canada. Interventions directed at this population are necessary. The full article is available at the following web link http://ww2.heartandstroke.ca/Page.asp?PageID=110&ArticleID=743&Src=new

Anand, et al. (2000) conducted a population based study to determine why differences in the prevalence of cardiovascular disease vary among three ethnic groups in Canada; South Asians, Chinese and Europeans. A total of 985 study participants were drawn from Toronto, Hamilton and Edmonton. Cardiovascular disease was defined via patient history or electrocardiography findings. In addition, risk factors such as smoking, hypertension, diabetes, high cholesterol and prothromobotic state were measured. Findings indicated that South Asians had a higher prevalence of cardiovascular disease compared to Europeans and Chinese, 11%, 5% and 2% respectively. In addition, South Asians had a higher prevalence of glucose intolerance and higher cholesterol. Further study is required to explain the differences in cardiovascular disease and risk factors.

A study by Sheth, Nair, Nargundkar, Anand, & Yusuf (1999), investigated the cardiovascular and cancer mortality rates among Canadians aged 35-74 years from European, Chinese and South Asian origin between 1979-1993. A total of 1.2 million deaths occurred among these groups during the 14 year period. The study found that the rate of heart disease was higher among South Asian immigrants compared to the Canadian-born population. More specifically, the findings indicated that deaths from ischemic heart disease and cerebrovascular disease were significantly higher among the South Asian population compared to the European and Chinese-Canadians. Further, death rates resulting from cancer were the lowest among the South Asian group compared to the Chinese and European populations. In summary, this study showed that South Asian Canadians had a very low rate of death from cancer and a relatively high rate of death from cardiovascular disease. For more detailed information on the results of this study, please refer to the following link http://www.cmaj.ca/cgi/reprint/161/2/132

An article outlining the high risk of heart disease among South Asian women is available for review at the following web link (link no longer available)

(Top of Page)

References, Reports and Websites

References:

1. Noh, S., Beiser, M., Kaspar, V., Hou, F., Rummens, J. (1999). Perceived Racial Discrimination, Depression, and Coping: A Study of Southeast Asian Refugees in Canada. Journal of Health and Social Behavior 40(3): 193-207.

2. Beiser, M., & Hou, F. (2001). Language acquisition, unemployment and depressive disorder among Southeast Asian refugees: a 10 year study. Social Science and Medicine, 53, 1321-1334.

3. Sheth, T., Nair, C., Nargundkar, M., Anand, S., Yusuf, S. (1999). Cardiovascular and cancer mortality among Canadians of European, south Asian and Chinese origin from 1979 to 1993: an Analysis of 1.2 million deaths. Canadian Medical Association Journal. 161(2), 132-138.

4. Tran, K., Kaddatz, J., Allard, P. (2005). South Asians in Canada: Unity through Diversity. Available at http://www.statcan.ca/english/kits/pdf/social/asian.pdf

5. Choudhry, U., Srivastava, R., Fitch, M. (1998). Breast Cancer detection practices of South Asian women: knowledge, attitudes and beliefs. Oncology Nursing Forum, 25(10): 1693-1701.

6. Ahmad, F., & Stewart, D. (2004). Predictors of clinical breast examination among South Asian Immigrant women. Journal of Immigrant Health. 6(3): 119-126.

7. Public Health Agency of Canada. (2003). Centre for Chronic Prevention and Control: Cervical Cancer. Available at http://www.phac-aspc.gc.ca/ccdpc-cpcmc/cc-ccu/index_e.html

8. Gupta, A., Kumar, A., & Stewart, D. (2002). Cervical cancer screening among South Asian women in Canada: the role of education and acculturation. Health Care Women International Journal, 23(2): 123-134.

9. Ahmad, F., Shik, A., Vanza, R., Cheung, A., George, U., Stewart, D. (2004). Voices of South Asian women: immigration and mental health. Women’s Health Journal. 40(4): 113-130.

10. Canadian Diabetes Association. (2006). Are you at Risk?. (link no longer available)

11. Health Canada. (2004). Type 2 Diabetes. (link no longer available)

12. Heart and Stroke Foundation. (2006). Risk Factors. Available at http://ww2.heartandstroke.ca/Page.asp?PageID=33&ArticleID=589&Src=heart&From=SubCategory

13. Anand, S., Yusuf, S., Vuksan, V., Devanesen, S., Teo, K., Montague, P., Kelemen, L., Yi, C., Lonn, E., Gerstein, H., Hegele, R., McQueen, M. (2000). Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the study of health assessment and risk in Ethnic groups. Lancet, 356, 279-284.

14. Alliance for South Asian AIDS Prevention. (1999). Discrimination and HIV/AIDS in South Asian Communities. Available at http://www.asaap.ca

Websites:

South Asian Partnership Canada
http://www.sapcanada.org/index.html

Service Coalition in the South Asian Community
http://www.cassa.on.ca/SC/

Canadian Centre for South Asian Studies
http://uoit.ca/sas/aboutUs.html

South Asian Alliance
http://www.southasianalliance.ca/home.php

Alliance for South Asian AIDS Prevention
http://www.asaap.ca

South Asian Women’s Centre
http://www.southasianwomenscentre.ca/

Canadian Centre for South Asian Studies
http://www.uoit.ca/sas/

South Asian links
http://uoit.ca/sas/SouthAsianLinks.html

Centre for South Asian Studies – University of Toronto.
http://www.sgs.utoronto.ca/sas/faculty.html

(Top of Page)

Diversity and Alberta Health Services Home Diversity Competency Resources Publications Demographics Programs & Services Health Info. for Diverse Populations Community Partners Contact Us Health and Ethnicity Chinese Canadians Philippine Canadians Southeast Asian Canadians Vietnamese Canadians Black Canadians First Nations, Inuit and Metis Populations Refugees Immigrants Sexual Orientation Seniors Persons with Disabilities Homeless Living in Poverty	Diversity and Alberta Health Services Diversity Resources Health and Diverse Populations Diversity FAQ's \| Diversity Library \| Research & Publications \| Definitions \| Health and Diverse Populations \| Healthy Diverse Populations in the Media Health and Southeast Asian Canadians Overview Mental Health Breast Cancer Cervical Cancer Heart Disease Diabetes References, Reports and Websites Overview According to the 2001 Census, South Asians were the second largest minority group in Canada, representing approximately 917,000 people (Statistics Canada, 2002). The South Asian community in Canada is a very diverse group, representing a range of ethnic, religious and linguistic groups with varying histories and backgrounds. According to the 2001 Census data, 29% of South Asians reported being born in Canada, while 69% were immigrants. South Asians have resided in many areas of Canada, however, the large majority have settled in Vancouver or Toronto. For clarification purposes, the term “South Asian” can also be referred to as East Indian and can be defined “as any person who reports an ethnicity associated with the southern part of Asia or who self-identifies as part of the South Asian visible minority group” (Statistics Canada, 2005, p. 21). Canadian research is scarce on the health of South Asian Canadians. However, limited research has indicated that South Asian Canadians are at increased risk for type 2 diabetes (Canadians Diabetes Association, 2006) and heart disease (Heart and Stroke Foundation of Canada, 2006) compared to the general Canadian population. In addition, research has been published that indicates mental health issues, poor breast and cervical cancer prevention knowledge and practice among South Asian refugees and immigrants in Canada (Beiser, & Hou, 2001; Choudhry, Srivastava, & Fitch, 1998; Gupta, Kumar, & Stewart, 2002). Significantly more research is required on the health status of South Asian communities in Canada. An overview of the characteristics of South Asian individuals in Canada is available in a Statistics Canada (2005) document entitled, “South Asians in Canada: Unity through Diversity”, which is located at the following web link http://www.statcan.ca/english/kits/pdf/social/asian.pdf A general history of South Asians in Canada is available at the following link http://www.thecanadianencyclopedia.com/index.cfm?PgNm=TCE&Params=A1ARTA0007574 (Top of Page) Mental Health A study by Beiser and Hou (2001) investigated the effects of unemployment and language facility on the mental health of Southeast Asian refugees in Canada. Data was gathered on 1348 refugees at three different time points during the first ten years of the refugees stay in Canada. Findings from the study indicated that language proficiency improved as time spent in Canada increased. In addition, employment rates improved among the refugees over the 10 year period. The prevalence of major depressive disorder declined during the 10 year period, from 6.48% when the refugees arrived to 2.27% ten years later. Unemployment rates were found to be high during the early years of resettlement. In addition unemployment was found to be significantly related to depression at the last two time points. Further, fluency in English was associated with increased probability of employment at the later two time points. Of concern however, were the 8% of refugees who reported speaking no English 10 years after arriving in Canada. This study suggests a relationship between mental health and language proficiency and depression among refugees. By the end of the first decade, this study found language proficiency to be a substantial predictor of depression and/ or employment. A study by Noh, Beiser, Kaspar, Hou and Rummens (1999) investigated the relationship between refugees’ experience of racial discrimination and their level of depression. In addition, they examined the experience of refugees that confront discrimination, and how individual ethnic identity affects the relationship between depression and racial discrimination. A total of 647 South Asian refugees participated in this study and completed personal interviews. Findings indicated that refugees who reported experiencing racial discrimination had increased levels of depression compared to those individuals reporting no racial discrimination. In addition, those individuals who reported confronting the racial discrimination were not significantly associated with depression. This study concluded in suggesting that strong ethnic identification may increase the likelihood of depression in the face of racial discrimination. Ahmad, Shik, Vanza, Cheung, George, & Stewart (2004) investigated the health experiences and beliefs of South Asian immigrant women after immigration. Focus groups were developed with 24 South Asian women who have settled in Canada for less than five years. Mental health was a major health issue identified among the focus groups. The economic uncertainties, lack of social support, lifestyle, climate and food changes, and barriers in accessing health services were all issues related to poor mental health status among these women. The women indicated inadequate coping strategies and available resources; this suggests that health and social programs are required to actively address the mental health burden among South Asian immigrant women. (Top of Page) Breast Cancer A study by Choudhry, Srivastava, & Fitch (1998) investigated the level of knowledge, attitudes, beliefs and practices in regards to breast cancer detection practices among South Asian women in the Toronto area. A total of 57 South Asian women aged 40 years and over were involved in the study. A general interview guide was developed for this study and conducted via face-to-face interviews with the women. The interview included questions regarding knowledge, attitudes, beliefs and practices about clinical breast examination, breast self-examination, and mammograms. Findings from the study revealed that 47% of study participants had never had a mammogram, 49% reported at least one clinical breast exam during their lifetime and 12% practiced breast self-examinations monthly. In regards to their level of knowledge, 54% of the women reported having little knowledge of breast cancer. A positive correlation was present among the women who had little knowledge of breast cancer and women who practiced breast health practices. In addition, findings indicated that the longer the women had lived in Canada, the more likely they were to participate in breast health practices. Ahmad & Stewart (2004) investigated the predictors of clinical breast examination among South Asian women in Toronto, Ontario. A total of 54 South Asian women participated in the study and completed a self-administered survey when visiting their family physician. Findings indicated that 38.5% of women had a clinical breast examination at one point in their lives. Women who reported having a clinical examination were significantly older and had resided in Canada for a longer period of time compared to the women who reported never having a clinical breast examination. In addition, women who reported having a clinical breast examination had better knowledge of breast cancer and were more likely to have regular health exams. Language and education were not significant factors between the two groups. This study suggests that there is a need for breast cancer education and screening initiatives among young and immigrant South Asian women in Canada. (Top of Page) Cervical Cancer Cervical Cancer testing via a Pap smear provides a method of early detection of cervical cancer among women, and is a health care prevention measure that should be readily available to all women at risk (Public Health Agency of Canada, 2003). A study by Gupta, Kumar, & Stewart (2002) examined the knowledge and use of Pap smears among South Asian women in Canada. A total of 124 South Asian women aged 18-60 years completed the self-administered questionnaire. Findings indicated a low level of Pap smear knowledge and prevalence among South Asian women in the study. In addition, the level of knowledge and prevalence was positively correlated with the level of formal education. This study suggested a need for educational and screening interventions in Canada directed specifically towards women of South Asian origin. (Top of Page) Diabetes According to Health Canada and the Canadian Diabetes Association, people of South Asian descent are at increased risk of developing type 2 diabetes (Health Canada, 2004; Canadian Diabetes Association, 2006). Specific prevalence or incidence studies within the Canadian South Asian population were not found in the review. (Top of Page) Heart Disease According to the Heart and Stroke Foundation of Canada, South Asians are considered a high-risk group for heart disease (Heart and Stroke Foundation, 2006). A 2001 article on the Heart and Stroke Foundation of Canada website outlines a study conducted by Dr. Milan Gupta from the Canadian Cardiovascular Congress in Halifax, Nova Scotia. Gupta examined the medical records of patients with coronary artery disease undergoing angiography over a one-year period. Individuals self-identified their ethnicity. Findings indicated that in South Asian patients, the three major arteries were more seriously diseased compared to the patients of European decent. No significant differences were present in the known risk factors for heart disease such as obesity, high blood pressure, high cholesterol or family history. Smoking was actually found to be at a lower prevalence among the South Asian patients. The prevalence of type 2 diabetes, which is a major risk factor for heart disease, was greater among the South Asian patients. Dr. Gupta concluded that heart disease is on the rise among South Asians in Canada. Interventions directed at this population are necessary. The full article is available at the following web link http://ww2.heartandstroke.ca/Page.asp?PageID=110&ArticleID=743&Src=new Anand, et al. (2000) conducted a population based study to determine why differences in the prevalence of cardiovascular disease vary among three ethnic groups in Canada; South Asians, Chinese and Europeans. A total of 985 study participants were drawn from Toronto, Hamilton and Edmonton. Cardiovascular disease was defined via patient history or electrocardiography findings. In addition, risk factors such as smoking, hypertension, diabetes, high cholesterol and prothromobotic state were measured. Findings indicated that South Asians had a higher prevalence of cardiovascular disease compared to Europeans and Chinese, 11%, 5% and 2% respectively. In addition, South Asians had a higher prevalence of glucose intolerance and higher cholesterol. Further study is required to explain the differences in cardiovascular disease and risk factors. A study by Sheth, Nair, Nargundkar, Anand, & Yusuf (1999), investigated the cardiovascular and cancer mortality rates among Canadians aged 35-74 years from European, Chinese and South Asian origin between 1979-1993. A total of 1.2 million deaths occurred among these groups during the 14 year period. The study found that the rate of heart disease was higher among South Asian immigrants compared to the Canadian-born population. More specifically, the findings indicated that deaths from ischemic heart disease and cerebrovascular disease were significantly higher among the South Asian population compared to the European and Chinese-Canadians. Further, death rates resulting from cancer were the lowest among the South Asian group compared to the Chinese and European populations. In summary, this study showed that South Asian Canadians had a very low rate of death from cancer and a relatively high rate of death from cardiovascular disease. For more detailed information on the results of this study, please refer to the following link http://www.cmaj.ca/cgi/reprint/161/2/132 An article outlining the high risk of heart disease among South Asian women is available for review at the following web link (link no longer available) (Top of Page) References, Reports and Websites References: 1. Noh, S., Beiser, M., Kaspar, V., Hou, F., Rummens, J. (1999). Perceived Racial Discrimination, Depression, and Coping: A Study of Southeast Asian Refugees in Canada. Journal of Health and Social Behavior 40(3): 193-207. 2. Beiser, M., & Hou, F. (2001). Language acquisition, unemployment and depressive disorder among Southeast Asian refugees: a 10 year study. Social Science and Medicine, 53, 1321-1334. 3. Sheth, T., Nair, C., Nargundkar, M., Anand, S., Yusuf, S. (1999). Cardiovascular and cancer mortality among Canadians of European, south Asian and Chinese origin from 1979 to 1993: an Analysis of 1.2 million deaths. Canadian Medical Association Journal. 161(2), 132-138. 4. Tran, K., Kaddatz, J., Allard, P. (2005). South Asians in Canada: Unity through Diversity. Available at http://www.statcan.ca/english/kits/pdf/social/asian.pdf 5. Choudhry, U., Srivastava, R., Fitch, M. (1998). Breast Cancer detection practices of South Asian women: knowledge, attitudes and beliefs. Oncology Nursing Forum, 25(10): 1693-1701. 6. Ahmad, F., & Stewart, D. (2004). Predictors of clinical breast examination among South Asian Immigrant women. Journal of Immigrant Health. 6(3): 119-126. 7. Public Health Agency of Canada. (2003). Centre for Chronic Prevention and Control: Cervical Cancer. Available at http://www.phac-aspc.gc.ca/ccdpc-cpcmc/cc-ccu/index_e.html 8. Gupta, A., Kumar, A., & Stewart, D. (2002). Cervical cancer screening among South Asian women in Canada: the role of education and acculturation. Health Care Women International Journal, 23(2): 123-134. 9. Ahmad, F., Shik, A., Vanza, R., Cheung, A., George, U., Stewart, D. (2004). Voices of South Asian women: immigration and mental health. Women’s Health Journal. 40(4): 113-130. 10. Canadian Diabetes Association. (2006). Are you at Risk?. (link no longer available) 11. Health Canada. (2004). Type 2 Diabetes. (link no longer available) 12. Heart and Stroke Foundation. (2006). Risk Factors. Available at http://ww2.heartandstroke.ca/Page.asp?PageID=33&ArticleID=589&Src=heart&From=SubCategory 13. Anand, S., Yusuf, S., Vuksan, V., Devanesen, S., Teo, K., Montague, P., Kelemen, L., Yi, C., Lonn, E., Gerstein, H., Hegele, R., McQueen, M. (2000). Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the study of health assessment and risk in Ethnic groups. Lancet, 356, 279-284. 14. Alliance for South Asian AIDS Prevention. (1999). Discrimination and HIV/AIDS in South Asian Communities. Available at http://www.asaap.ca Websites: South Asian Partnership Canada http://www.sapcanada.org/index.html Service Coalition in the South Asian Community http://www.cassa.on.ca/SC/ Canadian Centre for South Asian Studies http://uoit.ca/sas/aboutUs.html South Asian Alliance http://www.southasianalliance.ca/home.php Alliance for South Asian AIDS Prevention http://www.asaap.ca South Asian Women’s Centre http://www.southasianwomenscentre.ca/ Canadian Centre for South Asian Studies http://www.uoit.ca/sas/ South Asian links http://uoit.ca/sas/SouthAsianLinks.html Centre for South Asian Studies – University of Toronto. http://www.sgs.utoronto.ca/sas/faculty.html (Top of Page)
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