Hepatitis B Team Releases Clinical Findings and Comic Book to Encourage Hepatitis B Virus (HBV) Testing

Universal childhood vaccination programs since the 1980s have successfully reduced new hepatitis B virus (HBV) infections in endemic countries by increasing immunity and protection against HBV infection.  However, approximately one-third of the world’s population has been infected and most do not know their status. An estimated 257 million people world-wide have chronic HBV infection, and may live without symptoms for decades before developing serious liver complications.

For some individuals, HBV remains inactive in the liver, but may reactivate to cause liver damage. Reactivation occurs if the immune system becomes weakened by medications commonly used to treat cancer and certain chronic diseases. HBV screening is essential to identify and counsel infected individuals about risks to their health.

At Charles B. Wang Community Health Center, over 25,000 adults, mostly foreign-born and from China, were screened with three blood tests to detect chronic or prior infection, and immunity status.  The Health Center found the following trends:

• Over half of all adults screened for HBV had either chronic (13%) or prior (38%) HBV infection.
• Adults who lived with someone with chronic HBV had the highest rates of infection: 21% with chronic HBV and 49% with prior HBV infection.
• Foreign-born adults were about 7 times more likely to have chronic or prior HBV infection compared to U.S. born adults (55% vs. 8%).
• Adults born before 1980 were significantly more likely to have chronic or prior HBV infection compared to adults born after 1980 (59% vs. 38%)

To celebrate World Hepatitis Day on July 28, 2017 and raise awareness about the importance of HBV screening in our community, the Health Center’s Hepatitis B Program and Health Education Department partnered with renowned NYC-based comic book writer, Amy Chu, and Chinatown-raised illustrator, Louie Chin, to create, “The Test”, a comic book about a nurse practitioner who encourages members of her community to get tested for HBV.  The story follows each character as they receive and interpret their test results.

The Health Center hopes this fun and new visual educational material will engage readers of all ages to better understand HBV screening results and the importance of getting their family and community members tested. Download your digital copy here.

Development of this material is made possible with a grant funded by Miranda Wong Tang.

What You Can Expect During a Breast Biopsy

If your doctor finds a breast lump or sees a suspicious area in a mammogram or sonogram, he or she may recommend that you get a breast biopsy. You might wonder, what is a breast biopsy? Biopsy is an effective way to find out if the area is cancerous.

A breast biopsy removes a suspicious area in the breast, and cells are sent to a lab for testing. It may take more than a week to get results. There are three main types of biopsy: fine needle aspiration biopsy, core needle biopsy, and surgical biopsy. Your doctor will recommend the type of biopsy based on your situation.

During a fine needle aspiration biopsy, your doctor will use a thin needle to take out a sample of cells or fluid from the suspicious area. This biopsy can be done in a clinic.

Core needle biopsy is similar to the fine needle aspiration biopsy, but with a slightly larger needle. Your doctor may use X-ray equipment, ultrasound, or MRI to find the location of the suspicious area. This biopsy can be done in a clinic where you may have local anesthesia.

In a surgical biopsy, your doctor will remove part or all of the breast lump. This is usually done in a hospital where you will be put under local or general anesthesia.

What do the results mean? If the final results come back negative, this means the cells are not cancerous, but you may need early follow-up or intervention. If the results are inconclusive, you may need another biopsy. The results could come back positive, which means the cells are cancerous. Your doctor will help you determine the next steps based on the nature of the cancer cells.

It is important to understand the need to have a biopsy does not mean you have cancer. A biopsy sample is the most accurate way to diagnose cancer cells.

Talk to your doctor about any abnormal changes you have experienced and what preventive measures are suitable for you. You can make an appointment at our OB/GYN Department by calling (212) 966-0228 (Manhattan), (718) 886-1287 (37th Avenue, Queens) and (929) 362-3006 (45th Avenue, Queens). Learn more by visiting our OB/GYN webpage.

Birth Control Methods Myths and Facts

Written by Adella Brown

As an OB/GYN health educator at Charles B. Wang Community Health Center, much of what I do is help women understand the benefits of pregnancy planning and birth control options.  When it comes to choosing a birth control method, many women are afraid of using hormonal methods or methods that need to be inserted into the body. Here are the most common myths women have brought up during our encounters, and what the facts are.

Myth: Women need to have menstrual period regularly to remove toxins from the body. It is harmful to use birth control methods that may stop one’s period.

Fact: While having regular menstrual period is an indicator of reproductive health for women, using birth control methods to stop having periods is harmless. In fact, women who have more than the average menstrual cycles in their lifetime are more likely to suffer from ovarian cancer and uterine diseases. The use of hormonal birth control methods is shown to lower risks of these diseases and relieve the symptoms of uterine fibroids and endometriosis.

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Myth: Birth control pills will lead to weight gain.

Fact: Many studies showed that birth control pills rarely cause weight gain. When weight gain does happen, it is usually due to fluid retention and goes away within 2 to 3 months, along with other side effects.

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Myth: The hormones in birth control can increase risk of getting breast cancer.

Fact: Most studies have shown that hormonal birth control use is not associated with increased risk of breast cancer. Also, women who have used these methods over many years have lowered rates of ovarian and uterine cancer. Discuss your health history with a healthcare provider to decide if hormonal birth control methods are right for you.

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Myth: Fertility awareness is effective in preventing pregnancy and has no side effects.

Fact: 12-24% of women will get pregnant in a year using fertility awareness method.  Many factors, such as stress and changes in diet or lifestyle, can change a woman’s menstrual cycle, making ovulation hard to predict. Although other birth control methods may have side effects, they are usually temporary and mild. An unplanned pregnancy will have more impact on your health and lifestyle.

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Myth: Use of IUD increases the risk of getting uterine injuries or gynecological infections.

Fact: Some types of IUD were known to have caused uterine injuries and gynecological infections. However, IUDs currently available in the U.S., such as progestin IUDs (Mirena, Skyla, and Liletta) and non-hormonal IUD (ParaGard) have been extensively tested for safety and effectiveness. Large studies have proven that modern IUDs do not cause gynecological infections.  Keep in mind that women who are at high risk of getting sexually transmitted infections (STIs) should continue to use condoms after IUD insertion.

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Myth: Getting an IUD is painful and it will feel weird inside the body.

Fact: IUD insertion is a quick procedure that usually does not require anesthesia. Some women may take pain medicine before the insertion. Some spotting and cramping are common in the first few days following the insertion. After that, most women don’t feel anything in their body. Their partners usually don’t feel the IUD either. If pain or spotting persists or worsens, see your provider for a check-up.

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Myth: Using birth control methods may lead to infertility.

Fact: All reversible birth control methods will help prevent pregnancy while you’re using them, but none have long-lasting effects on your ability to get pregnant when you stop. If a woman has difficulty getting pregnant after stopping a birth control method, it may be due to 1) an undiagnosed condition prior to the birth control use; 2) natural decrease in fertility due to older age; or 3) sexually transmitted infections such as Chlamydia and Gonorrhea that can damage the reproductive system.

Trying a new birth control method can be intimidating. Remember, you can stop using these methods if you are not satisfied or change your plan. Come talk to our health educators and providers to learn more about your options. The Charles B. Wang Community Health Center offers comprehensive, high quality primary care services at convenient locations in Manhattan and Queens. The Health Center is open seven days a week and serves all patients regardless of their ability to pay. To learn more about the Health Center’s family planning services, please call (212) 966-0228 (Manhattan), (718) 886-1287 (37th Avenue, Queens) and (929) 362-3006 (45th Avenue, Queens), or by visiting our OB/GYN webpage.

Adella Brown is a Health Educator in the OB/GYN Department at Charles B. Wang Community Health Center. One of her current roles is providing one-on-one reproductive health education. She graduated from Brigham Young University with a Bachelor’s Degree in Neuroscience. She is also a Certified Lactation Counselor and passionately promotes breastfeeding in the Chinese American community.

We Are Here to Serve Everyone – Seek Health Care When You Need It

The Charles B. Wang Community Health Center has been serving the Asian American community for more than 45 years. We want our patients and community members to know that they should not be afraid to visit their doctors. We will do our best to make sure that you have good health care, and care for you with respect and compassion.  We will never release your personal information unless we have your written approval or we are required to do so by law. Our staff is trained to keep your information private and confidential. We will not turn you away because you do not speak English, do not have a social security number, or do not have health insurance.

The Charles B. Wang Community Health Center is here to serve all New Yorkers regardless of your immigration history or ability to pay. We believe that health care is a basic right and everyone should receive care when they are in need.

Our health centers in Lower Manhattan and in Flushing, Queens are open seven days a week. Our doctors, nurses and staff care about you.  Many of them are immigrants or children of immigrants.  We speak Chinese, Korean and Vietnamese and will provide translation in other languages to make sure that we understand  your needs.  You have a right to interpretation at no cost to you.

There are other services in New York City to help you if you need health care.  These services are available to everyone:

• Emergency room care.
• Public and safety net hospitals (NYC HHC hospitals).
• Public health services such as immunizations, mental health, screening and treatment for communicable diseases such as HIV, STD and tuberculosis.
• Programs providing health services necessary to protect life and safety such as emergency medical, food or shelter, domestic violence, crime victim assistance, disaster relief.
• Emergency Medicaid including labor and delivery for pregnancy.
• Charity care at hospitals and sliding fee scale services at community health centers.
• Children’s Health Insurance Program (CHIP) coverage for children and youth.

Many services do not cost a lot of money. To learn more, please call 311 which provides information about New York City government services.  You can also ask one of our social workers.  Our staff are available to answer any questions you have and help you find the services that meet your needs.

We want to help everyone in the community to live the healthiest life possible.

Learn more about the Charles B. Wang Community Health Center at http://www.cbwchc.org.

Immigrants are America’s Past, Present, and Future

Written by Jane Eng, CEO

I grew up in an immigrant family.  My parents operated a hand laundry in Poughkeepsie, New York.  Sadly, my father passed away when I was in high school.  My mother was left with the responsibility to raise four children.  Despite the challenging circumstances, she made sure that all of her children went to college and beyond.  Today, my siblings and I are contributing members of our communities.

Jane Eng’s brother in front of Eng’s Hand Laundry.

My family’s immigration history is not unique.  People from around the world have come to this country seeking freedoms and opportunities woven into the American dream.  The first generation works hard, and many make great sacrifices to secure a better future for their children.  In doing so, immigrants contribute to the rich diversity of cultures, backgrounds, skills and experiences that makes this nation great.

In New York City, immigrants have helped revitalize neighborhoods such as Coney Island, Jackson Heights, Flushing and Sunset Park, and account for about $250 billion of economic activity annually.  About 20% of Fortune 500 companies in the United States are founded by immigrants.  Many of these firms have a strong presence in this city.

Immigrants are also playing an important role in helping New York meet its healthcare workforce gaps.  One in three physicians in New York graduated from a foreign medical school, a sign that they were born outside the United States.

Immigrants are bringing vibrancy to the cultural life of this city through food, songs, dance, music, and other performing arts.  Their economic and cultural contributions have made New York a truly international city.

Jane Eng with her mother and brother inside Eng’s Hand Laundry.

Today, I am proud to give back to immigrant communities by working at the Charles B. Wang Community Health Center.  The Health Center provides high quality primary health care to all patients regardless of language, culture, age, disability, gender, sexual orientation, immigration history, or ability to pay.  More than 85% of our patients prefer to be served in a language other than English.  I truly believe that the Health Center’s success is due to our staff’s unwavering commitment to excellence and our ability to deliver linguistically accessible and culturally effective services.

2016 Grand Opening of CBWCHC 45th Ave site in Flushing, Queens. CEO Jane Eng is 8th from left.

The Charles B. Wang Community Health Center has served a vital role in meeting the health care needs of Asian Americans and other immigrant communities for more than 45 years.  My hope is that we will continue to be a vital force in building healthy immigrant communities for many more decades to come.

Jane Eng is the chief executive officer of the Charles B. Wang Community Health Center. A graduate of Harvard Law School, Jane has been involved with the Health Center since 1975. She is a board member of the Association of Asian Pacific Community Health Organizations (AAPCHO) and Community Health Care Association of New York State (CHCANYS).

Talk to Your Doctor about Colorectal Cancer

Colorectal cancer affects men and women equally, regardless of race and ethnicity. It is most often found in people who are 50 years old or older. However, there is an increasing rate of colorectal cancer in those who are under 50, because of physical inactivity and an unhealthy diet. It is important for younger adults to start paying attention to their colorectal health.

According to Dr. Robert Andrew Heyding, a physician at the Charles B. Wang Community Health Center, “Colorectal cancer causes almost one out of every ten cancer deaths in the United States. Fortunately it can be prevented. You can lower your risk by choosing healthy habits and getting regular screening”.

It’s never too early to start living healthy. Here are some good health habits to lower the risk of developing colorectal cancer:

• Do not smoke – quit smoking and try avoid second hand smoke. Talk to your doctor about smoking cessation resources. Charles B. Wang Community Health Center has bilingual quit smoking resources, you can view those here.
• Reduce alcoholic drinks – limit to one drink a day or less.
• Eat a healthy diet – limit high fat or sugary foods, preserved foods, and red meat. Add more fruits and vegetables to your plate.
• Exercise regularly – walk, jog, swim, or dance. Strive to be active for at least 30 minutes a day, 5 days a week.
• Keep a healthy weight – talk to your family doctor about what is a healthy weight for you.

Other than having healthy habits, getting screened is very important to prevent cancer. When detected early, there are more treatment options and fewer complications. The most commonly used screening methods include:

• A Fecal Occult Blood Test (FBOT) checks for blood in stool. Blood in stool may indicate presence of diseases and a colonoscopy may be needed for a diagnosis.
• A colonoscopy is a thin, flexible tube with a small camera and light on the end is used to examine the colon. It may also have a tool to remove abnormal tissue to be checked under a microscope for signs of disease.

In general, it is recommended that men and women of average risk levels begin screening at age 50. However, some individuals may need to begin screening earlier, such as those who have family or personal history of colorectal cancer or chronic colorectal diseases, and those who are experiencing symptoms of colorectal diseases, such as persistent abdominal pain or changes in bowel habits for at least two weeks.

Discuss with your primary care doctor about when to start screening, which screening method to use, and how often you should get screened. Also speak to your doctor regarding your risk factors or anything unusual in your body. You can make an appointment to see a primary care provider here at Charles B. Wang Community Health Center by calling (212) 379-6998 for Manhattan, and (718) 886-1200 (37^th Ave) or (929) 362-3006 (45^th Ave) for Queens.

Repeal of the Affordable Care Act and Impact on Our Patients

Written by Maria Bryan

The Charles B. Wang Community Health Center knows firsthand that this country has come a long way in in expanding health insurance coverage for millions of uninsured Americans. About 20 million Americans have gained health insurance as a result of the Affordable Care Act (Obamacare) since it became law in 2010. Congress is now vowing to repeal the Affordable Care Act, which puts this advancement in danger if an appropriate replacement is not in place.

Lanying Lee was one of the first people we assisted to enroll for health insurance through the New York State of Health exchange in 2013. The exchange was set up by New York State to meet the requirements of Obamacare and help consumers shop for health insurance and apply for government subsidies.

Lanying is a petite Chinese woman who lives in Flushing, Queens with her small family. She had been a manicurist in New York City for ten years. Her husband owns a small shop that sharpens tools used in nail salons and does odd part-time work for added income. While their modest income made them ineligible for government funded health insurance, they did not earn enough to pay the high cost of private health insurance. “I read about Obamacare,” says Lee. “We were hearing a lot about it. I thought, ‘I need this.’”

According to the Department of Health and Mental Hygiene, two in ten Asian American residents of New York City were uninsured prior to the implementation of the New York State of Health initiative under the Affordable Care Act. For Lanying Lee, Obamacare could not have arrived soon enough. “We did not have health insurance for three years. We are getting older, and we want to take care of our health. We have specialist doctors to go to and general check-ups that we should have regularly. We were not going to the doctors because we could not pay. Having insurance has made such a difference for us. We are going to the doctors on schedule, and we are staying healthy. Obamacare is what we needed. It has been a bumpy ride to enroll, but it was worth it. We are very happy.”

Since the NY State of Health exchange was implemented, the percentage of uninsured New Yorkers was reduced by half. Having health insurance means that patients are able to maintain regular check-ups and preventative care, where they otherwise might forgo care or resort to going to an emergency room.  Many plans under the Obamacare provide free preventative care and well-woman visits, and reduced costs on prescription drugs.

On January 4^th, 2017, NY Governor Cuomo stated his concern for the repeal of the Affordable Care Act without a replacement in place. The repeal of the Affordable Care Act may result in over 2.7 million New Yorkers losing their health coverage.  “Since its implementation, the Affordable Care Act has become a powerful tool to lower the cost of health insurance for local governments and New Yorkers, and it is essential that the federal government does not jeopardize the health and livelihoods of millions of working families,” Governor Cuomo said.

We believe that patients like Lanying Lee may suffer great harm if they lose their health insurance. We implore our members of congress to not repeal the Affordable Care Act without a replacement in place.

*Name of client has been changed

Read our thoughts on the Repeal of the Affordable Care Act and Impact on Community Health Centers