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This “Screen at 23” national campaign webpage was made possible through the generous support of Medtronic.

The National "Screen at 23" Campaign

The Asian American Diabetes Initiative (AADI) at Joslin Diabetes Center, (affiliated with Harvard Medical School) is a founding partner of the Asian American Native Hawaiian Pacific Islander Diabetes Coalition (AANHPI DC). The AADI conducts and publishes some of the leading research on diabetes among AANHPI populations, including the foundational studies that led to the formation of the "Screen at 23" campaign. The AADI is proud to be leading the national “Screen at 23" campaign together with the National Council of Asian Pacific Islander Physicians (NCAPIP), the campaign organizer, and members of the AANHPI DC.

Asian Americans are at risk for Type 2 Diabetes at a lower Body Mass Index (BMI)

The general rule has been that if you have a body mass index below 25, you aren't at risk for diabetes. Research on Asian Americans, however, proves different. The American Diabetes Association (ADA), National Institutes of Health (NIH), and the Centers for Disease Control (CDC) have all acknowledged that Asian Americans should be screened for diabetes at a lower BMI, and 23 is that number.

This does NOT mean that a BMI of 23 is a new definition of “overweight” or “obesity” for Asian Americans. It is a number to look out for, so we can think about making healthy changes to our diet or lifestyle, or talk to our healthcare providers.

More than half of Asian Americans with type 2 diabetes, and even more with prediabetes, are undiagnosed; there isn't enough awareness among patients and providers of this appropriate guideline. To treat, intervene, and even prevent diabetes, we need to first ensure that it is revealed. That means making doctors and patients aware that a BMI of 23 is a risk factor to consider for screening diabetes in an Asian American patient.

Equitable testing would reveal hundreds of thousands of cases of prediabetes and diabetes among Asian Americans, allowing them to get the treatment or intervention they need to live healthier, happier lives.

The national “Screen at 23” campaign is to get every Asian American adult with a BMI of 23 or higher to be screened for diabetes. The goal of the campaign is to unmask diabetes and prediabetes in Asian Americans, so it can be treated, intervened, and even be prevented.

Check out the Tools and Resources section and join us in promoting the national “Screen at 23” campaign!

Tools and Resources

About Screen at 23

Asian BMI Resources

Diabetes Resources

Cities and States that have passed "Screen at 23" Resolutions

San Francisco (2015), the first city and county to "Screen at 23"

From the San Francisco Department of Public Health press statement:
[October 21, 2015] the San Francisco Department of Health, the San Francisco Health Commission voted unanimously to support a campaign to unmask the hundreds of thousands of hidden cases of diabetes among Asian Americans. Organized by the National Council of Asian Pacific Islander Physicians (NCAPIP) in partnership with the Asian American, Native Hawaiian, and Pacific Islander Diabetes Coalition, the campaign's goal is to screen Asian Americans with a body mass index of 23 for type 2 diabetes. The passing of the resolution makes San Francisco the first city and county to encourage the adoption of these appropriate screening guidelines throughout its citywide healthcare system. To view the resolution Click Here.

Hawaii (2016)

Hawaii became the first state to "Screen at 23" on March 22, 2016. The Hawaii State Legislature voted to pass Joint Resolution S.R. 23. In Hawaii, where close to half of the population is of Asian American descent, screening at 23 would reveal more than 10,000 additional cases of diabetes and more than 30,000 new cases of prediabetes and allow treatment to begin, interventions occur before damaging associated conditions develop or worsen, or make diabetes prevention possible. To view the resolution Click Here.

California (2016)

California followed the San Francisco and Hawaii resolutions, passing its own Screen at 23 resolution, SCR 134 by State Senator Dr. Richard Pan, on September 9, 2016. Screening at 23 in California would reveal close to 70,000 additional cases of type 2 diabetes in Asian Americans, and many more cases of prediabetes. To view the resolution Click Here.

Massachusetts (2018)

On January 25, 2018, the Commonwealth of Massachusetts passed a Joint Resolution to Screen at 23. Screening at 23 in Massachusetts would reveal over 6,000 additional cases of type 2 diabetes in Asian Americans. To view the resolution Click Here.

Read the interview with Dr. George King Here.

Illinois (2018)

Illinois passed its Screen at 23 Resolution on November 28, 2018 to step up efforts in identifying over 9,000 Asian Americans in the state with diabetes, and many more with prediabetes. To view the resolution Click Here.

Washington (2019)

Washington State passed its Screen at 23 Resolution on April 27, 2019. To view the resolution Click Here.

Cooperating Organizations and Individuals

Background

In 2011, National Council of Asian Pacific Islander Physicians (NCAPIP) organized a diabetes symposium in Hawaii with the support of the American Diabetes Association (ADA) and Joslin Diabetes Center. This led to the formation of the AANHPI Diabetes Coalition (AANHPI DC), a coalition of organizations and individuals dedicated to alleviating and eliminating the diabetes disparities in AANHPI communities. NCAPIP has coordinated the Coalition since 2011, pushed the Coalition's agenda forward, and created the "Screen at 23" campaign to raise awareness of the need to screen Asian Americans for diabetes at a lower body mass index.

Leaders within the AANHPI Diabetes Coalition (AANHPI DC) are some of the foremost experts in diabetes research among AANHPI, and their research has been the foundation that the ADA guidelines are based on. The "Screen at 23" campaign is a reflection of their work.

Here is the list of organizations and individuals supporting and promoting the national “Screen at 23” campaign. Contact AADI and join the AANHPI Diabetes Coalition to push “Screen at 23” in your network / community!

Campaign Organizer

The National Council of Asian Pacific Islander Physicians (NCAPIP) is a nonprofit organization of physicians working towards eliminating health disparities in Asian American, Native Hawaiian, and Pacific Islander (AANHPI) patients. NCAPIP members are comprised of leaders in national, state, and local physician organizations and medical groups. They are physicians practicing across a wide variety of settings from small and solo private practices, medical groups, community health centers, private and public hospitals, academic health centers, and state and local health departments. Their experience across all levels of medicine, care, and knowledge of the population makes NCAPIP an organization uniquely capable to advocate for the health of AANHPIs. NCAPIP acts as a bridge between physicians, patients, and health policy makers.

Partner Organizations

The American Diabetes Association (ADA) is the world's largest organization dedicated to eliminating diabetes. In January 2015, the Association changed its Standards of Medical Care in Diabetes to reflect the need to screen Asian Americans at a body mass index of 23. The Association has focused on diabetes among minority populations through efforts such as our Diabetes Disparities Action Councils which focuses on advocating for the needs of higher risk communities, and in 2011 helped form the AANHPI Diabetes Coalition to push forward initiatives focused on diabetes in AANHPIs. The Association has provided guidance and crucial funding support to the AANHPI Diabetes Coalition. The Association is committed to addressing diabetes disparities and advocating for health equity.

Chinese American Medical Society (CAMS) is a non-profit, charitable, educational, and scientific organization committed to education and community service. Established in 1963, it is the oldest and now one of the largest and most successful national Chinese American medical societies in North America with regional chapters in Boston and Albany and over 1,300 members. The officers and the trustees of the governing board are leading physicians in the New York metropolitan area who volunteer their services to CAMS.

NYU Center for the study of Asian American Health was established in 2003 through an NIH NIMHD Project EXPORT (Excellence in Partnership, Outreach, Research, and Training) Center grant, CSAAH is committed to understanding, addressing, and reducing Asian American, Native Hawaiian, and Pacific Islander (AA and NH/PI) health disparities through rigorous, transdisciplinary, and community-engaged research.

NYU Langone Health is one of the nation’s premier academic medical centers. Our trifold mission to serve, teach, and discover is achieved daily through an integrated academic culture devoted to excellence in patient care, education, and research.

Individual Supporters

  • Alice Chen, MD, Chief Medical Officer, San Francisco Health Network
  • Angela Sun, PhD, Executive Director, Chinese Community Health Resource Center (CCHRC)
  • Ben Lui, MD, Medical Director, Chinatown Public Health Center
  • Brenda Yee, CEO, Chinese Community Health Plan (CCHP)
  • Christopher Kang, National Director, National Council of Asian Pacific Americans
  • Diana Lau, PhD, Executive Director, Asian Heart Institute at UCSF
  • Ninh Tran, MD
  • Edward A. Chow, MD, Co-Chair AANHPI Diabetes Coalition
  • Edwin Chandrasekar, PhD, Executive Director, Asian Health Coalition of Illinois (AHCI)
  • Elisa Choi, MD, FACP Chairperson, Commonwealth of MA Asian American Commission
  • George King, MD, Research Director, Co-Chair AANHPI Diabetes Coalition, Joslin Diabetes Center
  • George Liu, MD, Chairman of the board, Chinese American Independent Provider Association (CAIPA)
  • Gregory Lam, MD, National Physicians Alliance
  • Happy Araneta, PhD, Professor of Epidemiology UCSD, Principle Investigator Filipino Health Study
  • Ho L. Tran, MD, MPH, President and CEO, National Council of Asian Pacific Islander Physicians (NCAPIP)
  • Jeffrey Caballero, Executive Director, AAPCHO
  • Jiun-Ruey Hu, President, APAMSA - Asian Pacific American Medical Students Association
  • John Williams, PharmD, CEO, Chinese Community Health Care Association (CCHCA)
  • Jose Powell, MD, Sutter Health
  • Josh Green, MD, Executive Director, HI Independent Provider Association (HI IPA)
  • Julieta Gabiola, MD, Clinical Associate Professor of Medicine, Stanford University
  • Kathy Ko Chin, President and CEO, Asian Pacific Islander American Health Forum (APIAHF)
  • Kenneth Sim, MD, Chairman, Allied Pacific IPA
  • Kent Woo, Executive Director, NICOS Chinese Health Coalition SF, CA
  • Lawrence Ng, MD, Chairman of the board, Chinese American Medical Society of Oakland CA
  • Lloyd Asato, Executive Director, American Pacific Community in Action (APCA) AZ
  • Manju Sankarappa, Executive Director, The Ohio Asian American Health Coalition
  • Mele Look, Director of Community Engagement, University of Hawaii, Medical School, Dept Native Hawaiian Health
  • Moon Chen, PhD, Founding Primary Investigator, Asian American Network for Cancer, Awareness, Research, and Training (AANCART)
  • Myat Myat Mon, MD, FACS Chair, Board of Directors, The Myanmar American Medical Education Society, Inc.
  • Nia Aitaoto, PhD, Co-Director, Center for Pacific Islander Health at UAMS
  • Paul Lee, MD, President, Chinese American Medical Society (CAMS) New York
  • Peter Bretan, MD, President, Philippine Medical Society of Northern California
  • Roger Eng, MD, President, San Francisco Medical Society
  • Rudy Asercion, CEO, NaFFAA Region 8, Pacific
  • Samuel So, Executive director, Asian Liver Center at Stanford University
  • San Francisco Health Commission, San Francisco Department of Public Health
  • Shereen Arent, Chief Advocacy Officer, American Diabetes Association (ADA)
  • Son Tuong Do, MD, Chair Emeritus, Vietnamese American Medical Association
  • Steven Larson, MD, MPH, President, California Medical Association
  • Stuart Fong, community health outreach, Chinese Hospital
  • Tana Lepule, Executive Director, EPIC
  • Tung Nguyen, MD, Director & Chair of the WHIAAHPI Commission, Asian American Research Center on Health (ARCH), UCSF
  • Uyen Luong, Patient
  • Viviene Bucsit, Director of Programs & Operations, Skinny Gene Project
  • Warren Chin, MD, Chairman, Federation of Chinese American and Chinese Canadian Medical Societies (FCMS)
  • Weylin Eng, MD, Founder/Optometrist, Orinda Optometry Group
  • William Chiong, MD, Chairman of the board, US Burma Medical Society (USBMS)

Publications and Media Coverage

ADA Standards Of Medical Care In Diabetes - 2015 Abridged For Primary Care Providers Published by the American Diabetes Association (ADA) in 2015. The revised standards, based on scientific evidence, highlight a Body Mass Index (BMI) of 23 as a risk factor for diabetes among Asian Americans.

Hsia DS, Larrivee S, Cefalu WT, Johnson WD. Impact of Lowering BMI Cut Points as Recommended in the Revised American Diabetes Association Standards of Medical Care in Diabetesd2015 on Diabetes Screening in Asian Americans. Diabetes Care. 2015;38(11)2166-68

Araneta MRG, Kanaya AM, Hsu WC, Chang HK, Grandinetti A, Boyko EJ, Hayashi T, Kahn SE, Leonetti DL, McNeely MJ et al. Optimum BMI Cut Points to Screen Asian Americans for Type 2 Diabetes. Diabetes Care. 2015;38(5):814-20.

Hsu WC, Araneta MRG, Kanaya AM, Chiang JL, Fujimoto W. BMI Cut Points to Identify At-Risk Asian Americans for Type 2 Diabetes Screening. Diabetes Care. 2015;38(1):150-8.

Hsu WC, Boyko EJ, Fujimoto WY, Kanaya A, Karmally W, Karter A, King GL, Look M, Maskarinec G, Misra R et al. Pathophysiologic Differences Among Asians, Native Hawaiians, and Other Pacific Islanders and Treatment Implications. Diabetes Care. 2012;35(5):1189-98.

King GL, McNeely MJ, Thorpe LE, Mau MLM, Ko J, Liu LL, Sun A, Hsu WC, Chow EA. Understanding and Addressing Unique Needs of Diabetes in Asian Americans, Native Hawaiians, and Pacific Islanders. Diabetes Care. 2012;35(5):1181-8.

Where Diabetes Is Concerned, Hawaii Isn't THAT Healthy

12/16/05 in West Hawaii Today, Dr. Wilfred Fujimoto, a pioneer researcher in diabetes among Asian Americans and a founding member of the AANHPI Diabetes Coalition, wrote that while Hawaii was just ranked "the healthiest state in the US" – including low overall obesity rates – that assertion is based on obesity data that "may be wrong", especially as applied to Asians who comprise over 50% of Hawaii's population.

"Asians have the lowest prevalence of obesity yet have higher prevalence of diabetes than blacks, whites and Hispanics," wrote Dr. Fujimoto. "Health care providers must be vigilant about undiagnosed diabetes when they are faced with an Asian patient and remember that they should "Screen at 23."

Los Angeles Physicians And Congresswoman Chu: Screen At 23!

On Saturday, November 14th 2015, Congresswoman Judy Chu, Dr. George King, and Dr. Ho Tran presented and gave remarks around the Screen at 23 campaign to members of Allied Pacific Independent Practitioners Association. "I urge the AAPI community to encourage family members, friends, and loved ones to get screened and be on alert for BMI number 23," Representative Chu announced. To see the press release, Click Here.