New research suggests that South Asians are the most unsatisfied with the health care in the United States.

Researchers at the University of Missouri found that this dissatisfaction with health care partly is caused by health practices in the United States clashing with the practices Asian patients and families may be more used to experiencing overseas. Health care providers perceive South Asians to be more reluctant than other ethnicities to report pain as well as seek medications to treat the pain they experience near the end of their lives.

"In future years, health care workers in the United States will provide care to an increasingly diverse group of patients that will include growing numbers of South Asians," Karla Washington, co-author of the study, said in a statement. "It is important to understand the cultural differences in medical practice in South Asia, such as their low use of pain medication, so that health care providers here can better understand the factors that influence their patients' attitudes toward pain medicines."

For the study, researchers conducted focus groups and individual interviews with health care professionals who had experience providing care to seriously ill South Asian patients and their families. Health care providers said South Asian patients had minimalistic attitudes toward medication in general. Further, South Asians may have prior experiences having limited access to pain medication overseas.

"Doctors in South Asia do not routinely ask patients about their pain like they do here," said researcher Nidhi Khosla said. "In South Asian culture, it is common for patients not to report their pain to avoid burdening others or being seen as weak."

Researchers said the findings, which are detailed in the American Journal of Hospice and Palliative Medicine, provides an opportunity for health care professionals to deliver better culturally responsive care to South Asian patients and their families.