Key result
Disaggregation of Asian-American ethnic groups revealed 16 and >22 percentage point differences between the lowest and highest prevalence of diabetes and hypertension, respectively, demonstrating that aggregated data masks meaningful health disparities.
Why the study?
Few large cohort studies have examined the prevalence of diabetes, hypertension, coronary artery disease, obesity, and smoking among major Asian-American ethnic groups and Native Hawaiian/Pacific Islanders.
Cohort (n=1,400,000)
Reporting cardiovascular risk factors for an aggregated Asian-American racial group masks substantial and clinically meaningful differences among specific Asian ethnic subgroups.
Answers are grounded in this paper and cite their sources.
May support disaggregated ethnicity reporting to unmask Asian subgroup disparities; hypothesis-generating for targeted interventions.
BACKGROUND: Few large cohort studies have examined the prevalence of diabetes mellitus (DM), hypertension (HTN), coronary artery disease (CAD), obesity, and smoking among middle-aged and older adults in the major Asian-American ethnic groups and Native Hawaiian/Pacific Islanders (PIs). The aim of this study was to evaluate how prevalence of these conditions and risk factors differs across Asian-American and PI ethnic groups and compares with an aggregated All Asian-American racial group. METHODS: This study used a cohort of 1.4 million adults aged 45 to 84 who were Kaiser Permanente Northern California health plan members during 2016. The cohort included approximately 274,910 Asian-Americans (Chinese, Filipino, Japanese, Korean, Southeast Asian, South Asian, other), 8450 PIs, 795,080 non-Hispanic whites, 107,200 blacks, and 210,050 Latinos. We used electronic health record data to produce age-standardized prevalence estimates of DM, HTN, CAD, obesity (using standard and Asian thresholds), and smoking for men and women in all racial/ethnic subgroups and compared these subgroups to an aggregated All Asian-American racial group and to whites, blacks, and Latinos. RESULTS: threshold) ranged from 14 to 39% among women and 21 to 45% among men. Prevalence of smoking ranged from 1 to 4% among women and 5 to 14% among men. Across all conditions and risk factors, prevalence estimates for Asian-American and PI ethnic groups significantly differed from those for the All Asian-American group. In general, Filipinos and PIs had greater health burden than All Asians, with prevalence estimates approaching those of blacks. CONCLUSIONS: In a population of middle-aged and older adult Northern California health plan members, we found substantive differences in prevalence of chronic cardiovascular conditions, obesity, and smoking across Asian-American ethnic groups and between Asian-American ethnic groups and an aggregated All Asian racial group. Our study confirms that reporting statistics for an aggregated Asian-American racial group masks meaningful differences in Asian-American ethnic group health.
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Gordon et al. (2019) conducted a cohort in Cardiovascular conditions, obesity, and smoking (n=1,400,000). Disaggregated Asian-American ethnic subgroup classification vs. Aggregated All Asian-American classification was evaluated on Age-standardized prevalence of diabetes mellitus, hypertension, coronary artery disease, obesity, and smoking. Disaggregation of Asian-American ethnic groups revealed 16 and >22 percentage point differences between the lowest and highest prevalence of diabetes and hypertension, respectively, demonstrating that aggregated data masks meaningful health disparities.
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