Dataset Information

Years of Potential Life Lost Because of Cardiovascular Disease in Asian-American Subgroups, 2003-2012.

ABSTRACT: Background Asian-American subgroups (Asian-Indian, Chinese, Filipino, Korean, Japanese, and Vietnamese) display varied cardiovascular disease mortality patterns, especially at younger ages. This study aims to examine the years of potential life lost because of ischemic heart disease and cerebrovascular disease among the 6 largest Asian-American subgroups compared with non-Hispanic whites. Methods and Results We used National Center for Health Statistics Multiple Causes of Death mortality files from 2003 to 2012 to calculate race-specific life expectancy, mean years of potential life lost, and years of potential life lost per 100 000 population for each Asian subgroup and non-Hispanic whites. Asian-American subgroups display heterogeneity in cardiovascular disease burden. Asian-Indians had a high burden of ischemic heart disease; Asian-Indian men lost 724 years per 100 000 population in 2012 and a mean of 17 years to ischemic heart disease. Respectively, Vietnamese and Filipino men and women lost a mean of 17 and 16 years of life to cerebrovascular disease; Filipino men lost 352 years per 100 000 population in 2012. All Asian subgroups for both sexes had higher years of life lost to cerebrovascular disease compared with non-Hispanic whites. Conclusions Cardiovascular disease burden varies among Asian subgroups, and contributes to greater premature mortality in certain subgroups. Asian-Indian and Filipino populations have the highest years of life lost because of ischemic heart disease and Filipino and Vietnamese have the highest years of life lost because of cerebrovascular disease. Analysis of risk factors and development of subgroup-specific interventions are required to address these health disparities.

SUBMITTER: Iyer DG

PROVIDER: S-EPMC6509739 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Years of Potential Life Lost Because of Cardiovascular Disease in Asian-American Subgroups, 2003-2012.

Iyer Divya G DG Shah Nilay S NS Hastings Katherine G KG Hu Jiaqi J Rodriguez Fatima F Boothroyd Derek B DB Krishnan Aruna V AV Falasinnu Titilola T Palaniappan Latha L

Journal of the American Heart Association 20190401 7

Background Asian-American subgroups (Asian-Indian, Chinese, Filipino, Korean, Japanese, and Vietnamese) display varied cardiovascular disease mortality patterns, especially at younger ages. This study aims to examine the years of potential life lost because of ischemic heart disease and cerebrovascular disease among the 6 largest Asian-American subgroups compared with non-Hispanic whites. Methods and Results We used National Center for Health Statistics Multiple Causes of Death mortality files f ...[more]

PMID: 30890022

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Project description:BackgroundOur current understanding of Asian American mortality patterns has been distorted by the historical aggregation of diverse Asian subgroups on death certificates, masking important differences in the leading causes of death across subgroups. In this analysis, we aim to fill an important knowledge gap in Asian American health by reporting leading causes of mortality by disaggregated Asian American subgroups.Methods and findingsWe examined national mortality records for the six largest Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) and non-Hispanic Whites (NHWs) from 2003-2011, and ranked the leading causes of death. We calculated all-cause and cause-specific age-adjusted rates, temporal trends with annual percent changes, and rate ratios by race/ethnicity and sex. Rankings revealed that as an aggregated group, cancer was the leading cause of death for Asian Americans. When disaggregated, there was notable heterogeneity. Among women, cancer was the leading cause of death for every group except Asian Indians. In men, cancer was the leading cause of death among Chinese, Korean, and Vietnamese men, while heart disease was the leading cause of death among Asian Indians, Filipino and Japanese men. The proportion of death due to heart disease for Asian Indian males was nearly double that of cancer (31% vs. 18%). Temporal trends showed increased mortality of cancer and diabetes in Asian Indians and Vietnamese; increased stroke mortality in Asian Indians; increased suicide mortality in Koreans; and increased mortality from Alzheimer's disease for all racial/ethnic groups from 2003-2011. All-cause rate ratios revealed that overall mortality is lower in Asian Americans compared to NHWs.ConclusionsOur findings show heterogeneity in the leading causes of death among Asian American subgroups. Additional research should focus on culturally competent and cost-effective approaches to prevent and treat specific diseases among these growing diverse populations.

Project description:This cross-sectional study aims to better understand the heterogeneous associations of acculturation level on CV risk factors among disaggregated Asian subgroups. We hypothesize that the association between acculturation level and CV risk factors will differ significantly by Asian subgroup. We used the National Health Interview Survey (NHIS), a nationally representative US survey, years 2014-18. Acculturation was defined using: (a) years in the US, (b) US citizenship status, and (c) level of English proficiency. We created an acculturation index, categorized into low vs. high (scores of 0-3 and 4, respectively). Self-reported CV risk factors included diabetes, high cholesterol, hypertension, obesity, tobacco use, and sufficient physical activity. Rao-Scott Chi Square was used to compare age-standardized, weighted prevalence of CV risk factors between Asian subgroups. We used logistic regression analysis to assess associations between acculturation and CV risk factors, stratified by Asian subgroup. The study sample consisted of 6,051 adults ≥ 18 years of age (53.9% female; mean age 46.6 [SE 0.33]). The distribution by race/ethnicity was Asian Indian 26.9%, Chinese 22.8%, Filipino 18.1%, and other Asian 32.3%. The association between acculturation and CV risk factors differed by Asian subgroups. From multivariable adjusted models, high vs. low acculturation was associated with: high cholesterol amongst Asian Indian (OR=1.57, 95% CI: 1.11, 2.37) and other Asian (OR=1.48, 95% CI: 1.10, 2.01) adults, obesity amongst Filipino adults (OR= 1.62, 95% CI: 1.07, 2.45), and sufficient physical activity amongst Chinese (OR= 1.54, 95% CI: 1.09, 2.19) and Filipino adults (OR=1.58, 95% CI: 1.10, 2.27). This study demonstrates that acculturation is heterogeneously associated with higher prevalence of CV risk factors among Asian subgroups. More studies are needed to better understand these differences that can help to inform targeted, culturally specific interventions.

Project description:Background and objectiveTo date, the impact of the COVID-19 pandemic on life expectancy for the Asian American (AA) population has been reported in aggregate. This study provides estimates of life expectancy at birth before and during the pandemic, with a set of demographic, health, and socioeconomic risk factors for the four largest subgroups: Asian Indians, Chinese, Filipinos, and Vietnamese. These estimates are placed in context of the broader U.S. population.MethodsThis study uses age-specific all-cause mortality from CDC WONDER and population counts from the American Community Surveys. We apply methodologies to address variability in population sizes over time (smoothing) and data quality issues at older ages (Brass relational model life table system) to produce three sets of sex-specific life expectancy estimates by subgroup for 2019, 2020, and 2021.ResultsAlmost all estimates show that the four AA subgroups experienced greater losses between 2019 and 2020 than Whites. These losses ranged from 1.1 to 3.9 years, with the largest drops among Chinese women (2.0-2.4) and Filipino men (3.5-3.9). Under all scenarios, losses in life expectancy were considerably smaller in 2021 than in 2020 among the four subgroups - with several subgroups experiencing a modest rebound - but these improvements did not compensate for the large increases in death rates in 2020. Filipino men had the largest decline in life expectancy from 2019 to 2021 among the four subgroups (3.4-4.2 years), and Vietnamese men and women experienced large losses which continued into the second year of the pandemic.ConclusionsDespite high pre-pandemic life expectancies, AAs suffered a large, and rarely acknowledged, increase in mortality during the pandemic, with substantial heterogeneity across subgroups and between women and men. This variability is due in part to the pronounced differences in risk factors for infection and severity which have been documented within the AA population.

Dataset Information

Years of Potential Life Lost Because of Cardiovascular Disease in Asian-American Subgroups, 2003-2012.

Publications

Years of Potential Life Lost Because of Cardiovascular Disease in Asian-American Subgroups, 2003-2012.

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