How social determinants affect cardiovascular risk factors among Asian Americans

Asian Americans are the second largest immigrant group in the United States (U.S.) after Latinos, but little is known about cardiovascular risk factors for this population and how social determinants such as nativity status and education pattern risk in the U.S. context. Using the National Health and Nutrition Examination Survey (2011-2014), the study examined prevalence of Type II diabetes, smoking and obesity for Asian Americans (n = 1363) and non-Latino Whites (n = 4121). Diabetes and obesity prevalence (applying Asian-specific BMI cut points) were higher among Asian Americans when compared to non-Latino Whites but smoking prevalence was lower. These patterns remained in fully adjusted models and showed small increases with longer duration in the U.S. among foreign-born Asian Americans. Models that tested for interaction (joint effects) showed higher odds of prevalent Type II diabetes and obesity (Asian-specific BMI) for foreign-born Asians, regardless of years in the U.S. and slightly higher risk for low education, when compared to non-Latino Whites with high education.

The study indicates the urgent need to address diabetes and obesity risk in Asian Americans and suggests that social as well as clinical factors should be considered when developing interventions. Dr. Echeverria explains, “Our paper highlights the urgent need to address diabetes and obesity risk in Asian Americans. The study also provides new data on the salience of social contexts, such as immigrant status, in shaping diabetes risk for this population. It is becoming increasingly clear that the health of immigrants is the health of the nation, as Asian Americans and other immigrant groups represent the fastest growing segment of the United States. Innovative, socially and culturally responsive public health initiatives are needed to meet the health needs of immigrants and achieve the nation’s goals of health for all.”

Echeverria SE, Mustafa M, Pentakota SR, et al. Social and clinically-relevant cardiovascular risk factors in Asian Americans adults: NHANES 20112014. Preventive Medicine. 2017. doi:10.1016/j.ypmed.2017.02.016.