Social factors may inform CV risk assessment for certain Asian American subgroups
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Key takeaways:
- Social determinants of health may have disparate effects on CV risk factors for different Asian American subgroups.
- Understanding how social factors affect risk for specific subgroups may improve their CV care.
The impact of social determinants of health on cardiovascular risk factors may vary across Asian American subgroups such as Filipino, Asian Indian, Chinese and other Asian populations, researchers reported.
“Despite the perception that Asian Americans may be less impacted by social determinants of health compared to people in other racial/ethnic groups, our findings indicate unfavorable social factors are associated with higher prevalence of cardiovascular risk factors among Asian American adults,” Eugene Yang, MD, a professor of medicine at the University of Washington School of Medicine in Seattle, said in a press release. “People of South Asian heritage have higher rates of premature heart disease globally, and they recently have been found to have higher cardiovascular mortality than non-Hispanic white people. Better understanding of why differences in cardiovascular risk exist among Asian subgroups is vital to reducing risk and improving outcomes.”
To evaluate the association between social determinants of health (SDOH) and CV risk factors among Asian Americans, Yang and colleagues used data from the nationally representative National Health Interview Survey from 2013 to 2018.
With 27 SDOH variables — including categories of economic stability, neighborhood and social cohesion, food security, education and health care utilization — each unfavorable variable added 1 point to overall scores.
CV risk factors of interest included self-reported diabetes, high cholesterol, high BP, obesity, insufficient physical activity, suboptimal sleep and nicotine exposure.
Their findings were published in the Journal of the American Heart Association.
Overall, the study included 6,395 Asian American adults, of which 22.1% self-identified as Filipino, 21.6% as Asian Indian, 21% as Chinese and 35.3% as other Asian (56% women; 77% foreign-born; 52% aged 18-44 years; 16% aged 65 years).
Yang and colleagues reported that every 2.8 point (1 standard deviation) increase in SDOH was associated with higher odds of:
- diabetes among Chinese (OR = 1.45; 95% CI, 1.04-2.03) and Filipino adults (OR = 1.24; 95% CI, 1.02-1.51);
- high BP among Filipino adults (OR = 1.28; 95% CI, 1.03-1.6);
- insufficient physical activity among Asian Indian (OR = 1.42; 95% CI, 1.22-1.65), Chinese (OR = 1.58; 95% CI, 1.33-1.88) and Filipino adults (OR = 1.24; 95% CI, 1.06-1.46);
- suboptimal sleep among Asian Indian adults (OR = 1.2; 95% CI, 1.01-1.42); and
- nicotine exposure among Chinese (OR = 1.56; 95% CI, 1.15-2.11) and Filipino adults (OR = 1.5; 95% CI, 1.14-1.97).
“It is important to understand how different Asian subgroups are affected,” Yang said in the release. “When Asian people are lumped together, higher risk groups like South Asian people may not be treated aggressively enough, while groups with lower risk, like people of Korean and Japanese descent, may be overtreated for blood pressure or cholesterol.”
Reference:
- Unfavorable social factors may raise heart disease risk factors in Asian American adults. https://newsroom.heart.org/news/unfavorable-social-factors-may-raise-heart-disease-risk-factors-in-asian-american-adults. Published April 3, 2024. Accessed April 3, 2024.
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