Cardiometabolic Risk in Asian Americans by Social Determinants of Health: Serial Cross-sectional Analyses of the NHIS, 1999-2003 to 2014-2018.
J Gen Intern Med
; 38(3): 571-581, 2023 02.
Article
en En
| MEDLINE
| ID: mdl-36418646
ABSTRACT
BACKGROUND:
Diabetes and hypertension are common in Asian Americans and vary by subgroup. There may be further variation by social determinants of health (SDOHs), but few studies have examined this previously.OBJECTIVE:
To examine the associations of SDOHs and diabetes and hypertension within and across Asian subgroups in the USADESIGN:
Series cross-sectional analysesSETTING:
National Health Interview Surveys (NHIS) from 1999 to 2018PARTICIPANTS:
Asian-American adults (Chinese, Filipino, Asian Indian, and Other Asian [Korean, Vietnamese, Japanese, and other]) MEASUREMENTS Self-reported diabetes and hypertension prevalence in pooled 5-year increments over 1999-2018 and multivariable regression models to assess the adjusted prevalence of diabetes or hypertension by poverty, marital status, education, and years in the USA, adjusting for age, sex, BMI, and health insurance statusRESULTS:
From 1999-2003 to 2014-2018, the age- and sex-adjusted prevalence of diabetes increased for Other Asians (absolute change 4.6%) but not for other subgroups; age- and sex-adjusted hypertension prevalence significantly increased for Asian Indians and Other Asians (absolute change 5-7.5%). For Filipinos, high school education or less was associated with an increase in diabetes prevalence over time (difference from 1999-2003 to 2014-2018 +6.0 (95% CI 2.0-10.0)), while for Asian Indians, college education or higher was associated with an increase in diabetes prevalence for the same period (difference +2.7 (95% CI 0.01-5.4). Differences over the 2 time periods (1999-2003 and 2014-2018) show that Filipino and Other Asians, who lived in the USA for ≥10 years, increased in diabetes prevalence. Similar variations in associations of SDOHs by Asian subgroup were seen for hypertension.LIMITATIONS:
Self-reported primary outcomes and multi-year data were pooled due to small sample sizes.CONCLUSIONS:
The influence of SDOHs on cardiometabolic risk is not uniform among Asian Americans, implying tailored strategies may be needed for different population subgroups. PRIMARY FUNDING SOURCE NIH.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Asiático
/
Hipertensión
Tipo de estudio:
Etiology_studies
/
Prevalence_studies
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Risk_factors_studies
Límite:
Adult
/
Humans
Idioma:
En
Revista:
J Gen Intern Med
Asunto de la revista:
MEDICINA INTERNA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos