Abstract 12190: Cardiovascular Disease Mortality Trends Among Native Hawaiian and Pacific Islander Adults—United States, 2018 to 2022

Abstract

Introduction: Native Hawaiian and Pacific Islander (NHPI) adults have historically been grouped with Asian adults in US mortality surveillance, potentially masking important differences between these two populations. In 2018, US death certificate race categories were modified, enabling the disaggregation of NHPI national CVD mortality surveillance data from the Asian population. Methods: Using National Vital Statistics System mortality data from 2018 to 2022, we identified CVD deaths among adults aged ≥35 years with ICD-10 codes I00-I99 listed as the underlying cause of death. Of all CVD decedents with non-Hispanic origin and NHPI listed alone or in combination with other race groups on the death certificate, we classified those with NHPI listed as the only race group as NHPI (60.1%). Rate ratios (RR) and 95% confidence intervals (CI) compared age-standardized mortality rates (ASMR) among NHPI adults compared to non-Hispanic Asian adults and US adults overall. Results: From 2018 to 2022, 6,088 CVD deaths (72.0% heart disease, 19.8% stroke) occurred among NHPI adults of Hawaiian (24.5%), Samoan (24.3%), Guamanian (11.0%), or other Pacific Islander (40.2%) descent. The NHPI ASMR was 464.5 CVD deaths per 100,000 (95% CI: 452.4-476.6), second only to the non-Hispanic Black ASMR (590.3 CVD deaths per 100,000, CI: 588.7-591.8; Figure). The ASMR among NHPI adults was significantly higher than non-Hispanic Asian adults (RR: 1.86, CI: 1.81-1.91) and US adults overall (RR: 1.07, 95% CI: 1.04-1.10). Conclusions: Single-race NHPI adults had the second-highest CVD death rate in the US from 2018 to 2022, second only to Black adults, and significantly higher than Asian adults. Surveillance using broader multi-race definitions to identify the NHPI population, further disaggregate by NHPI subgroup, and explore geographic variation is needed to better understand potential health disparities and target interventions to reduce CVD mortality disparities among NHPI adults.