Abstract
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.
Highlights
Our findings show heterogeneity in the leading causes of death among Asian American subgroups
As one of the fastest growing racial/ethnic groups in the U.S, the Asian Americans population is expected to double in size from18 million in 2010 to 34 million in 2050.[1][3] Certain Asian subgroups have seen dramatic increases in population sizes since 2000, ranging from a 20% increase for Koreans to 50% increase for Asian Indians.[2]
Our current understanding of Asian American health is largely based on aggregated data [3,4,5,6], and very little is known about the individual Asian subgroups which vary in disease occurrence, immigration patterns, socioeconomic backgrounds, and dietary and cultural practices
Summary
As one of the fastest growing racial/ethnic groups in the U.S, the Asian Americans population is expected to double in size from million in 2010 to 34 million in 2050.[1][3] Certain Asian subgroups have seen dramatic increases in population sizes since 2000, ranging from a 20% increase for Koreans to 50% increase for Asian Indians.[2]. The majority of death record data available in the U.S is from California, where several studies have suggested important differences in cause-specific mortality, with Asian Indians having higher mortality due to coronary heart disease[9, 10] and Chinese and Japanese having higher stroke[10] and cancer[11]mortality. Our 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
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