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Abstract
BackgroundIn the U.S., the prevalence of diabetes and hypertension are higher among African American/Black (Black), Latinx, and Filipino adults than non-Hispanic White (White) and Chinese adults. We compared the racial/ethnic-specific prevalence of several modifiable cardiometabolic risks in an insured adult population to identify behaviors that may drive racial/ethnic differences in cardiometabolic health.MethodsThis cross-sectional study used data for middle-aged (35–64) and older (65–79) Kaiser Permanente Northern California (KPNC) adult health plan members. Smoking status and BMI were derived from electronic health record data. Weighted pooled self-reported data from the 2014/2015 and 2017 KPNC Member Health Survey cycles were used to estimate daily number of servings of fruits/vegetables, general sodium avoidance, sugar-sweetened beverage (SSB) consumption frequency, alcohol use within daily recommended limit, weekly exercise frequency, and number of hours of sleep daily. Age-standardized estimates of all cardiometabolic risks were produced for middle-aged and older-aged women and men in the five racial/ethnic groups. Analyses focused on racial/ethnic differences within age-gender groups and gender and age group differences within racial/ethnic groups.ResultsIn both age groups, Black, Latinx, and Filipino adults were more likely than White and Chinese adults to have overweight and obesity and were less likely to engage in health promoting dietary (fruit/vegetable and SSB consumption, sodium avoidance (women only)) and sleep behaviors. Middle-aged Black and Filipino men were more likely than White men to be current smokers. Less racial/ethnic variation was seen in exercise frequency. Significant gender differences were observed for dietary behaviors overall and within racial/ethnic groups, especially among middle-aged adults; however, these gender differences were smaller for sleep and exercise. Age differences within gender and racial/ethnic groups were less consistent. Racial/ethnic and gender differences in these behaviors were also seen in the subsample of adults with diabetes and/or hypertension and in the subsample of adults who reported they were trying to engage in health promoting behaviors.ConclusionsBlack, Latinx, and Filipino adults were more likely than White and Chinese adults to report dietary and sleep behaviors associated with development and worsening of cardiometabolic conditions, with men exhibiting poorer dietary behaviors than women.
Highlights
In the U.S, the prevalence of diabetes and hypertension are higher among African American/Black (Black), Latinx, and Filipino adults than non-Hispanic White (White) and Chinese adults
In surveys of U.S adults and studies based on electronic health records (EHR), Filipino adults have been found to have a higher prevalence than Chinese adults of hypertension [7,8,9,10], diabetes [7, 9, 11], coronary heart disease [7, 12], and obesity [7,8,9, 12], with diabetes and hypertension prevalence among Filipino adults similar to that among Black adults and prevalence among Chinese adults more similar to that among White adults [7]
Filipino adults were more likely than Black and Latinx adults, but less likely than Chinese adults, to be college graduates
Summary
In the U.S, the prevalence of diabetes and hypertension are higher among African American/Black (Black), Latinx, and Filipino adults than non-Hispanic White (White) and Chinese adults. Disparities between African American/Black (Black), Hispanic/Latinx (Latinx), and non-Hispanic White (White) adults in the prevalence of diabetes, hypertension, and obesity have been well-documented, with Black and Latinx populations having a higher prevalence than White populations of all three health conditions [1,2,3,4,5] The prevalence of these conditions in Filipino Americans (Filipino) and Chinese Americans (Chinese), the two largest Asian ethnic groups in the U.S, and how the prevalence in these ethnic groups compares with each other and with the prevalence among White, Black, and Latinx adults has been less studied [6, 7]. A survey of Chinese and Filipino adults residing in the Philadelphia, PA, area found that low percentages were following recommended guidelines for fruit and vegetable consumption, use of salt, consumption of sweets, and physical activity [16]
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