title: Social and clinically-relevant cardiovascular risk factors in Asian Americans adults: NHANES 2011-2014.
abstract: Little evidence exists examining cardiovascular risk factors among Asian Americans and how social determinants such as nativity status and education pattern risk in the United States (U.S.) context. We used the National Health and Nutrition Examination Survey, which purposely oversampled Asian Americans from 2011 to 2014, and examined prevalence of Type II diabetes, smoking and obesity for Asian Americans (n=1363) and non-Latino Whites (n=4121). We classified Asian Americans as U.S. or foreign-born and by years in the U.S. Obesity status was based on standard body mass index (BMI) cut points of ≥30kg/m2and Asian-specific cut points (BMI≥25kg/m2) that may be more clinically relevant for this population. We fit separate logistic regression models for each outcome using complex survey design methods and tested for the joint effect of race, nativity and education on each outcome. Diabetes and obesity prevalence (applying Asian-specific BMI cut points) were higher among Asian Americans when compared to non-Latino Whites but smoking prevalence was lower. These patterns remained in fully adjusted models and showed small increases with longer duration in the U.S. Joint effects models showed higher odds of prevalent Type II diabetes and obesity (Asian-specific) for foreign-born Asians, regardless of years in the U.S. and slightly higher risk for low education, when compared to non-Latino Whites with high education. Smoking models showed significant interaction effects between race and education for non-Latino Whites only. Our study supports the premise that social as well as clinical factors should be considered when developing health initiatives for Asian Americans.
authors.affiliation: CUNY Graduate School of Public Health and Health Policy, New York, NY, United States. Electronic address: Sandra.Echeverria@sph.cuny.edu.
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Echeverria
authors.affiliation: New Jersey Department of Health and Human Services, United States.
authors.forename: Mehnaz
authors.initials: M
authors.lastname: Mustafa
authors.affiliation: Department of Surgery, Rutgers New Jersey Medical School, Newark, NY, United States. Electronic address: pentaks1@njms.rutgers.edu.
authors.forename: Sri Ram
authors.initials: SR
authors.lastname: Pentakota
authors.affiliation: Department of Biostatistics, Rutgers School of Public Health, New Brunswick, NY, United States. Electronic address: sk1362@sph.rutgers.edu.
authors.forename: Soyeon
authors.initials: S
authors.lastname: Kim
authors.affiliation: Division of General Medical Disciplines, Stanford University School of Medicine, Stanford, CA, United States. Electronic address: katiegh@stanford.edu.
authors.forename: Katherine G
authors.initials: KG
authors.lastname: Hastings
authors.affiliation: CUNY Graduate School of Public Health and Health Policy, New York, NY, United States. Electronic address: Chioma.Amadi@sph.cuny.edu.
authors.forename: Chioma
authors.initials: C
authors.lastname: Amadi
authors.affiliation: Division of General Medical Disciplines, Stanford University School of Medicine, Stanford, CA, United States. Electronic address: lathap@stanford.edu.
authors.forename: Latha
authors.initials: L
authors.lastname: Palaniappan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia / Q000208:ethnology; D001213:Asian / Q000523:psychology / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000517:prevention & control / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology / Q000208:ethnology; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology / Q000208:ethnology; D014481:United States
keywords: Asian Americans; Cardiovascular risk factors; Disparities; Nativity; Socioeconomic position