Understanding the Impact of Social Factors on Heart Disease Risk in Asian American Adults

The study also found that the connection between these negative social determinants of health and risk factors for cardiovascular disease varied greatly among individuals in various Asian American subgroups in this research. It’s important to note that an association does not necessarily mean that social determinants of health directly caused the risk factor.

“Although there is a common belief that social determinants of health have less impact on Asian Americans compared to other racial or ethnic groups, our results show that unfavorable social factors are linked to higher prevalence.”The research focused on the prevalence of cardiovascular risk factors among Asian American adults,” stated Eugene Yang, M.D., the lead study author and a professor of medicine at the University of Washington School of Medicine in Seattle.

“The Asian American population is the fastest growing racial/ethnic group in the United States,” Yang explained. “Individuals of South Asian descent have higher rates of premature heart disease worldwide and have recently been found to have higher cardiovascular mortality than non-Hispanic white individuals. Understanding the reasons for differences in cardiovascular risk among Asian subgroups is crucial for reducing risk and improving outcomes.”

A study analyzed data from the National Health Interview Survey in the U.S. from 2013 to 2018. The survey included 6,395 adults who identified as Asian. The researchers evaluated 27 social determinants of health factors in six areas: economic stability, neighborhood and social cohesion, psychological distress, food security, education, and health care utilization. They looked at whether these factors were favorable or unfavorable. The analysis revealed a strong connection between unfavorable social determinants of health and cardiovascular disease.Disease risk factors. The link between these factors differed among individuals in various Asian American subgroups. Here are the key findings from the data:

• For all Asian groups in the data, a higher score of unfavorable social determinants of health by one standardized unit corresponded to a 14% higher risk of high blood pressure; a 17% higher risk of poor sleep; and a 24% higher risk of Type 2 diabetes — all of which elevate the chances of developing cardiovascular disease.

• More specifically, greater unfavorable social determinants were linked to:
  • a 45% higher likelihood of Type 2 diabetes among Chinese adults.have a 24% higher risk of diabetes; a 28% higher risk of high blood pressure; a 42% higher risk of insufficient physical activity; a 20% chance of suboptimal sleep; and a 50% likelihood of nicotine exposure. Similarly, Asian Indian adults have a 42% increased likelihood of insufficient physical activity and a 20% likelihood of suboptimal sleep, while Chinese adults have a 58% increased likelihood of insufficient physical activity and a 56% likelihood of nicotine exposure.The study found that 4 out of 7 cardiovascular risk factors had the highest prevalence, including poor sleep, high cholesterol, high blood pressure, and obesity. Yang emphasized the interconnected nature of many social determinants of health, such as neighborhood cohesion, economic stability, and use of the healthcare system. He also stressed the importance of understanding how different Asian subgroups are affected, as higher risk groups like South Asian people may not be treated aggressively enough if they are lumped together with lower risk groups like people of Korean and Japanese descent.The study background and details are as follows:
    • A large, cross-sectional study examined data from 2013-2018 National Health Interview Surveys, which are annual, nationally representative surveys of U.S. adults.
    • Among the 6,395 Asian adults in the survey, approximately 22% identified themselves as Filipino adults, 22% as Asian Indian adults, 21% as Chinese adults, and 36% as other Asian.
    • The sample size of Asian American individuals in the national survey was too small to analyze several major Asian populations, including Japanese, Korean, and Vietnamese individuals, as well as other smaller Asian subgroups.
    • More than half of the group consisted of women, and over half were aged between 18 and 44. The majority of the participants, about 77%, were not born in the United States.
    • Participants had their social determinants of health assessed by assigning scores to 27 variables, categorized as either favorable or unfavorable.
    • Cardiovascular risk factors were self-reported and aligned with the American Heart Association’s Life’s Essential 8, which includes following a healthy diet, maintaining a healthy weight, regular exercise, quality sleep. The study did not measure healthy diet, but it did find that maintaining healthy levels of blood pressure, glucose, cholesterol, and nicotine exposure can improve heart health and reduce the risk of heart disease and stroke. However, the study’s small sample size limited its ability to analyze certain Asian subgroups. Additionally, the use of self-reported survey data only provided a snapshot of social factors and cardiovascular risk factors at a single point in time, so it could not assess long-term social determinants of health. The study’s findings suggest the importance of maintaining optimal levels of these eight metrics for heart health.The study found that there were no significant differences in cardiovascular disease risk factors among different ethnic groups, and it could not establish a direct link between unfavorable social factors and the development of these risk factors. Additionally, language barriers may have affected some participants as the National Health Interview Surveys were only conducted in English and Spanish.The authors of the study emphasized the importance of including more Asian Americans in national surveys to uncover potential differences in social determinants of health and cardiovascular risk factors.