Disaggregating Asian American and Pacific Islander Health Data: Multilevel Analysis of Neighborhood Context and Cardiovascular Health using the Medicare Health Outcomes Survey

分解亚裔美国人和太平洋岛民的健康数据：使用医疗保险健康结果调查对社区环境和心血管健康进行多层次分析

• 批准号: 9755319
• 负责人: Lan N Doan
• 金额: $ 6.54万
• 依托单位: OREGON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9755319
• 关键词: Adult; African American; Age; Asian Americans; Asian Indian; Asians; Body mass index; Cardiovascular Diseases; Categories; Censuses; Cessation of life; Characteristics; Chinese People; Clinical; Data; Data Analyses; Data Set; Diabetes Mellitus; Disease Outcome; Educational Background; Elderly; Environment; Epidemiology; Ethnic Origin; Face; Filipino; Foundations; Geography; Goals; Guidelines; Health; Health Status; Heterogeneity; High Prevalence; Hispanics; Household; Hypertension; Immigrant; Incidence; Income; Individual; Individual Differences; Japanese Population; Koreans; Language; Limited English Proficiency; Link; Literature; Masks; Medicare; Minority Groups; Morbidity - disease rate; Native Hawaiian; Neighborhoods; Not Hispanic or Latino; Outcome; Pacific Island Americans; Patient Self-Report; Population; Population Heterogeneity; Positioning Attribute; Poverty; Prevalence; Race; Recommendation; Regression Analysis; Research; Research Priority; Risk; Risk Factors; Rural; Sampling; Strategic Planning; Subgroup; Surveys; Time; United States Centers for Medicare and Medicaid Services; Vulnerable Populations; base; beneficiary; cardiovascular disorder risk; cardiovascular health; comparison group; deprivation; health data; health difference; health disparity; high risk population; human old age (65+); improved; individualized medicine; insight; mortality; multilevel analysis; racial and ethnic; risk prediction model; social

PROJECT SUMMARY/ABSTRACT Cardiovascular disease (CVD) is the leading cause of mortality in the US and for Asian Americans and Pacific Islander (AAPIs) adults age 65 and older. The prevalence of CVD has been well documented for non-Hispanic white, African American, and Hispanic populations. However, CVD morbidity and mortality disproportionately impacts AAPIs living in the US and the true magnitude of CVD by specific racial subgroup (e.g. Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, and Native Hawaiian and Pacific Islander) has not been accurately characterized. The paucity of data on AAPI subgroups has resulted in the inability to precisely estimate CVD incidence and prevalence and develop appropriate clinical guidelines and recommendations for CVD research priorities. Moreover, traditional CVD risk factors (e.g. hypertension, body mass index, and diabetes) are unequally distributed across AAPI subgroups and the relative importance of these CVD risk factors is unclear. Neighborhood context (e.g. median household income, neighborhood deprivation, and rural/urban status) has been identified as an important determinant of health status and underlying factor in health disparities. However, the relationship between neighborhood context and CVD health in AAPI subgroups is not well understood. AAPIs represent more than 40 cultures of origin and 100 different languages and are projected to be the fastest growing racial group in the US by 2050. AAPI older adults will also be the fastest growing group in the US elderly population. Most AAPI older adults are foreign-born and recent immigrants to the US, and typically have low education levels, limited English proficiencies, and high poverty rates. AAPI older adults are a particularly vulnerable population as they face the compounding effects of minority group status and older age. Furthermore, these current issues are exacerbated by the absence of AAPIs in research. The primary objectives of this study are to identify the prevalence and determinants of CVD in AAPI subgroups and determine the associations between neighborhood context and individual health status in AAPI older adults through secondary data analysis of US Census Bureau data and the Medicare Health Outcomes Survey (HOS). We propose multilevel regression analysis of the HOS (N=1,017500), a nationally representative survey administered by the Centers for Medicare & Medicaid Services. The HOS is a unique dataset that began collecting expanded ethnic and racial data in 2011, including 4 Hispanic-origin and 11 AAPI-origin categories, which allows for disaggregated analysis of AAPI subgroups (44,705 self-reported an AAPI subgroup). The HOS will be linked to geographic-level census data to investigate neighborhood factors that impact individual differences in health status. We expect that the findings will establish a better understanding of the CVD prevalence in AAPI subgroups and the intersections between neighborhood and CVD and race/ethnicity. The proposed research will inform culturally relevant strategies to improve CVD health in high-risk groups, manage CVD risk factors, and reduce CVD morbidity and mortality in diverse older adults.

项目摘要/摘要 心血管疾病（CVD）是美国和亚裔美国人和太平洋死亡率的主要原因 岛民（AAPIS）65岁及以上的成年人。 CVD的患病率已被充分记录在非西班牙裔 白人，非裔美国人和西班牙裔人口。但是，CVD发病率和死亡率不成比例 影响居住在美国的Aapis和特定种族亚组的CVD的真正大小（例如，亚洲印度人， 中国，菲律宾，日语，韩国，越南人以及夏威夷原住民和太平洋岛民都没有 精确表征。 AAPI亚组的数据缺乏导致无法精确的 估计CVD发病率和患病率，并制定适当的临床准则和建议 CVD研究的重点。此外，传统的CVD风险因素（例如高血压，体重指数和 糖尿病）分布在AAPI亚组中，这些CVD风险的相对重要性 因素尚不清楚。邻里环境（例如，家庭收入中值，邻里剥夺和 农村/城市地位）已被确定为健康状况和根本因素的重要决定因素 健康差异。但是，AAPI的邻里环境与CVD健康之间的关系 亚组不太了解。 AAPI代表了40多种原产地文化和100种不同的语言 并预计到2050年，美国成长最快的种族群体。AAPI老年人也将是 美国老年人口增长最快的群体。大多数AAPI老年人都是外国出生的，最近 美国的移民，通常的教育水平较低，英语能力有限和贫困较高 费率。 AAPI老年人面临着特别脆弱的人口 少数群体的地位和年龄较大。此外，由于缺乏，这些当前问题会加剧 Aapis研究。这项研究的主要目标是确定CVD的患病率和决定因素 在AAPI亚组中，并确定邻里环境与个人健康状况之间的关联 在AAPI老年人中，通过美国人口普查局数据和Medicare Health的二级数据分析 结果调查（HOS）。我们提出了HOS的多级回归分析（N = 1,017500），这是全国性的 代表性调查由Medicare＆Medicaid Services中心管理。 HOS是一个独特的 在2011年开始收集扩大种族和种族数据的数据集，包括4个西班牙裔 - 原来和11个 AAPI-ORIGIN类别，可以分解AAPI亚组的分析（44,705个自我报告 AAPI子组）。 HOS将链接到地理级别的人口普查数据，以调查邻里因素 这会影响健康状况的个体差异。我们希望这些发现将建立更好 了解AAPI亚组中CVD患病率以及邻里和社区之间的相互作用 CVD和种族/种族。拟议的研究将为与文化相关的策略提供信息，以改善CVD健康 在高风险组中，管理CVD风险因素，并降低不同老年人的CVD发病率和死亡率。

项目成果

Epidemiologists Count: The Role of Diversity and Inclusion in the Field of Epidemiology.

流行病学家计数：多样性和包容性在流行病学领域的作用。

• DOI: 10.1093/aje/kwaa108
• 发表时间: 2020
• 期刊: American journal of epidemiology
• 影响因子: 5
• 作者: Ðoàn,LanN;Bacong,AdrianM;Ma,KrisPuiKwan;Morey,BrittanyN
• 通讯作者: Morey,BrittanyN