Racism, other social factors may affect Asian Americans’ heart health

Immigration status, structural racism and other social factors may contribute to disparities in cardiovascular health among Asian Americans, according to a statement prepared by a group of clinicians and researchers and published in the American Heart Association journal, Circulation.

Asian Americans are less likely than White adults to have or die of heart disease, according to the Department of Health and Human Services Office of Minority Health. But researchers in the Circulation note that cardiovascular health can vary widely between subgroups of Asian Americans, and warn that combining different subgroups of people into a single "Asian" category could mask important differences.

A 2021 Pew Research Center analysis of federal census data found that the number of Asian Americans grew 81 percent between 2000 and 2019, making it the nation's fastest-growing racial group. Yet the term includes people from different subgroups, including Chinese, Indian, Filipino, Vietnamese, Korean and Japanese Americans.

Asian Americans are often underrepresented in health research or considered alongside distinct populations such as Native Hawaiians and Pacific Islanders, the AHA researchers write.

That could mask differences among Asian Americans, the researchers suggest. They highlight disparities among Type 2 diabetes rates, for example; one 2019 study they cite found that the prevalence of Type 2 diabetes among South Asians was 23.3 percent, compared with just 14 percent for East Asians and 19.1 percent when calculated across all non-Hispanic Asians.

Socioeconomic factors, lack of English language proficiency and structural racism also may uniquely affect cardiovascular health among Asian Americans, the researchers note.

They identify factors such as "the experience of racism and discrimination, the unique patterns of and reason for immigration, and ethnicity-specific cultural norms and acculturation process" as probable contributors to cardiovascular health behaviors among the broader group and call for more research into how and why these factors affect cardiovascular health and health behaviors.

"All of these social determinants of health are likely interrelated, and the cumulative impact of these structural and social risk factors contributes to suboptimal cardiovascular health in Asian Americans," Nilay S. Shah, an assistant professor of cardiology and preventive medicine at Northwestern University's Feinberg School of Medicine in Chicago and the statement-writing group's chair, said in a news release . "There is an urgent need to understand these challenges and address them with effective prevention strategies to help improve their long-term cardiovascular health."