Leading Causes of Death among Asian American Subgroups (2003–2011)

Abstract

BackgroundOur current understanding of Asian American mortality patterns has been distorted by the historical aggregation of diverse Asian subgroups on death certificates, masking important differences in the leading causes of death across subgroups. In this analysis, we aim to fill an important knowledge gap in Asian American health by reporting leading causes of mortality by disaggregated Asian American subgroups.Methods and FindingsWe examined national mortality records for the six largest Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) and non-Hispanic Whites (NHWs) from 2003-2011, and ranked the leading causes of death. We calculated all-cause and cause-specific age-adjusted rates, temporal trends with annual percent changes, and rate ratios by race/ethnicity and sex. Rankings revealed that as an aggregated group, cancer was the leading cause of death for Asian Americans. When disaggregated, there was notable heterogeneity. Among women, cancer was the leading cause of death for every group except Asian Indians. In men, cancer was the leading cause of death among Chinese, Korean, and Vietnamese men, while heart disease was the leading cause of death among Asian Indians, Filipino and Japanese men. The proportion of death due to heart disease for Asian Indian males was nearly double that of cancer (31% vs. 18%). Temporal trends showed increased mortality of cancer and diabetes in Asian Indians and Vietnamese; increased stroke mortality in Asian Indians; increased suicide mortality in Koreans; and increased mortality from Alzheimer’s disease for all racial/ethnic groups from 2003-2011. All-cause rate ratios revealed that overall mortality is lower in Asian Americans compared to NHWs.ConclusionsOur findings show heterogeneity in the leading causes of death among Asian American subgroups. Additional research should focus on culturally competent and cost-effective approaches to prevent and treat specific diseases among these growing diverse populations.

Nativity Status and Cardiovascular Disease Mortality Among Hispanic Adults

“…Population data were obtained from the 2000 and 2010 US Census data, and midyear estimates were calculated using linear interpolation and extrapolation out to 2012 to generate denominator data for age‐adjusted mortality rates (AMRs). Methods for linear interpolation have been described previously 24, 25. Educational attainment was categorized as no formal education, high school or GED (General Equivalency Diploma), some college, bachelor's degree or higher , and unknown , using both 2003 and 1989 revisions because different states adopted different revisions.…”

Errors Associated with Aggregating Asian American Ethnic Groups in Diabetes Research, Education, and Clinical Practice

“…For some groups, proper estimation of the prevalence of T2DM affects mortality. Diabetes by itself accounts for 5% of all deaths of both Asian Indian and Filipino women [50]. But, the complications of diabetes can also be lethal.…”

“…The relative frequency of heart disease as a cause of death varies among Asian American ethnic groups. Death from heart disease accounts for 23% of Japanese American, 22% of Korean American, and 19% of Vietnamese American deaths overall [50]. When gender is factored in, heart disease is the leading cause of death for 28.2% of Filipino males, 27.2% of Japanese males, and18% of Asian Indian males.…”

“…Heart disease is the second leading cause of death for23.2% of Chinese males, 19.2% of Korean males, and 17.8% of Vietnamese males. Heart disease is the leading cause of death for 27.8% of Asian Indian females, but the second leading cause of death for 24.4% of Filipino females, 23.7% of Chinese females, 22.6% of Japanese females, 21.6% of Korean females, and 19.1% of Vietnamese females [50].…”

“…As Hastings et al [50] noted: "The aggregation of Asian Americans masks important differences in mortality among subgroups. "…”