Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115-5899, USA.
J Gen Intern Med. 2010 May;25(5):435-40. doi: 10.1007/s11606-009-1241-0. Epub 2010 Feb 9.
Because Pacific Islanders and Asian Americans have often been aggregated in federal health surveys, we assessed whether they differ substantially in important health measures.
Retrospective analyses of the 2005-2007 Behavioral Risk Factor Surveillance System (BRFSS) surveys.
A total of 2,609 Pacific Islanders, 17,892 Asians, and 894,289 whites over age 18.
We compared self-reported health risk factors (smoking, BMI > or = 25 kg/m(2), alcohol intake, physical activity, fruit/vegetable intake), chronic diseases (diabetes, hypertension, coronary heart disease, asthma, hypercholesterolemia, arthritis, fair or poor health status), and access to care (insurance status, cost barriers, and regular physician) for Pacific Islanders relative to Asian Americans and whites. Logistic regression was used to adjust for sociodemographic factors.
Pacific Islanders were more likely than Asian Americans to report an elevated body-mass index (adjusted odds ratio 2.26; 95% confidence interval 1.80, 2.84), current smoking (2.15; 1.57, 2.93), and high alcohol intake (3.14; 1.60, 6.18), but also more likely to report adequate physical activity (1.62; 1.23, 2.14). Pacific Islanders reported higher adjusted rates of hypertension (1.50; 1.06, 2.13), diabetes (1.82; 1.25, 2.63), asthma (2.32; 1.65, 3.25), and arthritis (1.68; 1.20, 2.35). Pacific Islanders also more frequently reported having fair or poor health (1.46; 1.05, 2.04). Most differences in self-reported health status and chronic disease outcomes were mediated by higher rates of overweight and obesity, but not higher rates of smoking, among Pacific Islanders. Differences in smoking, hypertension, and diabetes were more pronounced among Pacific Islander women than men. Relative to whites, Pacific Islanders were more likely to report a diagnosis of diabetes (1.56; 1.13, 2.14) and less likely to report arthritis (0.61; 0.46, 0.82). All other outcomes measures were statistically similar for whites and Pacific Islanders.
Health surveys and policies should distinguish between Pacific Islanders and Asian Americans given the significantly higher rates of health risks and chronic diseases among Pacific Islanders.
由于太平洋岛民和亚裔美国人在联邦健康调查中经常被合并，我们评估了他们在重要健康指标上是否有显著差异。
对 2005-2007 年行为风险因素监测系统（BRFSS）调查的回顾性分析。
共有 2609 名太平洋岛民、17892 名亚洲人和 894289 名 18 岁以上的白人。
我们比较了自我报告的健康风险因素（吸烟、BMI≥25kg/m2、饮酒、身体活动、水果/蔬菜摄入量）、慢性病（糖尿病、高血压、冠心病、哮喘、高胆固醇血症、关节炎、健康状况不佳）以及太平洋岛民与亚洲裔美国人与白人相比获得医疗保健的机会（保险状况、费用障碍和定期医生就诊）。使用逻辑回归调整社会人口因素。
与亚洲裔美国人相比，太平洋岛民更有可能报告体重指数升高（调整后的优势比 2.26；95%置信区间 1.80，2.84）、当前吸烟（2.15；1.57，2.93）和大量饮酒（3.14；1.60，6.18），但也更有可能报告充足的身体活动（1.62；1.23，2.14）。太平洋岛民报告的高血压（1.50；1.06，2.13）、糖尿病（1.82；1.25，2.63）、哮喘（2.32；1.65，3.25）和关节炎（1.68；1.20，2.35）的调整率也较高。太平洋岛民也更频繁地报告健康状况不佳（1.46；1.05，2.04）。自我报告的健康状况和慢性病结果的大多数差异都通过太平洋岛民中更高的超重和肥胖率来解释，但并非通过更高的吸烟率来解释。与男性相比，吸烟、高血压和糖尿病在太平洋岛民女性中更为明显。与白人相比，太平洋岛民更有可能报告糖尿病诊断（1.56；1.13，2.14），而不太可能报告关节炎（0.61；0.46，0.82）。对于白人和平民岛民来说，所有其他结果测量都在统计学上相似。
鉴于太平洋岛民的健康风险和慢性病发生率明显更高，健康调查和政策应区分太平洋岛民和亚裔美国人。
