Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA; email:
Department of Health, Society, and Behavior, and Chao Family Comprehensive Cancer Center, University of California, Irvine, California, USA.
Annu Rev Public Health. 2024 May;45(1):401-424. doi: 10.1146/annurev-publhealth-060922-040413. Epub 2024 Apr 3.
The health of Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) is uniquely impacted by structural and social determinants of health (SSDH) shaped by immigration policies and colonization practices, patterns of settlement, and racism. These SSDH also create vast heterogeneity in disease risks across the AANHPI population, with some ethnic groups having high disease burden, often masked with aggregated data. Longitudinal cohort studies are an invaluable tool to identify risk factors of disease, and epidemiologic cohort studies among AANHPI populations have led to seminal discoveries of disease risk factors. This review summarizes the limited but growing literature, with a focus on SSDH factors, from seven longitudinal cohort studies with substantial AANHPI samples. We also discuss key information gaps and recommendations for the next generation of AANHPI cohorts, including oversampling AANHPI ethnic groups; measuring and innovating on measurements of SSDH; emphasizing the involvement of scholars from diverse disciplines; and, most critically, engaging community members to ensure relevancy for public health, policy, and clinical impact.
亚裔美国人、夏威夷原住民和太平洋岛民(AANHPI)的健康受到移民政策和殖民化实践、定居模式和种族主义等因素塑造的健康结构和社会决定因素(SSDH)的独特影响。这些 SSDH 还导致 AANHPI 人群中的疾病风险存在巨大异质性,一些族裔群体的疾病负担很高,而这些往往被汇总数据所掩盖。纵向队列研究是识别疾病风险因素的宝贵工具,而 AANHPI 人群中的流行病学队列研究已经带来了疾病风险因素的重要发现。本综述总结了来自七个具有大量 AANHPI 样本的纵向队列研究的有限但不断增长的文献,重点关注 SSDH 因素。我们还讨论了关键的信息差距和对下一代 AANHPI 队列的建议,包括对 AANHPI 族裔进行过采样;衡量和创新 SSDH 的衡量标准;强调来自不同学科的学者的参与;以及,最重要的是,让社区成员参与进来,以确保公共卫生、政策和临床影响的相关性。