Zhu David T, Zhong Anthony, Ho Winnie J, Tamang Suzanne
Medical Scientist Training Program, School of Medicine, Virginia Commonwealth University, 1201 E Marshall St, Richmond, VA, 23298, USA.
Harvard Medical School, Boston, MA, USA.
J Racial Ethn Health Disparities. 2025 Jun;12(3):1508-1516. doi: 10.1007/s40615-024-01983-5. Epub 2024 Mar 26.
Asian Americans have been historically underrepresented in the national drug overdose discourse due to their lower substance use and overdose rates compared to other racial/ethnic groups. However, aggregated analyses fail to capture the vast diversity among Asian-American subgroups, obscuring critical disparities. We conducted a cross-sectional study between 2018 and 2021 examining Asian-American individuals within the CDC WONDER database with drug overdoses as the underlying cause of death (n = 3195; ICD-10 codes X40-X44, X60-X64, X85, and Y10-Y14) or psychoactive substance-related mental and behavioral disorders as one of multiple causes of death (n = 15,513; ICD-10 codes F10-F19). Proportional mortality ratios were calculated, comparing disaggregated Asian-American subgroups to the reference group (Asian Americans as a single aggregate group). Z-tests identified significant differences between subgroups. Compared to the reference group (0.99%), drug overdose deaths were less prevalent among Japanese (0.46%; p < 0.001), Chinese (0.47%; p < 0.001), and Filipino (0.82%; p < 0.001) subgroups, contrasting with a higher prevalence among Asian Indian (1.20%; p < 0.001), Vietnamese (1.35%; p < 0.001), Korean (1.36%; p < 0.001), and other Asian (1.79%; p < 0.001) subgroups. Similarly, compared to the reference group (4.80%), deaths from mental and behavioral disorders were less prevalent among Chinese (3.18%; p < 0.001), Filipino (4.52%; p < 0.001), and Asian Indian (4.56%; p < 0.001) subgroups, while more prevalent among Korean (5.60%; p < 0.001), Vietnamese (5.64%; p < 0.001), Japanese (5.81%; p < 0.001), and other Asian (6.14%; p < 0.001) subgroups. Disaggregated data also revealed substantial geographical variations in these deaths obscured by aggregated analyses. Our findings revealed pronounced intra-racial disparities, underscoring the importance of data disaggregation to inform targeted clinical and public health interventions.
历史上，与其他种族/族裔群体相比，亚裔美国人在全国药物过量问题的讨论中代表性不足，因为他们的物质使用和过量率较低。然而，汇总分析未能捕捉到亚裔美国人亚群体之间的巨大差异，掩盖了关键的差异。我们在2018年至2021年期间进行了一项横断面研究，在疾病控制与预防中心（CDC）的WONDER数据库中调查以药物过量作为根本死因（n = 3195；国际疾病分类第十版（ICD - 10）编码X40 - X44、X60 - X64、X85和Y10 - Y14）或精神活性物质相关的精神和行为障碍作为多种死因之一（n = 15513；ICD - 10编码F10 - F19）的亚裔美国人个体。计算了比例死亡率，将细分的亚裔美国人亚群体与参考组（作为一个单一汇总群体的亚裔美国人）进行比较。Z检验确定了亚群体之间的显著差异。与参考组（0.99%）相比，药物过量死亡在日本裔（0.46%；p < 0.001）、华裔（0.47%；p < 0.001）和菲律宾裔（0.82%；p < 0.001）亚群体中的发生率较低，而在印度裔亚裔（1.20%；p < 0.001）、越南裔（1.35%；p < 0.001）、韩裔（1.36%；p < 0.001）和其他亚裔（1.79%；p < 0.001）亚群体中的发生率较高。同样，与参考组（4.80%）相比，精神和行为障碍导致的死亡在华裔（3.18%；p < 0.001）、菲律宾裔（4.52%；p < 0.001）和印度裔亚裔（4.56%；p < 0.001）亚群体中的发生率较低，而在韩裔（5.60%；p < 0.001）、越南裔（5.64%；p < 0.001）、日本裔（5.81%；p < 0.001）和其他亚裔（6.14%；p < 0.001）亚群体中的发生率较高。细分数据还揭示了这些死亡在汇总分析中被掩盖的显著地理差异。我们的研究结果揭示了明显的种族内差异，强调了数据细分对于为有针对性的临床和公共卫生干预提供信息的重要性。
