Stanford University Center for Asian Healthcare Research and Education Stanford CA.
College of Arts and Sciences, School of Global Public Health New York University New York NY.
J Am Heart Assoc. 2024 Apr 16;13(8):e032509. doi: 10.1161/JAHA.123.032509. Epub 2024 Apr 3.
Social determinants of health (SDOH) play a significant role in the development of cardiovascular risk factors. We investigated SDOH associations with cardiovascular risk factors among Asian American subgroups.
We utilized the National Health Interview Survey, a nationally representative survey of US adults, years 2013 to 2018. SDOH variables were categorized into economic stability, neighborhood and social cohesion, food security, education, and health care utilization. SDOH score was created by categorizing 27 SDOH variables as 0 (favorable) or 1 (unfavorable). Self-reported cardiovascular risk factors included diabetes, high cholesterol, high blood pressure, obesity, insufficient physical activity, suboptimal sleep, and nicotine exposure. Among 6395 Asian adults aged ≥18 years, 22.1% self-identified as Filipino, 21.6% as Asian Indian, 21.0% as Chinese, and 35.3% as other Asian. From multivariable-adjusted logistic regression models, each SD increment of SDOH score was associated with higher odds of diabetes among Chinese (odds ratio [OR], 1.45; 95% CI, 1.04-2.03) and Filipino (OR, 1.24; 95% CI, 1.02-1.51) adults; high blood pressure among Filipino adults (OR, 1.28; 95% CI, 1.03-1.60); insufficient physical activity among Asian Indian (OR, 1.42; 95% CI, 1.22-1.65), Chinese (OR, 1.58; 95% CI, 1.33-1.88), and Filipino (OR, 1.24; 95% CI, 1.06-1.46) adults; suboptimal sleep among Asian Indian adults (OR, 1.20; 95% CI, 1.01-1.42); and nicotine exposure among Chinese (OR, 1.56; 95% CI, 1.15-2.11) and Filipino (OR, 1.50; 95% CI, 1.14-1.97) adults.
Unfavorable SDOH are associated with higher odds of cardiovascular risk factors in Asian American subgroups. Culturally specific interventions addressing SDOH may help improve cardiovascular health among Asian Americans.
社会决定因素（SDOH）在心血管风险因素的发展中起着重要作用。我们研究了亚裔美国人亚群中 SDOH 与心血管风险因素的关联。
我们利用了全国健康访谈调查（National Health Interview Survey），这是一项对美国成年人进行的全国代表性调查，时间为 2013 年至 2018 年。SDOH 变量分为经济稳定性、邻里和社会凝聚力、食品安全、教育和医疗保健利用。SDOH 评分是通过将 27 个 SDOH 变量归类为 0（有利）或 1（不利）来创建的。自我报告的心血管风险因素包括糖尿病、高胆固醇、高血压、肥胖、身体活动不足、睡眠质量差和尼古丁暴露。在 6395 名年龄≥18 岁的亚裔成年人中，22.1%自认为是菲律宾人，21.6%是印度人，21.0%是中国人，35.3%是其他亚洲人。从多变量调整后的逻辑回归模型中，SDOH 评分每增加一个单位，与中国人（比值比[OR]，1.45；95%置信区间[CI]，1.04-2.03）和菲律宾人（OR，1.24；95%CI，1.02-1.51）患糖尿病的几率增加有关；菲律宾人患高血压（OR，1.28；95%CI，1.03-1.60）；印度人身体活动不足（OR，1.42；95%CI，1.22-1.65），中国人（OR，1.58；95%CI，1.33-1.88）和菲律宾人（OR，1.24；95%CI，1.06-1.46）；印度人睡眠质量差（OR，1.20；95%CI，1.01-1.42）；中国人（OR，1.56；95%CI，1.15-2.11）和菲律宾人（OR，1.50；95%CI，1.14-1.97）尼古丁暴露。
不利的 SDOH 与亚裔美国人亚群中心血管风险因素的几率增加有关。针对 SDOH 的文化特异性干预措施可能有助于改善亚裔美国人的心血管健康。
