The Impact of Heart Disease on Asian Americans and

Pacific Islanders

From “Addressing Cardiovascular Health in Asian Americans and Pacific Islanders: A Background Report”

NIH Publication No. 00-3647

“Asian American and Pacific Islander Workshops Summary Report on Cardiovascular Health”

NIH Publication No. 00-3793

For more information, contact:

The National Heart, Lung, and Blood Institute

Health Information Network

P.O. Box 30105, Bethesda, MD 20824-0105

Tel: (301) 592-8573

Fax: (301) 592-8563

www.nhlbi.nih.gov

Background Reports

Source: U.S. Bureau of Census, 1992.

Chinese22%

Filipino19%

Japanese12%

Korean11%

Other Asian11%

Vietnamese9%

Asian Indian11%

Pacific Islander5%

Ethnic Distribution of the Asian American and Pacific Islander Population, United States, 1990

Asian American Population for Selected Groups, 1990 (excludes Pacific Islanders)

Source: U.S. Bureau of Census, We the Americans: Asians, 1993.

OTHER 9%:

Cambodian 2%

Thai 1%

Hmong 1%

Other Asian 4%

Filipino20%

Japanese12%

Asian Indian12%

Vietnamese9%

Other9%

Laotian2%

Chinese24%

Korean12%

Pacific Islander Population, 1990 (Excludes Asian Americans)

Source: U.S. Bureau of Census, 1993.

Samoan17%

Guamanian14%

Tongan5%

Fijian2%

Hawaiian57%

Other 5%

Breaking the “Model Minority Myth”Asian American and Pacific Islander Poverty Rates, 1990

63.6

42.6

34.7

25.7

12.59.7

6.4

18.2

25.8

15.317.11414.113 14 13.7

7

23.1

14.3

0

10

20

30

40

50

60

70

Pe

rce

nt

Source: U.S. Census, 1992

Breaking the “Model Minority Myth”Asian American and Pacific Islander Per Capita Income, 1990

13,806

10,34213,63814,143

17,77719,373

6,1447,690

10,83411,446

11,000

2,6925,1205,5979,03211,177

11,97013,61614,876

0

5,000

10,000

15,000

20,000

25,000

U.S. T

otal

Total

AAPI

Total

Asia

n

Total

PI

Japa

nese

Asian

India

n

Chine

se

FilipinoTha

i

Korea

n

Vietna

mes

e

Laot

ian

Cambo

dian

Hmon

g

Other

Asia

n

Hawaii

an

Guam

anian

Samoa

n

Tonga

n

Do

llars

Source: U.S. Census, 1992.

*Heart disease is the leading cause of death

Source: National Vital Statistics System, CDC, NCHS, 1994.

34.6

33.9

33.7

31.7

30.4

29.4

27.1

21.8

19.5

0 10 20 30 40

Asian Indian*

Hawaiian*

Guamanian*

Filipino*

Samoan*

Japanese*

Chinese

Korean

Vietnamese

Percentage

Heart Disease asPercentage of All Deaths

26.7

107.9

181.8

25.8

62.6

109.7

0

20

40

60

80

100

120

140

160

180

200

CardiovascularDisease

Coronary HeartDisease

Stroke

Ra

tes

pe

r 1

00

,00

0

All RacesAAPI

Source: Anderson, 1998.

Selected 1995 Age-AdjustedDeath Rates

Age-Adjusted Heart DiseaseDeath Rates for Hawaiians

443.2

340.8375.9

190

273.8

125.8146.8

89.368.5

96.5

142.9

79.2

0

50

100

150

200

250

300

350

400

450

500

1970 1980 1990

Per

100

,000

Po

pu

lati

on

Full Hawaiian

Part Hawaiian

Non-Hawaiian

Hawaii: All Races

Source: Look MA & Braun KL, 1995.

AAPI CV Health Status: Risk Factors

• Low levels of awareness and control

• Very little awareness among Cambodian, Laotian, and Vietnamese immigrants

• Significantly higher levels among Filipino Americans

• Significantly lower blood pressure screening rates among AAPIs

High Blood Pressure

AAPI CV Health Status: Risk Factors

• Low blood cholesterol screening rates

• Highest in Japanese men and women vs. other AAPI ethnic groups

• Cholesterol levels are lower in Asian countries than in Western countries

High Blood Cholesterol

AAPI CV Health Status: Risk Factors

• Highest rates among Southeast Asians

• Southeast Asian males start smoking early in life

• High tobacco use among Korean men in California

Cigarette Smoking

AAPI CV Health Status: Risk Factors

• Overweight and obesity are prevalent among

Pacific Islanders

• Native Hawaiians and Samoans are among the

most obese people in the world

• Molokai Heart Study (Native Hawaiians): 64%

were obese

Obesity

AAPI CV Health Status: Risk Factors

• BMI levels for selected Samoan population

subgroups*

Men (BMI) Women (BMI)

Western Samoan 26 28

Hawaii 31 33

California 35 34

American Samoa 30 33* NOTE: BMI > 30 is obese; BMI of 25-29 is overweight

Obesity (cont.)

AAPI CV Health Status: Risk Factors

• AAPIs engage in less physical activity compared to the general population

• Korean Americans in California are less likely to exercise than the general Californian population

Physical Inactivity

AAPI CV Health Status: Risk FactorsDiabetes

• Highly prevalent among Pacific Islanders

• Higher risk for Native Hawaiians vs. other Hawaiian groups

• Guam’s death rate is 5 times higher than U.S. mainland

• One of the leading causes of death in American Samoa

Diet-Related Characteristics

• Migration patterns affect diet

• Eating habits change among Korean students

• Filipinos: food high in salt increased risk for hypertension

Diet-Related Characteristics (cont.)

• Some groups maintain strong ties to traditional diet

• Micronesia: deaths due to CVD and diabetes have been attributed to poor diet

Designing Culturally Appropriate Community-Based Programs

Strategies

• Establish trust with the community

• Integrate a health topic within a comfortable setting

• Address the community’s priority issues first

• Recognize cultural factors may affect improved

health outcomes

Designing Culturally Appropriate Community-Based Programs

Strategies

• Use compelling and accurate data

• Develop a cadre of knowledgeable lay counselors

• Establish alliances and coalitions

• Provide culturally sensitive and linguistically appropriate materials

Designing Culturally Appropriate Community-Based Programs

Strategies

• Use cultural themes and symbols • Determine the role of public policy • Be prepared to respond to changing needs of the

population (e.g., use consumer feedback)