Sociodemographic, behavioral, and neighborhood-environment predictors of diabetes prevalence across Asian American ethnicities: Analyses of CHIS (2013-2015).

Tri Nhan Dai Le | 2017

Advisor: Anjum Hajat

Research Area(s): Environmental & Occupational Health, Social Determinants of Health



Asian Americans are the fastest growing minority group in the U.S. and are disproportionately affected by the burden of diabetes. However, little is known about the individual vs. environmental-level predictors of diabetes and the heterogeneity among Asian American ethnicities.


To examine whether socio-demographic factors, individual health behaviors, or neighborhood environmental factors are most strongly associated with the prevalence of diabetes among Asian Americans of different ethnicities. Methods: Using CHIS (2013-2015) data, Poisson log-link linear regression models were performed to assess the prevalence ratios of diabetes across Non-Hispanic Whites vs. Asian Americans, and if there was an interaction across six Asian American ethnicities; Chinese, Japanese, Korean, Vietnamese, Filipino and Other Asian. Sociodemographics, health behaviors, or neighborhood-environmental factors were identified as potential predictors associated with the primary outcome of diabetes.


The overall diabetes prevalence in the CHIs population was 7.8%. There was a disparity in diabetes prevalence by race/ethnicity, after adjusting for all the covariates. As compared to Non-Hispanic White (NHW), Vietnamese had a 44% (95% CI: 18%, 62%) lower prevalence of diabetes than Non-Hispanic Whites. In contrast, Filipinos had a 56% (95% CI: 21%, 101%) higher prevalence. Sociodemographic (age, gender, federal poverty level) and health behavior indicators (overweight/obesity status, perceived health status, smoking, alcohol and soda consumption) were the strongest and most significant predictors of diabetes across NHW and Asians in multivariate models. Interactions across six Asian-American subgroups were observed.


The present study provides insights into sociodemographic, behavioral and neighborhood-level factors that may predict diabetes across racial-ethnic groups. Findings from CHIS data warrant further studies across the US. Identifying specific predictors of diabetes within each subpopulation may allow more targeted interventions for each community.