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

BACKGROUND

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.

OBJECTIVE

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.

RESULTS

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.

CONCLUSIONS

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.