Lack of a job, health insurance and college education are social factors associated with an increased likelihood that Asian American adults have risk factors for heart disease and stroke, a new study finds.

But these and other factors, known as social determinants of health, may affect each Asian subgroup differently, according to a study published in the Journal of the American Heart Association.

“Despite the recognition that Asian Americans are less affected by social determinants of health than other racial/ethnic groups, our findings demonstrate that adverse social factors are associated with a higher prevalence of cardiovascular risk factors in adults,” Eugene Yang, lead author of the study, said in a news release. He is a professor of cardiology and medicine at the University of Washington School of Medicine in Seattle.

“The Asian American population is the fastest growing racial/ethnic group in the United States,” Yang said. “South Asians have the highest rates of early-onset heart disease worldwide and have recently been found to have higher rates of cardiovascular mortality than non-Hispanic whites.”

He said understanding why differences in cardiovascular risk exist between subgroups in Asia is essential to reducing risk and improving outcomes.

Researchers analyzed National Household Survey data from 2013 to 2018 of 6,395 U.S. adults who identify as Asian. Within this group, 22% identify as Filipino, 22% as Asian Indian, 21% as Chinese, and 35% as other Asian (including Japanese, Korean, Vietnamese, and other groups). I reported it.The majority of participants were born outside the United States

Self-reported cardiovascular risk factors included diabetes, high cholesterol, hypertension, obesity, lack of physical activity and sleep, and nicotine exposure. Healthy eating was not measured.

The researchers created a composite score for 27 social determinants of health and rated them as favorable or unfavorable. The factors were categorized into the following categories: financial stability, including employment and income status; Neighborhood and social cohesion, such as neighborhood trust and whether the home is rented or owned. mental health; food security; education; and access to health care.

Overall, there was a strong association between unfavorable social determinants of health and risk factors for cardiovascular disease. However, this association varied significantly across Asian subgroups.

For example, having more adverse social factors was associated with a 58% increased likelihood of insufficient physical activity among Chinese adults, a 42% increased likelihood among Asian Indian adults, and a 24% increased likelihood among Filipino adults. was. The association between type 2 diabetes and nicotine exposure was also strongest among Chinese adults. However, the association with hypertension was strongest among Filipino adults, and Asian Indian adults were more likely to have suboptimal sleep due to negative social factors than Chinese or Filipino adults. Ta.

Yang said many of the social vulnerabilities he and his team ranked are interconnected, such as neighborhood cohesion, economic stability, and access to the health care system.

Researchers added more Asian Americans to the national survey because the study’s small sample size precluded the ability to separately analyze some Asian subgroups, including Japanese, Koreans, and Vietnamese. He said it was important to include people.