Abstract Body: Introduction: The prevalence of diabetes mellitus (DM), a well-established mortality risk factor, is higher among Asian Americans collectively than non-Hispanic White (NHW) populations. Despite known racial/ethnic differences in diabetes-related outcomes, Asian Americans are often studied as a homogeneous group. This study investigates the disparities in the association between DM and all-cause mortality rates among different Asian American subgroups relative to NHWs.
Hypothesis: We assessed the hypothesis that the associations between diabetes mellitus and all-cause mortality rates differ among Asian American subgroups compared to NHWs.
Methods: Data from the National Health Interview Survey (NHIS) (1997–2018) was linked with the 2019 National Death Index (NDI). A total of n = 418,681 individuals were analyzed, with diabetes prevalence and all-cause mortality rates compared among Asian Indian (n = 5,478), Chinese (n = 5,848), Filipino (n = 6,419), and NHW (n = 400,936) groups. Hazard ratios (HRs) were calculated using weighted Cox proportional hazard modeling controlling for demographic and socioeconomic determinants of health.
Results: Compared to NHW individuals (8.3%, 95% CI [8.2-8.4]), the prevalence of diabetes was higher in Filipino individuals (9.7%, 95% CI [8.9-10.6]) and Asian Indian individuals (7.7%, 95% CI [6.9-8.6]) but lower in Chinese individuals (4.7%, 95% CI [4.1-5.4]). Among individuals with diabetes, the adjusted hazard ratios for all-cause mortality rates were lower for Chinese (HR = 0.85, 95% CI [0.76-0.96]), Filipino (HR = 0.75, 95% CI [0.71-0.79]), and Asian Indian (HR = 0.65, 95% CI [0.45-0.93]) populations compared to NHW individuals.
Conclusion: Asian Americans with diabetes experienced a lower mortality risk compared to NHW individuals with diabetes, despite some Asian subgroups having a higher prevalence of the disease. Variations in determinants of all-cause mortality, such as education, income, and nativity, likely contribute to these differences, underscoring the need for targeted interventions.