Abstract Body: Introduction: While Asian populations appear healthier than non-Hispanic Whites overall, recent studies have highlighted significant health disparities within Asian subgroups in the US. However, most US health databases aggregate Asians into broader categories, limiting understanding of subgroup-specific risks. This study aims to investigate the disparity in stroke risk among Asian subgroups in California – a state where nearly 30% of U.S. Asians live.
Methods: We analyzed 2013-2019 Behavioral Risk Factor Surveillance System (BRFSS) data from California. Stroke prevalence was determined by self-reported diagnosis. Asian subgroups were categorized as East Asian (Chinese, Japanese, Korean), South Asian (Indian, Pakistani), Southeast Asian (Filipino, Vietnamese, Cambodian), and Other Asian. Logistic regression models examined odds of stroke prevalence by Asian broadly and detailed categorized subgroups using non-Hispanic Whites as the reference and adjusting for age and sex.
Results: Among 1,768 Asian participants, females comprised 47% overall, ranging from 37% (South Asians) to 52% (Southeast Asians). The mean age for all Asians is about 42 years, and the subgroups show similar results. Detailed subgroups showed Filipinos had the highest female proportion (54%) and Indians the lowest (36%). Age distribution showed Japanese were oldest (52 years) and Cambodians youngest (37 years). After adjusting for age and sex, East Asians demonstrated significantly lower odds of stroke prevalence (OR=0.43; 95% CI: 0.24-0.77) compared to non-Hispanic Whites. Southeast Asians had increased stroke risk (OR=1.17), although non-significant. In detailed subgroup analysis, Chinese showed lower stroke prevalence (OR=0.39; 95% CI: 0.17-0.87), while Cambodians had significantly higher prevalence (OR=4.43; 95% CI: 1.02-19.23).
Conclusions: Our findings reveal significant heterogeneity in stroke prevalence among Asian American subgroups in California. The fluctuation in results underscores the importance of disaggregated analyses in stroke research, and future research should expand upon these findings to uncover the underlying causes in the variance. This study is the beginning of an important roadmap to mitigating stroke disparities in Asian populations by tailoring stroke prevention and treatment methods to specific Asian subgroups, rather than integrating all subgroups into a singular broad category.