Literature DB >> 34295131

Neighborhood-level Asian American Populations, Social Determinants of Health, and Health Outcomes in 500 US Cities.

Ben R Spoer1, Filippa Juul2, Pei Yang Hsieh1, Lorna E Thorpe1, Marc N Gourevitch1, Stella Yi1.   

Abstract

Introduction: The US Asian American (AA) population is projected to double by 2050, reaching ~43 million, and currently resides primarily in urban areas. Despite this, the geographic distribution of AA subgroup populations in US cities is not well-characterized, and social determinants of health (SDH) and health measures in places with significant AA/AA subgroup populations have not been described. Our research aimed to: 1) map the geographic distribution of AAs and AA subgroups at the city- and neighborhood- (census tract) level in 500 large US cities (population ≥66,000); 2) characterize SDH and health outcomes in places with significant AA or AA subgroup populations; and 3) compare SDH and health outcomes in places with significant AA or AA subgroup populations to SDH and health outcomes in places with significant non-Hispanic White (NHW) populations.
Methods: Maps were generated using 2019 Census 5-year estimates. SDH and health outcome data were obtained from the City Health Dashboard, a free online data platform providing more than 35 measures of health and health drivers at the city and neighborhood level. T-tests compared SDH (unemployment, high-school completion, childhood poverty, income inequality, racial/ethnic segregation, racial/ethnic diversity, percent uninsured) and health outcomes (obesity, frequent mental distress, cardiovascular disease mortality, life expectancy) in cities/neighborhoods with significant AA/AA subgroup populations to SDH and health outcomes in cities/neighborhoods with significant NHW populations (significant was defined as top population proportion quintile). We analyzed AA subgroups including Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, and Other AA.
Results: The count and proportion of AA/AA subgroup populations varied substantially across and within cities. When comparing cities with significant AA/AA subgroup populations vs NHW populations, there were few meaningful differences in SDH and health outcomes. However, when comparing neighborhoods within cities, areas with significant AA/AA subgroup vs NHW populations had less favorable SDH and health outcomes.
Conclusion: When comparing places with significant AA vs NHW populations, city-level data obscured substantial variation in neighborhood-level SDH and health outcome measures. Our findings emphasize the dual importance of granular spatial and AA subgroup data in assessing the influence of SDH in AA populations.
Copyright © 2021, Ethnicity & Disease, Inc.

Entities:  

Keywords:  Asian American Health; Population Health; Social Determinants of Health; Spatial Epidemiology

Mesh:

Year:  2021        PMID: 34295131      PMCID: PMC8288474          DOI: 10.18865/ed.31.3.433

Source DB:  PubMed          Journal:  Ethn Dis        ISSN: 1049-510X            Impact factor:   1.847


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