Chronic Diseases

Physical activity can delay functional decline in people with type 2 diabetes (T2D), but these associations have not been studied within a sample of Native Hawaiian or Pacific Islander adults with T2D.

A culturally-tailored, family-based mHealth intervention is feasible and acceptable among low-income, limited English-proficient Chinese families with T2D in NYC. Significant changes in HbA1c and self-management within the intervention group indicate this intervention may have potential efficacy. Given the small sample size of this study, a future RCT with adequate power is needed to test efficacy.

The risk of diabetes among Asian, Native Hawaiian, and Pacific Islander (ANHPI) women after breast cancer is unclear. This study estimated the risk of incident type II diabetes in older ANHPI and older non-Hispanic White (NHW) women with breast cancer from the US National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Medicare linked claims.

United States South Asians constitute a fast-growing ethnic group with high prevalence of type 2 diabetes (T2D) despite lower mean BMI and other traditional risk factors compared to other races/ethnicities. Bilirubin has gained attention as a potential antioxidant, cardio-protective marker. Hence we sought to determine whether total bilirubin was associated with prevalent and incident T2D in U.S. South Asians.

The following thematic patterns emerged in these dyads around support: independence, transitions, partnership, and stepping in. The findings point to various supportive stages that Asian American adult children and aging parents with T2D experience and the importance of developing supportive interventions for both adult children and aging parents at these various stages.

We demonstrated the feasibility of recruiting and retaining a geographically diverse sample of Chinese American immigrants with prior gestational diabetes during the COVID-19 pandemic. Recruiting Chinese immigrants via social media (e.g., WeChat) is a viable approach. Nonetheless, more inclusive recruitment strategies are needed to ensure broad representation from diverse socioeconomic groups of immigrants.

he Vietnamese American (VA) population is projected to grow to 3.9 million by 2030. This demographic shift could affect health care cost as VAs have greater susceptibility for type 2 diabetes mellitus (T2DM). Few studies have explored diabetes self-management (DSM) among VAs. The aim of this study was to explore and describe how VAs with T2DM perceive diabetes and DSM practices.

In 2009, President Obama signed an Executive Order calling for strategies to improve the health of Asian Americans and to seek data on the health disparities in Asian American subgroups. Data on Asian American subgroups are scarce and many health disparities remain unknown. The purpose of this Advisory is to highlight the gaps in existing research on cardiovascular disease (CVD) among Asian Americans, and to serve as a call to action on behalf of the American Heart Association to address these areas of need.

Asian Americans are often aggregated in national public health surveillance efforts, which may conceal important differences in the health status of subgroups that are included in this highly diverse population. Little is known about how cardiovascular health varies across Asian subpopulations and the extent to which lifestyle and social risk factors contribute to any observed differences. This national study used data from the National Health Interview Survey to evaluate the burden of cardiovascular risk factors (hypertension, hyperlipidemia, diabetes mellitus) and cardiovascular diseases (heart attack, coronary heart disease, angina, stroke) across Asian groups (Chinese, Asian Indian, Filipino, Other Asian), and determine whether differences are related to lifestyle factors and/or social determinants of health.

The DASH diet had the strongest association with reduced odds of HDP, but better diet quality in any of the indices was also predictive.

This study aimed to understand the reasons behind evidence-practice gaps and inequities in cardiovascular care for Māori and Pacific people, as evidenced by the experiences and perspectives of patients and their families.

This study highlights a gap between indigenous patients' understanding of CID and the western biomedical approach. Patients' understanding and treatment behaviours depend on symptoms, familial ties and spirituality. The findings support the need for transparency and culturally appropriate practices in healthcare. Considering these aspects may help to reduce health inequities for these populations.

Social determinants of health (SDOH) play a significant role in the development of cardiovascular risk factors. We investigated SDOH associations with cardiovascular risk factors among Asian American subgroups.

Cutting-edge approaches, such as genomewide association studies, admixture mapping, and phylogenetic analyses, offer new opportunities for dissecting the genetic basis for asthma in populations of African descent.

Although asthma affects all ethnic groups, the burden from this disease is disproportionately shared by certain minority groups and the economically disadvantaged. The prevalence of childhood asthma among Puerto Ricans (19.2%) or non-Hispanic blacks (12.7%) is higher than among non-Hispanic whites (8%) or Mexican Americans (6.4%) (2). Ethnic disparities in asthma morbidity and mortality are even more pronounced (3). Asthma mortality rates in children and adults are nearly eightfold and threefold higher, respectively, in non-Hispanic blacks than in non-Hispanic whites.

The SEM-based equity frameworks proposed provide the first multidisciplinary strategies dedicated to increase engagement of Black males in PCA GT, which are critical to reduce disparities in PCA-mortality through informing tailored screening, targeted therapy, and cascade testing in families.

“Our findings demonstrate that multiple, interacting factors contribute to disparities in breast cancer survival between Black and white women,” said senior author Erica Warner, ScD, MPH, a cancer epidemiologist at Massachusetts General Hospital, a founding member of the Mass General Brigham healthcare system. “To achieve equity, intervention is necessary at multiple levels—from community to healthcare systems and individual healthcare providers, to patients themselves learning about their disease and what their expectations should be for their care.”

PSA testing was associated with a reduced risk of PCSM in both NHB and NHW men diagnosed with PCa. Additionally, the positive impact of the screening rate seemed to be independent of race.

Diabetes care disparities are evident among cancer survivors and salient among non-cancer controls. Strategies to promote health equity should target specific care indices among survivors and emphasize equitable DCQ strategies among Black and Hispanic communities.

After decreasing death rates associated with CVD and PCa from 1999 to 2015, a reversal in the trend was observed from 2015 to 2019. Addressing this increase in death rates, especially among the vulnerable population, requires focused attention and targeted strategies to implement necessary safeguards in the upcoming years.

“The beginnings of a solution, he said, might be education. It needs to be culturally relevant and "delivered by individuals that have relatable backgrounds and experiences."”

“We suggest health care professionals create culturally tailored interventions that aid individuals in educating others, advocating for themselves, or recognizing situations outside one’s control and detaching from responsibility, rather than internalizing experiences of discrimination or engaging in strong responses that upon reflection are detrimental to one’s health.”

Statistics from the Office of Minority Health focusing on diabetes in the African American community.

People in racial and ethnic minority communities are most affected by diabetes because they are more likely to live in under-resourced neighborhoods. Factors called "social determinants of health" like poverty, lack of access to healthy food, restrictions on safe physical activity, inadequate employment and limited educational opportunities can result in negative health outcomes in such communities.”

“A study found that biological risk factors—including weight and fat around the abdomen—are primarily responsible for higher rates of diabetes for black Americans compared with white Americans. The study suggests that making positive changes in known risk factors, like losing excess weight, can help reduce the racial health disparity for developing diabetes.”

How high blood pressure, overweight and obesity, and diabetes “affect Black people and some tips on how to lower your risk.”

“In this article, cardiovascular disease in African Americans is used as an example to highlight the successes achieved during the last half-century in reducing mortality rates, the persisting challenge of suboptimal adoption of evidence-based practices to promote community health and prevent disease, and the still widespread and pervasive health disparities. The article concludes with a call for the scientific community to embrace implementation research in strategic partnership with community stakeholders to stem the tide of cardiovascular disease and reduce related cardiovascular health disparities.”

Statistics from the Office of Minority Health focusing on heart disease in the African American community.

“Cardiovascular disease is the leading cause of death in the U.S. But racial and ethnic minority groups carry a heavier burden. Heart disease risk factors and diagnoses are more common among ethnic minorities. Social factors, known as social determinants of health, drive these health disparities.”

The Black–White difference in CVD mortality diminished after adjustment for behavioral and metabolic risk factors and completely dissipated with adjustment for social determinants of health in the U.S. population.

6 things to know about heart health.

“Now, a new study from Tulane University published in Annals of Internal Medicine has found that this racial disparity can be attributed to social factors such as unemployment, low income, and lack of a partner rather than known factors such as hypertension and obesity.”

Although asthma affects all ethnic groups, the burden from this disease is disproportionately shared by certain minority groups and the economically disadvantaged. The prevalence of childhood asthma among Puerto Ricans (19.2%) or non-Hispanic blacks (12.7%) is higher than among non-Hispanic whites (8%) or Mexican Americans (6.4%) (2). Ethnic disparities in asthma morbidity and mortality are even more pronounced (3). Asthma mortality rates in children and adults are nearly eightfold and threefold higher, respectively, in non-Hispanic blacks than in non-Hispanic whites.

Children of Hispanic ethnicity with HRNBL receiving clinical trial-delivered therapy were more likely to experience ICU-level care compared to NHW children. These data suggest that further investigation of treatment-related toxicity as a modifiable mechanism underlying outcome disparities is warranted.

This systematic review represents a significant contribution to the field as it is the first comprehensive review in Latin America that addresses the influence of masculinity stigma on the diagnosis and treatment of metastatic prostate cancer.

Diabetes care disparities are evident among cancer survivors and salient among non-cancer controls. Strategies to promote health equity should target specific care indices among survivors and emphasize equitable DCQ strategies among Black and Hispanic communities.

Overall, participants liked the use of fotonovelas to increase GCT awareness and cancer conversations with family. Fotonovelas could potentially be used as educational tools to increase GCT awareness and cancer conversations among Latino families at-risk of HBOC.

Hispanic White children developing type 1 diabetes have a high prevalence of HLA DR4-DQ8, which can be utilized to select individuals for immune monitoring with islet autoantibodies to lessen diabetic ketoacidosis and potentially prevent diabetes onset.

This study identified late morning as a favorable meal timing in Hispanic/Latino adults, providing a novel perspective on type 2 diabetes prevention that warrants confirmation.

Communities with lower Healthy Places Index (HPI) scores were associated with higher prevalence of metabolic disease and a greater proportion of Latino residents. Cities in the lowest decile of HPI scores had 71% of the population identifying as Latino compared to 12% in the highest decile. HPI scores explained 61% of the variability in adult obesity.

Diabetes care disparities are evident among cancer survivors and salient among non-cancer controls. Strategies to promote health equity should target specific care indices among survivors and emphasize equitable DCQ strategies among Black and Hispanic communities.

Occupational therapists may use the whole day TLX to track progress in interventions focused on reducing clients’ whole day workload exposure to promote their health and well-being. Occupational therapists’ expertise in areas such as activity analysis, task adaptation, and energy conservation makes them especially well-suited to intervene on whole day workload.

“Cardiovascular disease is the leading cause of death in the U.S. But racial and ethnic minority groups carry a heavier burden. Heart disease risk factors and diagnoses are more common among ethnic minorities. Social factors, known as social determinants of health, drive these health disparities.”

Communities with lower Healthy Places Index (HPI) scores were associated with higher prevalence of metabolic disease and a greater proportion of Latino residents. Cities in the lowest decile of HPI scores had 71% of the population identifying as Latino compared to 12% in the highest decile. HPI scores explained 61% of the variability in adult obesity.

Interventions to reduce racial disparities in utilization of metabolic and bariatric surgery (MBS) should focus on progression from discussion to MBS. Interventions to increase the uptake of MBS among men are required across the care cascade.

Obesity interventions for Mexican American women may benefit from targeting relational skills to improve family functioning.

• Diverse/rural dyads experience barriers to engagement and retention in interventions.
• These barriers can be overcome by providers using specific communication strategies.
• Effective communication builds trust and may lead to better outcomes.

Native American genetic ancestry seems to play a small but distinct role in the development of low HDL cholesterol levels.

This prospective study of HF risk factors in American Indian communities identifies that smoking, body mass index, and indicators of diabetes control and kidney damage (glycated hemoglobin and albuminuria) are major determinants of HF. Our findings can improve HF risk assessment in populations with a high burden of diabetes.

Rates of obesity, diabetes, cardiovascular disease, and metabolic syndrome are clearly higher for AI/AN populations. Hypertension and hyperlipidemia differences are more equivocal. Our analysis also revealed that there are likely regional and gender differences in the degree of disparities observed.

In order to provide equitable breast health care, more awareness and widescale initiatives are needed and can be championed by breast radiologists.

Cancer patients in block groups with AI/AN-majority populations, nonmetropolitan location, and low socioeconomic status experience substantial travel disparities in access to RT. Future research with more granular community- and individual-level data should explore the many other known barriers to access to cancer care and their relationship to the barriers posed by distance to RT care.

To provide high quality cancer care to AI patients in their home communities, oncology clinicians should collaborate with local care providers, relevant organizations, and the Indian Health Service to identify and develop essential services. Future efforts must emphasize culturally responsive interventions in which Tribal community health workers serve as navigators to accompany patients and families during treatment and in survivorship.