Related Experiment Video
Updated: Sep 19, 2025
06:55
Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
14.7K
County-Level Factors and Mortality Among Pacific Islander Compared With Asian American Adults.
Jaimie Z Shing1, Paloma R Mitra1, Neal D Freedman1
1Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
JAMA Network Open
|June 6, 2025
Summary
Pacific Islander adults face higher mortality rates than Asian American adults, particularly in areas with better socioeconomic factors and higher population density. These disparities highlight the need for tailored health interventions.
Area of Science:
- Public Health and Epidemiology
- Sociomedical Sciences
- Health Services Research
Background:
- Interactions between race and county-level socioeconomic factors on mortality are understudied for Asian American and Pacific Islander populations.
- Previous research may have aggregated these distinct groups, potentially masking specific health disparities.
Purpose of the Study:
- To compare all-cause, cancer, and heart disease mortality rates between Pacific Islander and Asian American adults.
- To examine the influence of county-level factors (employment, education, income, population density) on these mortality rates.
Main Methods:
- Cross-sectional study using National Center for Health Statistics death certificate data (2018-2020).
- Included non-Hispanic Asian American and Pacific Islander adults aged 20-84 years.
- County-level socioeconomic data from the American Community Survey and population density from Rural-Urban Continuum Codes were analyzed.
Main Results:
- Pacific Islander adults exhibited elevated all-cause, cancer, and heart disease mortality rates compared to Asian American adults across all analyzed county-level factors.
- The largest disparities were observed in counties with the lowest unemployment, highest educational attainment, highest median household income, and highest population density.
- Significant mortality rate ratios (MRRs) were found, especially for heart disease in younger Pacific Islander adults in disadvantaged counties.
Conclusions:
- Mortality disparities between Asian American and Pacific Islander populations are exacerbated in counties with higher socioeconomic status and population density.
- The aggregation of these groups in past health initiatives may have obscured critical disparities, particularly for Pacific Islander adults in socioeconomically advantaged and populated areas.
- Findings underscore the need for race-specific and geographically tailored public health strategies.
Related Concept Videos
01:18Factors Affecting Illness
4.5K
When a person's physical, emotional, intellectual, social development or spiritual functioning is compromised, this deviation from a healthy normal state is called illness. Illness creates stress that in turn harms individuals. Irritation, anger, denial, hopelessness, and fear are behavioral and emotional changes an individual experiences in the phases of illness. A variety of factors influence a person's health and well-being.
For instance, risk factors are connected to illness,...
For instance, risk factors are connected to illness,...
4.5K
01:29Bias in Epidemiological Studies
709
Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:
709
01:20Actuarial Approach
140
The actuarial approach, a statistical method originally developed for life insurance risk assessment, is widely used to calculate survival rates in clinical and population studies. This method accounts for participants lost to follow-up or those who die from causes unrelated to the study, ensuring a more accurate representation of survival probabilities.
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
140
01:20Comparing the Survival Analysis of Two or More Groups
303
Survival analysis is a cornerstone of medical research, used to evaluate the time until an event of interest occurs, such as death, disease recurrence, or recovery. Unlike standard statistical methods, survival analysis is particularly adept at handling censored data—instances where the event has not occurred for some participants by the end of the study or remains unobserved. To address these unique challenges, specialized techniques like the Kaplan-Meier estimator, log-rank test, and...
303
01:12Relative Risk
366
Relative risk (RR) is a statistical measure commonly used in epidemiology to compare the likelihood of a particular event occurring between two groups. This metric is important for evaluating the relationship between exposure to a specific risk factor and the probability of a particular outcome. It plays a crucial role in medical research, public health studies, and risk assessment. Relative risk quantifies how much more (or less) likely an event is to occur in an exposed group compared to an...
366
01:20Lifestyle Factors and Health
134
Lifestyle factors play a critical role in maintaining overall health and preventing chronic diseases. Key elements, such as regular physical activity, a nutritious diet, and abstinence from smoking, can significantly enhance physical, mental, and emotional well-being while reducing the risk of several life-threatening conditions.
Benefits of Physical Activity
Physical activity, whether through structured exercise or casual activities like walking, biking, or dancing, is a cornerstone of a...
Benefits of Physical Activity
Physical activity, whether through structured exercise or casual activities like walking, biking, or dancing, is a cornerstone of a...
134