Journal of Asian Health

Racial and Ethnic Trends in Recommended Vaccinations Among US Adults, National Health Interview Survey 2006–2021

Armaan Jamal — 2024-04-30

Objectives:

Reducing racial/ethnic disparities in immunization rates is a major goal of Healthy people 2030. There is a lack of clear understanding regarding the trends in vaccination rates for recommended vaccines among different racial/ethnic subgroups. This study aims to describe United States adult vaccination trends by race/ethnicity between 2006-2021.

Study Design:

This is a cross-sectional study using the National Health Interview Survey data.

Methods

Temporal trends in influenza, pneumococcal, herpes zoster (shingles), hepatitis A and hepatitis B vaccination rates were examined by race/ethnicity between 2006-2021. Absolute annual change in vaccine rates were estimated using joinpoint regression. P-values <0.05 were considered statistically significant.

Results

In 2021, Non-Hispanic Blacks (NHBs) and Hispanics had significantly lower influenza rates compared to Non-Hispanic Whites (NHWs). Similarly, NHBs, Hispanics and Asians had significantly lower rates of pneumococcal and shingles vaccinations compared to NHWs. On the other hand, Asians had significantly higher hepatitis A and hepatitis B vaccination rates compared to NHWs. Since 2006, influenza vaccine rates have increased steadily across all race/ethnicity groups (p<0.001). However, pneumococcal vaccination rates increased only among NHBs and Asians (p=0.01). Shingles and hepatitis A vaccination rates increased for NHWs (p<0.001), NHBs (p<0.001 and p=0.016, respectively) and Hispanics (p<0.001 and p=0.043, respectively). Hepatitis B vaccination rates increased only for NHWs (p=0.04).

Conclusion

Racial/ethnic disparities in recommended vaccines continue to persist. This necessitates ongoing efforts to reduce disparities.

Oral Health Disparities among Asians in the U.S.: The Role of household Language

Chengming Han — 2024-04-30

This study aimed to explore the oral health disparities between Asian Americans and whites by examining the roles of household language, immigrant status, and socioeconomic status in access to dental care and their effects on oral health status. Data were drawn from the 2011-2018 National Health and Nutrition Examination Survey (NHANES). All analyses were stratified by whites, Asians who speak English at home, and Asians who do not speak English at home. Coefficient tests were employed to reveal differences between Asians and whites. The results suggested that Asians who speak English at home presented higher socioeconomic status (SES) and better oral health status than whites, whereas Asians who do not speak English at home presented fewer dentist visits, more missing teeth, and lower socioeconomic status. Higher education and family income played more significantly protective roles in dental care access and oral health status for whites than for each Asian language group.

Improving the diagnosis of under-recognized, rare diseases in Asian populations: Systematic analysis of rare disease databases

Daphne Ih — 2024-04-30

Rare diseases affect approximately 30 million Americans, but fewer than one in 10 of these patients receive an accurate diagnosis and timely, appropriate treatment. Many of these medical conditions disproportionately impact patients of Asian descent as well as other racial and ethnic minorities; however, at the time of this writing, they are not well recognized or sufficiently represented in current medical training curricula or existing scientific literature. To better assess these disparities, we conducted a systematic analysis of the National Organization for Rare Disorders (NORD) and Genetic and Rare Diseases (GARD) Information Center databases to identify rare diseases that are often misdiagnosed in individuals of Asian descent, as well as scientific studies through the PubMed search engine that discuss racial and ethnic disparities in rare clinical diagnoses. Searches in the NORD and GARD databases yielded 52 medical conditions with reported disproportionate prevalence across Asian populations. A subsequent PubMed search regarding these 52 medical conditions identified 133 articles relevant to the potential misdiagnosis and under-recognition of these rare diseases. Overall, there is a paucity of literature on rare diseases and our findings highlight the need for more research on underrecognized rare diseases that disproportionately impact Asian populations. Future educational programs for medical trainees and practitioners should increase focus on rare diseases in racial and ethnic minority groups to improve diagnosis and minimize disparities in health outcomes.

The Prevalence and Risk Factors for Presarcopenia among Young and Middle-aged Asian Americans: A Cross-Sectional Study using NHANES data

Ngan Huang — 2024-04-30

Objectives: To examine the prevalence of and risk factors for presarcopenia (low muscle mass with normal function) among Asian Americans (AAs), compared with non-Hispanic Whites (NHWs); and to assess the relationship between appendicular lean mass index (ALMI) and handgrip strength by race.

Design: A cross-sectional analysis of the National Health and Nutrition Examination Survey (2011-2014) was conducted, using ALMI (assessed via dual-energy X-ray absorptiometry) and handgrip strength data from adults aged 18-59 years.

Results: Of 3,116 participants (2,293 NHW, 823 AA), presarcopenia prevalence was 10% among NHWs and 27% among AAs. In multivariable regression, AA race (OR 4.2, 95% CI 2.6-6.6) and female sex (OR 1.6 ,95% CI 1.3-2.0) were associated with presarcopenia. Conversely, holding a college degree (OR 0.52, 95% CI 0.30-0.92), high physical activity (OR 0.59, 95% CI 0.43-0.80), being overweight (OR 0.06, 95% CI 0.04-0.08) and obesity (OR 0.00, 95% CI 0.00-0.02) status were inversely associated. Both AAs and NHWs exhibited increasing prevalence of low muscle mass with reduced handgrip strength.

Conclusion: Young and middle-aged AAs are at increased risk of presarcopenia, relative to NHWs. This vulnerable demographic group may benefit from targeted public health interventions to reduce progression toward sarcopenia later in life.