Changing Landscape of Diabetes Prevalence Among Asian Immigrants and White Americans in California 2003-2013
- Author(s): Fan, Wenjun
- Advisor(s): Wang, Ping H.
- et al.
Objectives: Asians are at high risk for diabetes mellitus (DM), yet there is little population-based information about DM prevalence among subgroups of immigrants and US-born Asians in the US over time. The purpose of this study is to compare the prevalence and odds ratios (ORs) of DM between Asian and Asian subgroup immigrants and White in California using data from 2003, 2005, 2007, 2009, 2011, 2013 California Health Interview Survey (CHIS).
Methods: Six CHIS datasets were analyzed and compared to determine the prevalence of DM among Asian Immigrants and White from 2003 to 2013. Subjects who reported a physician-diagnosis of diabetes (type 1 and type 2) were considered to have DM (borderline/prediabetes and gestational diabetes were not included). Multivariable logistic regression models were built to calculate adjusted ORs of DM and to find the potential explanations for the differences in the prevalence results.
Results: There was a trend towards higher rate of diabetes for both Asian Immigrants and White in California over the last decade. Asian Immigrants had a continuously higher prevalence of DM compared to White, and the difference was greater especially in 2013. Prevalence of DM varied greatly among Asian subgroups with Filipinos and Koreans being two highest groups. After adjusting for confounding variables (age, sex, obesity, education attainment, insurance status, English proficiency, smoking status, taking medication to control high blood pressure), the ORs of DM between Asian Immigrants and White were 1.71(0.96-3.05), 1.31(0.81-2.13), 1.22(0.79-1.89), 2.19*(1.13-4.22), 1.81*(1.15-2.87), 2.09*(1.05-4.18) for 2003, 2005, 2007, 2009, 2011 and 2013 CHIS dataset respectively.
Conclusions: Overall, Asian Immigrants were more likely to develop DM compared to White in California during the last decade, even after controlling for confounding variables. Great variability exists in DM prevalence among Asian subgroups and this should be considered in future studies.