Objective Asian Indians are among the fastest growing United States (US) ethnic subgroups. We characterized mortality trends for leading causes of death among foreign-born and US-born Asian Indians in the US between 2005–2017. Study design and setting Using US standardized death certificate data, we examined leading causes of death in 73,470 Asian Indians and 20,496,189 non-Hispanic whites (NHWs) across age, gender, and nativity. For each cause, we report age-standardized mortality rates (AMR), longitudinal trends, and absolute percent change (APC). Results We found that Asian Indians’ leading causes of death were heart disease (28% mortality males; 24% females) and cancer (18% males; 22% females). Foreign-born Asian Indians had higher all-cause AMR compared to US-born (AMR 271 foreign-born, CI 263–280; 175.8 US-born, CI 140–221; p<0.05), while Asian Indian all-cause AMR was lower than that of NHWs (AMR 271 Indian, CI 263–278; 754.4 NHW, CI 753.3–755.5; p<0.05). All-cause AMR increased for foreign-born Asian Indians over time, while decreasing for US-born Asian Indians and NHWs. Conclusions Foreign-born Asian Indians were 2.2 times more likely to die of heart disease and 1.6 times more likely to die of cancer. Asian Indian male AMR was 49% greater than female on average, although AMR was consistently lower for Asian Indians when compared to NHWs.

PurposeBreast cancer is the second leading cause of female cancer mortality in the United States and breast cancer mortality in Asian Americans (AA) is rising by 1.5% per year. However, aggregated AA breast cancer death rates may mask important mortality differences in major AA groups.Population & Setting11,388 AA and 473,927 non-Hispanic White (NHW) females based on the United States Centers for Disease Control and Prevention National Vital Statistics System database 2003-2017.MethodsAge-adjusted mortality rates (AAMR) were used to estimate trends in breast cancer mortality in Asian Indians, Chinese, Filipinas, Japanese, Koreans, Vietnamese, and non-Hispanic Whites from 2003–2017, with attention to annual percentage change (APC) and proportional mortality rates (PMR).ResultsFrom 2003-2017, breast cancer deaths comprised 14.4% in NHWs, 13.7% in aggregate AAs, 19.8% in Asian Indians, and 18.6% of all cancer deaths in Filipinas. While NHW breast cancer mortality rate significantly decreased (APC -2.1; CI -2.6, -1.6; p < 0.001) from 2003 to 2017, aggregate AA mortality rates were unchanged (APC 3.07; CI -0.37, 7.8; p = 0.071). However, when disaggregated, breast cancer mortality in Filipina (APC 1.9; CI 0.8, 3.0; p < 0.002), Chinese (APC 2.1; CI 1.3, 3.0; p < 0.001), and Korean (APC 2.6; CI 1.0, 4.1; p = 0.004) women significantly increased. Breast cancer mortality rates in Japanese women decreased (APC -1.9; CI -5.9, 2.1; p = 0.3).ConclusionWhile the proportion of women dying from breast cancer were similar in NHWs and aggregate Asians, when disaggregated, Filipina, Korean, and Chinese women had increased mortality rates over the past 15 years. During this time, breast cancer mortality in NHW and Japanese women decreased. Understanding disaggregated breast cancer mortality rates in Asians may improve culturally-tailored outreach, prevention, and treatment strategies to reduce cancer deaths from this critical disease.