Subgroup Variation and Neighborhood Social Gradients—an Analysis of Hypertension and Diabetes Among Asian Patients (New York City, 2014–2017)

Feldman, Justin M.; Conderino, Sarah; Islam, Nadia; Thorpe, Lorna E.

doi:10.1007/s40615-020-00779-7

Cited by 13 publications

(8 citation statements)

References 16 publications

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“…Asians experience overweight and obesity at lower BMI values than individuals of other racial groups, resulting in a higher prevalence of these conditions than expected. 21 Additionally, South Asians have high rates of diabetes and hypertension that are comparable to those observed among Black and Hispanic individuals, and they have a disproportionate burden of morbidity and mortality from cardiovascular disease. These factors are known to put individuals at elevated risk of COVID-19 infection, hospitalization, and death, and they are highly prevalent among many Asian Americans.…”

Section: Discussionmentioning

confidence: 99%

Disaggregating Asian Race Reveals COVID-19 Disparities among Asian Americans at New York City’s Public Hospital System

Marcello

Dolle

Tariq

et al. 2020

Preprint

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There is growing recognition of the burden of COVID-19 among Asian Americans, but data on outcomes among Asian ethnic subgroups remain extremely limited. We conducted a retrospective analysis of 85,328 patients tested for COVID-19 at New York City’s public hospital system between March 1 and May 31, 2020, to describe characteristics and COVID-19 outcomes of Asian ethnic subgroups compared to Asians overall and other racial/ethnic groups. South Asians had the highest rates of positivity and hospitalization among Asians, second only to Hispanics for positivity and Blacks for hospitalization. Chinese patients had the highest mortality rate of all groups and were nearly 1.5 times more likely to die than Whites. The high burden of COVID-19 among South Asian and Chinese Americans underscores the urgent needs for improved data collection and reporting as well as public health program and policy efforts to mitigate the disparate impact of COVID-19 among these communities.

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Section: Discussionmentioning

confidence: 99%

Disaggregating Asian Race Reveals COVID-19 Disparities among Asian Americans at New York City’s Public Hospital System

Marcello

Dolle

Tariq

et al. 2020

Preprint

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“…Rule-based algorithms developed for EHR were used to define diabetes and hypertension, as fully described elsewhere [ 11 , 12 ]. Briefly, burden estimates were defined by combining: ICD-9-CM and ICD-10-CM diagnostic codes, lab results or vitals, or relevant medications (Additional file 1 : Table S1).…”

Section: Methodsmentioning

confidence: 99%

Diabetes and hypertension among South Asians in New York and Atlanta leveraging hospital electronic health records

Beasley

Conderino

et al. 2021

Diabetol Metab Syndr

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Background Diabetes and hypertension disparities are pronounced among South Asians. There is regional variation in the prevalence of diabetes and hypertension in the US, but it is unknown whether there is variation among South Asians living in the US. The objective of this study was to compare the burden of diabetes and hypertension between South Asian patients receiving care in the health systems of two US cities. Methods Cross-sectional analyses were performed using electronic health records (EHR) for 90,137 South Asians receiving care at New York University Langone in New York City (NYC) and 28,868 South Asians receiving care at Emory University (Atlanta). Diabetes was defined as having 2 + encounters with a diagnosis of diabetes, having a diabetes medication prescribed (excluding Acarbose/Metformin), or having 2 + abnormal A1C levels (≥ 6.5%) and 1 + encounter with a diagnosis of diabetes. Hypertension was defined as having 3 + BP readings of systolic BP ≥ 130 mmHg or diastolic BP ≥ 80 mmHg, 2 + encounters with a diagnosis of hypertension, or having an anti-hypertensive medication prescribed. Results Among South Asian patients at these two large, private health systems, age-adjusted diabetes burden was 10.7% in NYC compared to 6.7% in Atlanta. Age-adjusted hypertension burden was 20.9% in NYC compared to 24.7% in Atlanta. In Atlanta, 75.6% of those with diabetes had comorbid hypertension compared to 46.2% in NYC. Conclusions These findings suggest differences by region and sex in diabetes and hypertension risk. Additionally, these results call for better characterization of race/ethnicity in EHRs to identify ethnic subgroup variation, as well as intervention studies to reduce lifestyle exposures that underlie the elevated risk for type 2 diabetes and hypertension development in South Asians.

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“…Selection bias is another key limitation of our analyses. Prior work has demonstrated the study sample is more economically privileged compared to NYC as a whole due to the nature of the NYU patient population (10), and the patient population at Emory is also a selected sample. Several other limitations of using EHR data in clinical research have been previously noted,(27-29) such as differences in procedures for documenting care across systems that could contribute to systematic differences in disease estimates across sites.…”

Section: Discussionmentioning

confidence: 99%

“…Rule-based algorithms developed for EHR were used to de ne diabetes and hypertension, as fully described elsewhere. (10,11) Brie y, burden estimates were de ned by combining: ICD-9-CM and ICD-10-CM diagnostic codes, lab results or vitals, or relevant medications (Supplemental le 1). Biologically implausible measurements for vitals and labs, such as systolic BP outside the range of 140-250 mmHg or diastolic BP outside the range of 90-150 mmHg, were excluded from these algorithms.…”

Section: Metric De Nitionsmentioning

confidence: 99%

Diabetes and Hypertension Among South Asians in New York and Atlanta Leveraging Hospital Electronic Health Records

Beasley

Conderino

et al. 2021

Preprint

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BACKGROUND: Diabetes and hypertension disparities are pronounced among South Asians. There is regional variation in the prevalence of diabetes and hypertension in the US, but it is unknown whether there is variation among South Asians living in the US. The objective of this study was to compare the burden of diabetes and hypertension between South Asian patients receiving care in the health systems of two US cities. METHODS: Cross-sectional analyses were performed using electronic health records (EHR) for 90,137 South Asians receiving care at New York University Langone in New York City (NYC) and 28,868 South Asians receiving care at Emory University (Atlanta). Diabetes was defined as having 2+ encounters with a diagnosis of diabetes, having a diabetes medication prescribed (excluding Acarbose/Metformin), or having 2+ abnormal A1C levels (≥6.5%) and 1+ encounter with a diagnosis of diabetes. Hypertension was defined as having 3+ BP readings of systolic BP ≥130 mmHg or diastolic BP ≥80 mmHg, 2+ encounters with a diagnosis of hypertension, or having an anti-hypertensive medication prescribed. RESULTS: Among South Asian patients at these two large health systems, age-adjusted diabetes burden was 10.7% in NYC compared to 6.7% in Atlanta. Age-adjusted hypertension burden was 20.9% in NYC compared to 24.7% in Atlanta. In In Atlanta, 75.6% of those with diabetes had comorbid hypertension compared to 46.2% in NYC.CONCLUSIONS: These findings suggest differences by region and sex in diabetes and hypertension risk. Additionally, these results call for better characterization of race/ethnicity in EHRs to identify ethnic subgroup variation, as well as intervention studies to reduce lifestyle exposures that underlie the elevated risk for type 2 diabetes and hypertension development in South Asians.

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Subgroup Variation and Neighborhood Social Gradients—an Analysis of Hypertension and Diabetes Among Asian Patients (New York City, 2014–2017)

Cited by 13 publications

References 16 publications

Disaggregating Asian Race Reveals COVID-19 Disparities among Asian Americans at New York City’s Public Hospital System

Disaggregating Asian Race Reveals COVID-19 Disparities among Asian Americans at New York City’s Public Hospital System

Diabetes and hypertension among South Asians in New York and Atlanta leveraging hospital electronic health records

Diabetes and Hypertension Among South Asians in New York and Atlanta Leveraging Hospital Electronic Health Records

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