Academic journal article Canadian Journal of Public Health

Diabetes among Non-Obese Filipino Americans: Findings from a Large Population-Based Study

Academic journal article Canadian Journal of Public Health

Diabetes among Non-Obese Filipino Americans: Findings from a Large Population-Based Study

Article excerpt

Although the Asian American and Pacific Islanders (AAPI) population is the fastest growing non-Caucasian group in the United States, with a dramatic 43% increase between 2000 and 2010,1 they remain under-represented in most epidemiological studies.2 Moreover, studies including AAPI samples typically aggregate multiple ethnic groups under one large category,2 despite the fact that there are substantial differences between the groups in terms of culture, language, lifestyle, habits and health practices. Aggregating such a diverse racial group in one category also masks the heterogeneity in disease prevalence and risk factors. Thus, it is important to take these differences into consideration when designing, implementing and evaluating studies on health risks and health conditions as well as when tailoring prevention and intervention approaches to target specific ethnic groups within the diverse AAPI population.

Filipinos are the second-largest AAPI subgroup, with about 3.4 million living in the US as of 2010.3 Most Filipino immigrants come to the US seeking better employment or educational opportunities, and/or to reunite with family members,4 as is the case for those who immigrate to Canada. One in every 50 Canadians is of Filipino descent.5-7 With a population of approximately 660 000, Filipino Canadians are the fourth-largest non-Caucasian group in Canada.5-7 Growing evidence suggests that there are discrepancies in health outcomes between Filipino Americans and their AAPI and white counterparts. In particular, the prevalence of cardiovascular disease (CVD) and cardiovascular risk factors is exceptionally high among Filipino Americans.8 An estimated two in five Filipino Americans have hypertension.9 In addition to cardiovascular disorders, Filipino Americans also have higher rates of obesity than other AAPI subgroups.10 The prevalence of many of these chronic conditions rises with age and time since immigration, increasing the susceptibility of older Filipino adults to chronic diseases11 as they age in the US.

Diabetes is another chronic disease that has been shown to be more prevalent among Filipino men (15.8%) than among the overall male population (6.1%) in the US.7 Indeed, a large crosssectional study showed that Filipino Americans had a higher overall prevalence of type 2 diabetes compared to their peers of the same sex from each of the following groups*: non-Hispanic whites, Chinese, South Asian, Japanese, Korean, Vietnamese and * We are aware that within many of these groups, considerable variation in health status and health practices may exist. For example, South Asian Americans should be disaggregated into Indians, Pakistani, Afghanis, Sri Lankans, etc., but those data are not readily available, and hence, in this study, we had to rely on these larger groupings for comparison purposes.

Author Affiliations

1. Sandra Rotman Chair in Social Work, Faculties of Social Work & Medicine, University of Toronto, Toronto, ON

2. Institute for Life Course and Aging, University of Toronto, Toronto, ON

3. Assistant Professor, School of Social Welfare, University at Albany, SUNY, Albany, NY, USA

4. Associate Professor and Research Affiliate, Department of Sociology and Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC

Correspondence: Esme Fuller-Thomson, PhD, Sandra Rotman Chair in Social Work, Faculties of Social Work & Medicine, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4, Tel: 416-978-3269, E-mail: esme.fuller.Thomson@utoronto.ca

Acknowledgements: The lead author gratefully acknowledges support received from the Sandra Rotman Endowed Chair in Social Work at the University of Toronto. The authors thank Senyo Agbeyaka for his assistance in preparing the manuscript.

Conflict of Interest: None to declare.

Mexican.7 The major risk factors for type 2 diabetes in Filipino Americans were increasing age, being male, family history of diabetes, and obesity; and in Filipina women, older age, low income and a history of gestational diabetes. …

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