Understanding Obesity and Cardiovascular Disease Risks Among Hmong-Americans
Author(s):
Ly, May Ying Nanette
Format:
Thesis
Degree granted:
Ph.D.
Publisher:
Ann Arbor : University of California, Davis, 2017.
Pages:
106
Language:
English
Abstract:
Cardiovascular disease is the second leading cause of death among Asians; however, there is limited data on cardiovascular disease for Asian-American subgroups. For Hmong-Americans, there are no longitudinal studies on obesity and cardiovascular disease. Increasing prevalence of obesity has led the American Medical Association to declare obesity as a disease. Body Mass Index (BMI) is used to measure body fatness at normal weight (? 24.9 kg/m2), overweight (25 kg/m2 to 29.9 kg/m 2), and obese (? 30 kg/m2). Evidence is emerging that there is increased risk of diabetes and cardiovascular risk in Asian populations below the recommended cut-points for overweight and obese. The purpose of this study is to understand obesity and cardiovascular risks among Hmong-Americans using data from electronic health records of 83,091 adults between the ages of 30-74 years old who met the study inclusion criteria between the period of 2010 – 2015. The results are presented in three papers. The first paper is a systematic review of the literature on methodologies using names to classify ethnicity. Forty-five papers were reviewed with sensitivity from 50.3% to 99% and specificity from 60% to 100%. The positive predictive value ranges from 57% to 100% and the negative predictive value ranges from 71.75% to 100%. The moderate to high sensitivity and specificity ranges demonstrated the usefulness of the name algorithms to infer ethnicity in health disparity research. The second paper validated the Pacific Islander Identification Algorithm [NAPIIA v1.2] used in this study to infer Hmong ethnicity. The sensitivity was 52.48%, specificity was 99.74%, positive predictive value was 71.15% and negative predictive value was 99.43%. The NAPIIAv1.2 is useful to infer Hmong ethnicity. The third paper show results of the prevalence of obesity and CVD risk among Hmong Americans. The Hmong obesity rate was twice higher than other Asians using the Asian and standard BMI cut points. The CVD risk scores for Hmong Americans were slightly higher (9.3%) than other Asians (7.7%). When controlling for gender and race, Hmong were significantly different from other Asians and NHW. Race and gender have a significant impact on the relationship between BMI and CVD risk scores.