Differential gastrointestinal mortality in Native Hawaiian/Pacific Islander and Asian subgroups in the U.S.: a cross-sectional analysis of national mortality surveillance data 2018–2023

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas Pub Date : 2026-03-01 Epub Date: 2026-01-14 DOI:10.1016/j.lana.2026.101372

Tiange P. Zhang , Jennifer L. Dodge , Norah A. Terrault , Brian P. Lee

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引用次数: 0

Abstract

Background

Asians and Native Hawaiians/Pacific Islanders (NHPIs) comprise 8% of the U.S. population with over 40 subgroups. Health data often aggregate these subpopulations, limiting group-specific estimates. In 2018, modifications to death certificates allowed for the disaggregation of NHPIs from Asians. This study examines differences in gastrointestinal-related mortality between NHPI and Asian adults across all major gastrointestinal disease categories.

Methods

We analyzed mortality data for adults aged ≥25 years from the National Center for Health Statistics 2018–2023. Established definitions classified NHPI and Asian individuals based on single or multi-race listings. Gastrointestinal-related deaths were identified using validated ICD-10 codes and categorized into liver diseases, colorectal cancer, upper gastrointestinal cancers, and non-cancer digestive diseases. Age-standardized mortality rates (ASMRs) per 100,000 and rate ratios were calculated.

Findings

Between 2018 and 2023, there were 3322 gastrointestinal-related deaths among NHPI adults (mean age 63.9 years, standard deviation 14.4; 1373 [41.3%] female decedents) and 47,275 among Asian adults (mean age 70.2 years, standard deviation 14.6; 20,892 [44.2%] female decedents). Overall gastrointestinal-related ASMR for NHPIs was 66.8 (95% CI: 64.5–69.2) per 100,000 adults. NHPIs exhibited higher mortality rates than Asians in all gastrointestinal disease categories. NHPIs had 24% higher overall gastrointestinal-related mortality rate than Asians (RR: 1.24; 95% CI: 1.20–1.29), with 33% higher for liver diseases (RR: 1.33; 95% CI: 1.24–1.44) and 63% higher for non-cancer digestive diseases (RR: 1.63; 95% CI: 1.49–1.77).

Interpretation

NHPIs (vs. Asians) have higher gastrointestinal-related mortality rates, with the greatest disparities observed in liver diseases and non-cancer digestive diseases. By disaggregating data across the full spectrum of gastrointestinal diseases, this study provides a clearer understanding of NHPI-specific disparities and highlights critical areas for targeted public health efforts.

Funding

U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

查看原文本刊更多论文

美国夏威夷原住民/太平洋岛民和亚洲亚群胃肠道死亡率的差异：2018-2023年国家死亡率监测数据的横断面分析

亚洲人和夏威夷原住民/太平洋岛民（nhpi）占美国人口的8%，有40多个亚群。卫生数据往往汇总了这些亚群，限制了特定群体的估计。2018年，对死亡证明的修改允许对来自亚洲的nhpi进行分类。本研究考察了NHPI和亚洲成年人在所有主要胃肠道疾病类别中胃肠道相关死亡率的差异。方法分析国家卫生统计中心2018-2023年年龄≥25岁成人的死亡率数据。已建立的定义根据单一或多种族列表对NHPI和亚洲个体进行分类。使用经过验证的ICD-10代码确定胃肠道相关死亡，并将其分类为肝病、结直肠癌、上胃肠道癌症和非癌症消化系统疾病。计算了每10万人的年龄标准化死亡率（ASMRs）及其比率。在2018年至2023年期间，NHPI成年人（平均年龄63.9岁，标准差14.4；女性死者1373例[41.3%]）中有3322例胃肠道相关死亡，亚洲成年人（平均年龄70.2岁，标准差14.6；女性死者20,892例[44.2%]）中有47,275例。nhpi患者的总体胃肠道相关ASMR为每10万成人66.8例（95% CI: 64.5-69.2）。在所有胃肠道疾病类别中，非裔美国人的死亡率都高于亚洲人。nhpi的胃肠道相关死亡率比亚洲人高24% (RR: 1.24; 95% CI: 1.20-1.29)，肝脏疾病的死亡率比亚洲人高33% (RR: 1.33; 95% CI: 1.24 - 1.44)，非癌症消化系统疾病的死亡率比亚洲人高63% （RR: 1.63; 95% CI: 1.49-1.77）。nhpi（与亚洲人相比）具有更高的胃肠道相关死亡率，在肝脏疾病和非癌症消化系统疾病中观察到的差异最大。通过分解胃肠道疾病全谱的数据，本研究提供了对nhpi特异性差异的更清晰理解，并突出了有针对性的公共卫生努力的关键领域。国家糖尿病、消化和肾脏疾病研究所。

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来源期刊

Lancet Regional Health-Americas Multiple-

CiteScore

8.00

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0.00%

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期刊介绍： The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.