UCI-led study finds disparities in undiagnosed hypertension among Chinese and Korean American Immigrants

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Chinese and Korean American immigrants who lack health insurance are at an increased risk of having hypertension, but not knowing it, according to a UCI-led study recently published in the Journal of Community Health.

The study, led by corresponding author and assistant professor of health, society and behavior with the UCI Program in Public Health Brittany N. Morey, PhD, looked at a number of demographic, socioeconomic and immigration-related factors to examine their associations with hypertension status, including age, gender, marital status, level of education, employment and English speaking proficiency.

“Some associations were more strongly associated with undiagnosed hypertension than others,” Morey explained. “Although we found that male gender and being married were also associated with having undiagnosed hypertension, having no health insurance was by far the strongest predictor. And having lower income and being unemployed were factors associated with having no health insurance.”

Their work was prompted by the staggering statistic that an estimated 11 million people in the U.S. have hypertension but remain undiagnosed, with Asian Americans at disproportionate risk compared to non-Hispanic white Americans and immigrants more likely than their U.S.-born counterparts to have undiagnosed hypertension. The researchers’ study points to several factors that contribute to this overlooked problem among Asian Americans, including the incorrect perception that Asians are not at high risk for cardiovascular disease due to their lower prevalence of obesity and lower body mass indices (BMI) than other racial/ethnic groups in the U.S. In fact, Asian Americans face a disproportionately high burden of hypertension even at lower BMIs, which likely contributes to disparities in other severe health conditions like heart attack and hemorrhagic stroke.

Their study found that among participants ages 50 to 75 years, 53.5% had either diagnosed or undiagnosed hypertension. And among those with hypertension, 27.4% were found to be undiagnosed with the condition. These numbers are higher than previous studies estimated.

“Our study underscores the importance of increasing access to health insurance for Asian American immigrant groups to ensure that hypertension is diagnosed and treated,” Morey said. “Hypertension is one example of health disparities that must be addressed through equitable health policy. We need a system that works for everyone, and certainly one that acknowledges these often overlooked issues among our most vulnerable populations.”

Co-authors included UCI Public Health doctoral candidate Connie Valencia, MPH and professor in the Division of Hematology/Oncology at the UCI School of Medicine Sunmin Lee, ScD.