Uncovering health disparities in Asian American and Pacific Islander communities

Equity in healthcare series – part 7

May marks Asian American, Native Hawaiian, and Pacific Islander (AANHPI) Heritage Month—a time to honor the diversity, resilience, and contributions of these communities. It’s also an important time to shine a light on the health disparities that often go unnoticed, especially when it comes to chronic and life-threatening diseases like heart disease and cancer.

The danger of aggregated data

Too often, healthcare data lumps Asian Americans and Pacific Islanders into a single category. This masks the distinct health challenges faced by different ethnic subgroups and makes it harder to understand their unique needs. Disaggregating this data is critical to identifying health disparities, improving outcomes, and delivering better care.

Heart disease in Pacific Islander communities

Pacific Islanders (PIs), including Native Hawaiians, Samoans, Guamanians, and others, face a disproportionately high burden of cardiovascular disease (CVD). In fact, Native Hawaiians and other Pacific Islanders have the second-highest death rate from CVD in the U.S.

Key risk factors include:

• Obesity: PIs are 150% more likely to experience obesity than the general U.S. population, driven by changes in dietary patterns and reduced physical activity.
• High blood pressure: Nearly 45% of Native Hawaiians and PIs live with hypertension, putting them at greater risk of heart attack and stroke.
• Diabetes: NH/PIs are more than twice as likely to be diagnosed with diabetes compared to non-Hispanic white individuals.

Social determinants of health (SDOH) also play a major role. Higher poverty rates, limited access to education, language barriers, shift to processed foods, and reduced access to culturally competent care all contribute to adverse outcomes.

Liver cancer in Asian American populations

Asian Americans, on the other hand, face a different but equally serious threat: liver cancer. Although they make up less than 10% of the U.S. population, Asian Americans account for 60% of liver cancer cases.

The most common form, hepatocellular carcinoma, is closely linked to chronic hepatitis B and C infections, both of which are more prevalent among people of Asian descent. In many parts of Asia, hepatitis B screening and treatment programs are limited, and mother-to-child transmission remains common. As a result, nearly 1 in 10 Asian Americans is a chronic hepatitis B carrier, dramatically increasing their risk of liver cancer.

Asian American men have higher liver cancer rates than any other racial or ethnic group with Vietnamese men experiencing the highest mortality. Women are also impacted. Asian American women are almost twice as likely as non-Hispanic white women to develop liver cancer.

Addressing the gap

These statistics underscore the need for improved data collection, culturally tailored education, and expanded access to prevention and care services. Several academic institutions are already leading efforts to address liver disease in Asian communities, including:

• UCLA Asian Liver Program
• Columbia Liver Asian Outreach Office
• Stanford Asian Liver Center
• UCSF Asian Liver Health Center

Moving forward: Better health equity

Understanding and addressing the distinct health risks faced by Asian American and Pacific Islander communities requires more than just awareness. It requires action. From disaggregating health data to investing in culturally competent care and education, we have the opportunity to close the gap in health outcomes and ensure these communities receive the attention and care they deserve.

To learn more about liver cancer, visit the CDC’s liver cancer resource.

Further reading

• Exploring underrepresentation in clinical trials
• Understanding the disparities: Why Black Americans suffer from higher rates of diabetes
• A shift in language: How healthcare is tackling stigma
• Women and autoimmune diseases: Understanding causes, trends, and treatments
• Women and migraines: Understanding the impact, triggers, and treatment
• Pharmacy deserts: A growing problem in the U.S.

References

• Key Data on Health and Health Care for Native Hawaiian or Pacific Islander People
• Native Hawaiian and Pacific Islander adults have second-highest cardiovascular death rate in the U.S.
• Disparity in Obesity and Hypertension Risks Observed Between Pacific Islander and Asian American Health Fair Attendees in Los Angeles, 2011–2019 – PMC
• Some racial/ethnic groups have greater chance of developing high blood pressure regardless of weight or where they live
• Taking Care of Our Hearts Together in the Asian American, Native Hawaiian, and Pacific Islander Community
• Health Indicators of Native Hawaiian and Pacific Islanders in the United States – PMC
• Health and Economic Benefits of High Blood Pressure Interventions
• Diabetes and Native Hawaiians/Pacific Islanders | Office of Minority Health
• Disparities in Diabetes Prevalence Among Native Hawaiians/Other Pacific Islanders and Asians in Hawai‘i
• Liver Cancer Causes, Risk Factors, and Prevention
• Key Statistics About Liver Cancer
• Liver Disease and Why It’s a Concern for Asian Americans and Pacific Islanders
• Chronic Liver Disease and Asian Americans
• Asian Liver Disease
• Hepatitis C and liver cancer: What to know
• Liver Cancer (Hepatocellular Carcinoma)

Learn more

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