• Rebecca C Woodruff, Joseph Keawe'aimoku Kaholokula, Lorinda Riley, Xin Tong, LaTonia C Richardson, Kotryna Diktonaite, Fleetwood Loustalot, Adam S Vaughan, Omoye E Imoisili, and Donald K Hayes.
• Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia (R.C.W., X.T., L.C.R., F.L., A.S.V., O.E.I., D.K.H.).
• Ann. Intern. Med. 2024 Nov 1; 177 (11): 150915171509-1517.

BackgroundNative Hawaiian and Pacific Islander (NHPI) adults have historically been grouped with Asian adults in U.S. mortality surveillance. Starting in 2018, the 1997 race and ethnicity standards from the U.S. Office of Management and Budget were adopted by all states on death certificates, enabling national-level estimates of cardiovascular disease (CVD) mortality for NHPI adults independent of Asian adults.ObjectiveTo describe CVD mortality among NHPI adults.DesignRace-stratified age-standardized mortality rates (ASMRs) and rate ratios were calculated using final mortality data from the National Vital Statistics System for 2018 to 2022.SettingFifty states and the District of Columbia.ParticipantsAdults aged 35 years or older at the time of death.MeasurementsCVD deaths were identified from International Classification of Diseases, 10th Revision codes indicating CVD (I00 to I99) as the underlying cause of death.ResultsFrom 2018 to 2022, 10 870 CVD deaths (72.6% from heart disease; 19.0% from cerebrovascular disease) occurred among NHPI adults. The CVD ASMR for NHPI adults (369.6 deaths per 100 000 persons [95% CI, 362.4 to 376.7]) was 1.5 times higher than for Asian adults (243.9 deaths per 100 000 persons [CI, 242.6 to 245.2]). The CVD ASMR for NHPI adults was the third highest in the country, after Black adults (558.8 deaths per 100 000 persons [CI, 557.4 to 560.3]) and White adults (423.6 deaths per 100 000 persons [CI, 423.2 to 424.1]).LimitationPotential misclassification of underlying cause of death or race group.ConclusionNHPI adults have a high rate of CVD mortality, which was previously masked by aggregation of the NHPI population with the Asian population. The results of this study support the need for continued disaggregation of the NHPI population in public health research and surveillance to identify opportunities for intervention.Primary Funding SourceNational Institute of General Medical Sciences, National Institutes of Health.

30 keywords...

hide…