Disparities in Diabetes Prevalence Among Native Hawaiians/Other Pacific Islanders and Asians in Hawai‘i

INTRODUCTION: The prevalence of diabetes varies widely among racial/ethnic groups in Hawai‘i. How prevalence varies by age for Asian subgroups and Native Hawaiian/Other Pacific Islanders (NHOPIs) is understudied. We examined diabetes prevalence by age and race/ethnicity and assessed how socioeconomic status and lifestyle behaviors affected prevalence among Japanese, Filipino, Chinese, NHOPI, and white populations in Hawai‘i. METHODS: We studied 18,200 subjects aged 18 or older from the Hawai‘i Behavioral Risk Factor Surveillance System. We performed Poisson regression analyses to examine the prevalence of diabetes by race/ethnicity, age, sex, marital status, education, income, health care coverage, obesity, smoking and drinking status, physical activity, and fruit and vegetable consumption and examined the interactions of these factors with age and race/ethnicity. RESULTS: We found disparities in diabetes prevalence among respondents aged 35 to 44 and among Asians and NHOPIs, and disparities increased with age. NHOPIs and Filipinos had the highest prevalence of diabetes after controlling for other demographic factors and lifestyle variables. Japanese adults were less likely than NHOPIs and Filipinos to have diabetes; however, whites had the lowest prevalence. Income, physical activity, and obesity were the strongest predictors of diabetes. CONCLUSION: NHOPIs and Filipinos have higher rates of diabetes compared with other races/ethnicities in Hawai‘i. More research is needed to reduce diabetes disparities among NHOPI and Filipino populations in Hawai‘i. This study also shows the importance of conducting age-specific analyses of racial/ethnic-subgroups for health disparities.