The health disparity of cardiovascular disease in Chinese immigrants

Health Disparity of Cardiovascular Disease in Chinese Immigrants Student Name University Course Professor Name Date Health Disparity of Cardiovascular Disease in Chinese Immigrants Cardiovascular disease (CVD) refers to conditions that affect the heart or blood vessels. The most common types of CVD include high blood pressure (hypertension), coronary artery disease (CAD)/coronary heart disease (CHD)/ischemic heart disease, cardiac arrest, arrhythmia, congestive heart failure, peripheral artery disease, congenital heart disease, and stroke. Studies on CVD have illustrated the presence of disparities in the prevalence of CVD and its risk factors for mortality and other health outcomes associated with CVD. In many cases, the disparities disproportionately affect minority or marginalized groups in a country. Chinese immigrants into most Western societies present what has been termed a Chinese immigrant paradox related to CVD. The paradox is in the form of low CVD incidence but higher short-term mortality. Such paradoxes appear in different types of CVDs, as illustrated in empirical studies. For example, some studies have found low CHD incidence but higher mortality caused by CHD (Jin et al., 2015). In other studies, Chinese immigrants are found to have a high prevalence and mortality of some CVDs, for example, CHD, but a higher prevalence and mortality of others, for example, stroke (Gong & Zhao, 2015). The purpose of this research is to explore the health disparity of CVD in Chinese immigrants. An in-depth analysis of the problem and its impact on the target population will be presented, including how the problem is significant to the nation. Innovative solutions and recommendations for change will also be discussed. This section used literature and evidence-based practice to highlight current and proposed interventions. The advanced practice nurse (APN) role will also be analyzed. Problem and Population Health disparities in CVD among Chinese immigrants have been studied at length, with recent studies highlighting the extent of the problem. According to Agyemang and Born (2022), a recent New York study established that the rate of ischemic stroke is lower among Chinese immigrants compared with Caucasians but has higher mortality from hemorrhagic stroke. Studies indicate that despite the low prevalence, mortality rates from CVD among Chinese immigrants are higher. Compared to other populations, many studies find that the prevalence rates are not significantly different from that of whites. Recent statistics on CVD and diabetes indicate that the highest rates of CAD occur among the Asia Indian American subgroup, with 4.4% and 13% for women and men, respectively. Filipino Americans exhibit prevalence rates of 4% and 9% for women and men, respectively. Among Chinese Americans, the rates are slightly above 2% and 6% for women and men, respectively. These statistics indicate that the CAD prevalence is higher among Chinese Americans than most Asian immigrants and comparable to Japanese Americans, Korean Americans, and Vietnamese Americans, whose respective statistics for men and women are 7% and 3%, 6% and 2%, and 6% and 4%, respectively (American Heart Association, 2023). Further statistics illustrate the mortality rate of Chinese immigrants compared to non-Hispanic whites. Such statistics can be summarized in the table below from Shah et al. (2022). Ischemic Heart Disease Heart Failure Cerebrovascular Disease Proportional mortality Proportional mortality ratio Proportional mortality Proportional mortality ratio Proportional mortality Proportional mortality ratio Women 11.9% 1.08 2.2% 0.66 8.2% 1.36 Men 14.7% 0.96 1.3% 0.49 6.9% 1.66 Table 1: CVD and cerebrovascular disease mortality among Chinese Americans. Even though prevalence rates seem smaller compared to native and other populations, CVD among Chinese immigrants is becoming a significant concern across most Western countries. The rationale is that the Chinese represent one of the fastest-growing populations of immigrants. Besides the US, such countries as Canada and Australia have also seen massive increases in the proportion of the Chinese population. For example, between 2000 and 2010, Chinese immigrants in Canada and Australia increased by 54% and 43%, respectively (Jin et al., 2015). By 2021, the Chinese population in the United States, as the Pew Research Center estimated, was over 3.8 million, with Chinese adults accounting for 22% of the total Asian adult population (Ruiz et al., 2023). As Chinese populations continue to rise, prevalence and mortality statistics will also change to accommodate a rising number of people facing CVDs. Another approach to demonstrate the nature of the problem is that Chinese immigrants do not compare favorably with those in mainland China in the context of CVD prevalence and mortality. Recent studies and surveys indicate that Chinese immigrants to North America and Western Europe record higher rates of diabetes, hypertension, obesity, and blood cholesterol levels compared to Chinese in mainland China (Zeng, 2022). Additionally, Chinese immigrants who migrate as children or adolescents are 71% more likely to develop diabetes, 47% more likely to face three or more CVD risk factors, and 49% more likely to become obese and overweight compared to adults (Antipolis, 2017). These observations indicate that immigrating to Western countries is a major CVD risk factor facing Chinese immigrants. Additionally, children and adolescents are disproportionately affected by CVD risk, indicating the need to develop practical preventive approaches targeting children and adolescents. A growing population facing a particular health problem at the national level leads to a national health crisis. Statistics in 2014 indicate that in the United States, a third of all adults have hypertension, which translates to 67 million people (Chen & Hu, 2014). This figure has significantly grown due to population changes, including immigration. Chinese are the fastest immigrants into the US. It means that bringing in more people prone to CVD creates a public health problem of its own and is part of the broader CVD crisis affecting the country. Innovative Solutions and Recommendations for Change The available literature on the prevalence and mortality associated with CVD among Chinese immigrants is often encompassed in that targeting the general Asian immigrants. As a result, the main disparity in CVD among Chinese immigrants, manifests in the form of higher mortality rates among CVD patients as compared to other races/ethnicities, including the host population. It happens despite Chinese immigrants recording lower CVD prevalence levels, with figures often comparable to those of the white population (Jin et al., 2015). However, health disparities related to CVD among Chinese Americans manifest in various other forms. According to Chen and Hu (2014), the key factors causing the disparities include genetic and biological factors, sociocultural factors, health behavio...