Lessons Learned from Immigrant Health Cohorts: A Review of the Evidence and Implications for Policy and Practice in Addressing Health Inequities among Asian Americans, Native Hawaiians, and Pacific Islanders

Annu Rev Public Health. 2024 May;45(1):401-424. doi: 10.1146/annurev-publhealth-060922-040413. Epub 2024 Apr 3.

Abstract

The health of Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) is uniquely impacted by structural and social determinants of health (SSDH) shaped by immigration policies and colonization practices, patterns of settlement, and racism. These SSDH also create vast heterogeneity in disease risks across the AANHPI population, with some ethnic groups having high disease burden, often masked with aggregated data. Longitudinal cohort studies are an invaluable tool to identify risk factors of disease, and epidemiologic cohort studies among AANHPI populations have led to seminal discoveries of disease risk factors. This review summarizes the limited but growing literature, with a focus on SSDH factors, from seven longitudinal cohort studies with substantial AANHPI samples. We also discuss key information gaps and recommendations for the next generation of AANHPI cohorts, including oversampling AANHPI ethnic groups; measuring and innovating on measurements of SSDH; emphasizing the involvement of scholars from diverse disciplines; and, most critically, engaging community members to ensure relevancy for public health, policy, and clinical impact.

Keywords: Asian American; cohorts; health equity; public health; race and ethnicity; racial inequities.

Publication types

  • Review

MeSH terms

  • Asian* / statistics & numerical data
  • Emigrants and Immigrants* / statistics & numerical data
  • Health Inequities
  • Health Policy
  • Health Status Disparities
  • Humans
  • Native Hawaiian or Other Pacific Islander* / statistics & numerical data
  • Pacific Island People
  • Risk Factors
  • Social Determinants of Health* / ethnology
  • United States