Why do Asian Americans Live So Much Longer Than Other Ethnic Groups?

Francesco Acciai Department of Sociology Pennsylvania State University University Park, PA

Francesco Accia

MedicalResearch.com Interview with:
Francesco Acciai,
Aggie J Noah and Glenn Firebaugh

Department of Sociology
Pennsylvania State University
University Park, PA

MedicalResearch: What is the background for this study?

Response : Life expectancy in the United States varies greatly by race. Asian–Americans enjoy the greatest longevity, with a nearly 8 year mortality advantage on whites. This advantage can derive from two separate processes. One, from a more favorable allocation of causes of death (incidence effect); i.e. from the fact that Asians tend to die of causes that strike on average at older ages while avoiding causes of death that afflict the young. Two, they can die of the same causes of death, but at an older age (age effect). By using the age-incidence decomposition method we are able to distinguish and quantify these contributions to the 7.8 year gap in life expectancy between Asians and whites.

MedicalResearch: What are the main findings?

Response: Nearly 90% (or 6.9 years) of this gap is attributable to the fact that Asians tend to outlive whites regardless of the cause of death (age effect). The causes that contribute the most to the gap are heart disease (24%) and cancers (18%). The incidence effect accounts for the remaining 0.9 years of the Asian-white gap in life expectancy. Moreover, sex-specific analyses show that men contribute somewhat more to the gap than women do (55% vs 45%), primarily because Asian–white differences in mortality are greater among men than among women with respect to suicide, traffic accidents and accidental poisoning.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Response: Since Asians and whites generally succumb to the same causes of death, researchers can focus on why Asian victims tend to outlive white victims. Are there any individual (e.g. health behaviors) or contextual (e.g. family network) factors that contribute to the Asian mortality advantage? Is the onset of disease delayed for Asians, or do they live longer while in poor health? Studies of mortality gaps, then, need to be juxtaposed with studies of morbidity gaps. Future research should also make use of the heterogeneity of Asian-Americans themselves (their country of origin, generation, length of time in the USA and so on) as leverage for understanding the exceptional life expectancy of Asian-Americans. Lastly, nativity data should be routinely transferred from death certificates to data archives to permit the comparison of US-born and foreign-born Asians. The best studies will compare those data with data from countries of origin to test more directly the idea that Asians live longer in America because of self-selection, that is, the Asians who move to America tend to be healthier than those who do not migrate.

MedicalResearch: What should clinicians and patients take away from your report?

Response : The fact that Asians in America live so much longer than other Americans suggests that the longevity of other groups can be increased. Clinicians should be aware of this difference, and they should be especially alert to differences in the life style and habits of Asians that might account for their longer lifespans. Once researchers and clinicians have a better understanding of the protective factors that contribute to Asian longevity, clinicians should disseminate this knowledge so that patients know not only that living a longer (and healthier) life is possible, but also the actions that are most likely to help them achieve this goal.

Citation:

Pinpointing the sources of the Asian mortality advantage in the USA

Francesco Acciai, Aggie J Noah, Glenn Firebaugh

J Epidemiol Community Health jech-2015-205623Published Online First: 1 June 2015 doi:10.1136/jech-2015-205623

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Francesco Acciai (2015). Why do Asian Americans Live So Much Longer Than Other Ethnic Groups?