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Racial and Ethnic Health Disparities"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Asian Americans have been historically underrepresented in the national drug overdose discourse due to their lower substance use and overdose rates compared to other racial\/ethnic groups. However, aggregated analyses fail to capture the vast diversity among Asian-American subgroups, obscuring critical disparities. We conducted a cross-sectional study between 2018 and 2021 examining Asian-American individuals within the CDC WONDER database with drug overdoses as the underlying cause of death (<jats:italic>n<\/jats:italic>\u2009=\u20093195; ICD-10 codes X40\u2013X44, X60\u2013X64, X85, and Y10\u2013Y14) or psychoactive substance\u2013related mental and behavioral disorders as one of multiple causes of death (<jats:italic>n<\/jats:italic>\u2009=\u200915,513; ICD-10 codes F10\u2013F19). Proportional mortality ratios were calculated, comparing disaggregated Asian-American subgroups to the reference group (Asian Americans as a single aggregate group). <jats:italic>Z<\/jats:italic>-tests identified significant differences between subgroups. Compared to the reference group (0.99%), drug overdose deaths were less prevalent among Japanese (0.46%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), Chinese (0.47%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and Filipino (0.82%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) subgroups, contrasting with a higher prevalence among Asian Indian (1.20%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), Vietnamese (1.35%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), Korean (1.36%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and other Asian (1.79%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) subgroups. Similarly, compared to the reference group (4.80%), deaths from mental and behavioral disorders were less prevalent among Chinese (3.18%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), Filipino (4.52%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and Asian Indian (4.56%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) subgroups, while more prevalent among Korean (5.60%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), Vietnamese (5.64%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), Japanese (5.81%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and other Asian (6.14%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) subgroups. Disaggregated data also revealed substantial geographical variations in these deaths obscured by aggregated analyses. Our findings revealed pronounced intra-racial disparities, underscoring the importance of data disaggregation to inform targeted clinical and public health interventions.<\/jats:p>","DOI":"10.1007\/s40615-024-01983-5","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T15:07:12Z","timestamp":1711465632000},"page":"1508-1516","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Disaggregating Asian-American Mortality in Drug-Related Overdoses and Behavioral Disorders: A Cross-Sectional Study"],"prefix":"10.1007","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0173-495X","authenticated-orcid":false,"given":"David T.","family":"Zhu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winnie J.","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Tamang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,26]]},"reference":[{"key":"1983_CR1","unstructured":"Budiman A & Ruiz NG. Key facts about Asian Americans, a diverse and growing population. Pew Research Center. 2021. Accessed: February 25, 2024. Available from: https:\/\/www.pewresearch.org\/short-reads\/2021\/04\/29\/key-facts-about-asian-americans\/"},{"key":"1983_CR2","first-page":"1","volume":"457","author":"MR Spencer","year":"2022","unstructured":"Spencer MR, Mini\u00f1o AM, Warner M. Drug overdose deaths in the United States, 2001\u20132021. NCHS Data Brief. 2022;457:1\u20138.","journal-title":"NCHS Data Brief"},{"key":"1983_CR3","unstructured":"United States Department of Health and Human Services Task Force on Black and Minority Health. Report of the Secretary's Task Force on Black & Minority Health. 1985. Accessed: November 11, 2023. https:\/\/collections.nlm.nih.gov\/catalog\/nlm:nlmuid-8602912-mvset"},{"key":"1983_CR4","doi-asserted-by":"publisher","first-page":"111088","DOI":"10.1016\/j.drugalcdep.2024.111088","volume":"256","author":"S Choi","year":"2024","unstructured":"Choi S, Hong S, Gatanaga OS, Yum AJ, Lim S, Neighbors CJ, Yi SS. Substance use and treatment disparities among Asian Americans, Native Hawaiians, and Pacific Islanders: a systematic review. Drug Alcohol Depend. 2024;256:111088.","journal-title":"Drug Alcohol Depend"},{"issue":"7","key":"1983_CR5","doi-asserted-by":"publisher","first-page":"1653","DOI":"10.1111\/dar.13522","volume":"41","author":"AM Subica","year":"2022","unstructured":"Subica AM, Guerrero EG, Martin TKK, Okamoto SK, Aitaoto N, Moss HB, Morey BN, Wu LT. Native Hawaiian\/Pacific Islander alcohol, tobacco and other drug use, mental health and treatment need in the United States during COVID-19. Drug Alcohol Rev. 2022;41(7):1653\u201363.","journal-title":"Drug Alcohol Rev"},{"issue":"2","key":"1983_CR6","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1377\/hlthaff.2021.01417","volume":"41","author":"SS Yi","year":"2022","unstructured":"Yi SS, Kwon SC, Suss R, \u00d0o\u00e0n LN, John I, Islam NS, Trinh-Shevrin C. The mutually reinforcing cycle of poor data quality and racialized stereotypes that shapes Asian American Health. Health Aff (Millwood). 2022;41(2):296\u2013303.","journal-title":"Health Aff (Millwood)"},{"issue":"1","key":"1983_CR7","doi-asserted-by":"publisher","first-page":"1551","DOI":"10.1186\/s12889-019-7683-3","volume":"19","author":"NP Gordon","year":"2019","unstructured":"Gordon NP, Lin TY, Rau J, Lo JC. Aggregation of Asian-American subgroups masks meaningful differences in health and health risks among Asian ethnicities: an electronic health record based cohort study. BMC Public Health. 2019;19(1):1551.","journal-title":"BMC Public Health"},{"issue":"3","key":"1983_CR8","doi-asserted-by":"publisher","first-page":"S166","DOI":"10.1016\/j.ekir.2023.02.373","volume":"8","author":"A Zhong","year":"2023","unstructured":"Zhong A, Dang N, Khunte M, Shah K, Hsiao LL. Disparities in kidney disease mortality among Asian American subgroups. Kidney Int Rep. 2023;8(3):S166\u20137 Accessed: November 11, 2023. https:\/\/www.kireports.org\/article\/S2468-0249(23)00423-0\/fulltext.","journal-title":"Kidney Int Rep."},{"issue":"3","key":"1983_CR9","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/j.cgh.2022.12.001","volume":"21","author":"PS Liang","year":"2023","unstructured":"Liang PS, Kwon SC, Cho I, Trinh-Shevrin C, Yi S. Disaggregating racial and ethnic data: a step toward diversity, equity, and inclusion. 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Psychol Med. 2015;45(3):481\u201394.","journal-title":"Psychol Med"},{"issue":"35","key":"1983_CR12","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.15585\/mmwr.mm6935a1","volume":"69","author":"J O'Donnell","year":"2020","unstructured":"O\u2019Donnell J, Gladden RM, Mattson CL, Hunter CT, Davis NL. Vital signs: characteristics of drug overdose deaths involving opioids and stimulants - 24 States and the District of Columbia, January-June 2019. MMWR Morb Mortal Wkly Rep. 2020;69(35):1189\u201397.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"1983_CR13","unstructured":"Centers for Disease Control and Prevention. CDC Wonder. April 1995. Accessed: August 29, 2023. http:\/\/wonder.cdc.gov\/."},{"key":"1983_CR14","doi-asserted-by":"crossref","unstructured":"Edlagan C, Vaghul K. How data disaggregation matters for Asian Americans and Pacific Islanders. 2016. Accessed: November 11, 2023. https:\/\/equitablegrowth.org\/how-data-disaggregation-matters-for-asian-americans-and-pacific-islanders\/","DOI":"10.4324\/9781003447931-2"},{"issue":"2","key":"1983_CR15","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1377\/hlthaff.2021.01417","volume":"41","author":"SS Yi","year":"2022","unstructured":"Yi SS, Kwon SC, Suss R, \u00d0o\u00e0n LN, John I, Islam NS, et al. The mutually reinforcing cycle of poor data quality and racialized stereotypes that shapes Asian American health. Health Aff. 2022;41(2):296\u2013303.","journal-title":"Health Aff"},{"issue":"11","key":"1983_CR16","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1136\/jech.2007.066811","volume":"62","author":"DH Chae","year":"2008","unstructured":"Chae DH, Takeuchi DT, Barbeau EM, Bennett GG, Lindsey JC, Stoddard AM, Krieger N. Alcohol disorders among Asian Americans: associations with unfair treatment, racial\/ethnic discrimination, and ethnic identification (the national Latino and Asian Americans study, 2002\u20132003). J Epidemiol Community Health. 2008;62(11):973\u20139.","journal-title":"J Epidemiol Community Health"},{"issue":"4","key":"1983_CR17","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.jsat.2009.05.006","volume":"37","author":"J Yu","year":"2009","unstructured":"Yu J, Clark LP, Chandra L, Dias A, Lai TF. Reducing cultural barriers to substance abuse treatment among Asian Americans: a case study in New York City. J Subst Abuse Treat. 2009;37(4):398\u2013406.","journal-title":"J Subst Abuse Treat"},{"issue":"61","key":"1983_CR18","doi-asserted-by":"publisher","first-page":"102079","DOI":"10.1016\/j.eclinm.2023.102079","volume":"6","author":"S Fujita-Imazu","year":"2023","unstructured":"Fujita-Imazu S, Xie J, Dhungel B, Wang X, Wang Y, Nguyen P, et al. 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