Disaggregating Asian Race Reveals COVID-19 Disparities Among Asian American Patients at New York City’s Public Hospital System

2021 ◽  
pp. 003335492110613
Author(s):  
Roopa Kalyanaraman Marcello ◽  
Johanna Dolle ◽  
Areeba Tariq ◽  
Sharanjit Kaur ◽  
Linda Wong ◽  
...  
Keyword(s):  
New York ◽  
Ethnic Groups ◽  
South Asian ◽  
Asian American ◽  
Chinese Patients ◽  
American People ◽  
Hospital System ◽  
Asian Patients ◽  
Ethnic Subgroups ◽  
Public Hospital System

Objectives: Data on the health burden of COVID-19 among Asian American people of various ethnic subgroups remain limited. We examined COVID-19 outcomes of people of various Asian ethnic subgroups and other racial and ethnic groups in an urban safety net hospital system. Methods: We conducted a retrospective analysis of 85 328 adults aged ≥18 tested for COVID-19 at New York City’s public hospital system from March 1 through May 31, 2020. We examined COVID-19 positivity, hospitalization, and mortality, as well as demographic characteristics and comorbidities known to worsen COVID-19 outcomes. We conducted adjusted multivariable regression analyses examining racial and ethnic disparities in mortality. Results: Of 9971 Asian patients (11.7% of patients overall), 48.2% were South Asian, 22.2% were Chinese, and 29.6% were in other Asian ethnic groups. South Asian patients had the highest rates of COVID-19 positivity (30.8%) and hospitalization (51.6%) among Asian patients, second overall only to Hispanic (32.1% and 45.8%, respectively) and non-Hispanic Black (27.5% and 57.5%, respectively) patients. Chinese patients had a mortality rate of 35.7%, highest of all racial and ethnic groups. After adjusting for demographic characteristics and comorbidities, only Chinese patients had significantly higher odds of mortality than non-Hispanic White patients (odds ratio = 1.44; 95% CI, 1.04-2.01). Conclusions: Asian American people, particularly those of South Asian and Chinese descent, bear a substantial and disproportionate health burden of COVID-19. These findings underscore the need for improved data collection and reporting and public health efforts to mitigate disparities in COVID-19 morbidity and mortality among these groups.

scholarly journals Disaggregating Asian Race Reveals COVID-19 Disparities among Asian Americans at New York City’s Public Hospital System

2020 ◽  
Author(s):  
Roopa Kalyanaraman Marcello ◽  
Johanna Dolle ◽  
Areeba Tariq ◽  
Sharanjit Kaur ◽  
Linda Wong ◽  
...  
Keyword(s):  
New York ◽  
Asian Americans ◽  
Public Hospital ◽  
South Asians ◽  
Chinese Americans ◽  
Chinese Patients ◽  
Hospital System ◽  
Ethnic Subgroups ◽  
Public Hospital System ◽  
Racial Ethnic

AbstractThere is growing recognition of the burden of COVID-19 among Asian Americans, but data on outcomes among Asian ethnic subgroups remain extremely limited. We conducted a retrospective analysis of 85,328 patients tested for COVID-19 at New York City’s public hospital system between March 1 and May 31, 2020, to describe characteristics and COVID-19 outcomes of Asian ethnic subgroups compared to Asians overall and other racial/ethnic groups. South Asians had the highest rates of positivity and hospitalization among Asians, second only to Hispanics for positivity and Blacks for hospitalization. Chinese patients had the highest mortality rate of all groups and were nearly 1.5 times more likely to die than Whites. The high burden of COVID-19 among South Asian and Chinese Americans underscores the urgent needs for improved data collection and reporting as well as public health program and policy efforts to mitigate the disparate impact of COVID-19 among these communities.

Negotiating Space and Making Place: Punjabi-Sikh Cabbies in New York City

2020 ◽  
pp. 089692052095423
Author(s):  
Diditi Mitra
Keyword(s):  
New York ◽  
New York City ◽  
South Asian ◽  
Asian American ◽  
Race And Ethnicity ◽  
Immigrant Status ◽  
Lower Socioeconomic Status ◽  
South Asian American ◽  
Lower Socioeconomic ◽  
Transnational Space

I examine how immigrant Punjabi-Sikhs make sense of themselves as yellow cabbies in New York with two complementary frameworks—Hill Collins’ “matrix of domination” and insights from the literature exploring the interplay between race and ethnicity. The cabbies discussed their immigrant status, non-whiteness, and social class as influential, emphasizing the effects of all three forms of marginalization as occurring simultaneously. They deployed “money” to frame this subordination and to negotiate dimensions of social location and identity. The transnational space they occupied emerges noteworthy too in their identity making. This analysis, based on interviews with 56 cabbies, advances scholarship on race and immigration/transnationalism, Asian and South Asian American identities, specifically research on immigrant Sikhs of lower socioeconomic status, attention on whom is scant.

scholarly journals Diabetes and hypertension among South Asians in New York and Atlanta leveraging hospital electronic health records

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jeannette M. Beasley ◽  
Joyce C. Ho ◽  
Sarah Conderino ◽  
Lorna E. Thorpe ◽  
Megha Shah ◽  
...  
Keyword(s):  
New York ◽  
Electronic Health Records ◽  
Health Systems ◽  
South Asian ◽  
South Asians ◽  
New York University ◽  
Health Records ◽  
Asian Patients ◽  
The Us ◽  
Electronic Health

Abstract Background Diabetes and hypertension disparities are pronounced among South Asians. There is regional variation in the prevalence of diabetes and hypertension in the US, but it is unknown whether there is variation among South Asians living in the US. The objective of this study was to compare the burden of diabetes and hypertension between South Asian patients receiving care in the health systems of two US cities. Methods Cross-sectional analyses were performed using electronic health records (EHR) for 90,137 South Asians receiving care at New York University Langone in New York City (NYC) and 28,868 South Asians receiving care at Emory University (Atlanta). Diabetes was defined as having 2 + encounters with a diagnosis of diabetes, having a diabetes medication prescribed (excluding Acarbose/Metformin), or having 2 + abnormal A1C levels (≥ 6.5%) and 1 + encounter with a diagnosis of diabetes. Hypertension was defined as having 3 + BP readings of systolic BP ≥ 130 mmHg or diastolic BP ≥ 80 mmHg, 2 + encounters with a diagnosis of hypertension, or having an anti-hypertensive medication prescribed. Results Among South Asian patients at these two large, private health systems, age-adjusted diabetes burden was 10.7% in NYC compared to 6.7% in Atlanta. Age-adjusted hypertension burden was 20.9% in NYC compared to 24.7% in Atlanta. In Atlanta, 75.6% of those with diabetes had comorbid hypertension compared to 46.2% in NYC. Conclusions These findings suggest differences by region and sex in diabetes and hypertension risk. Additionally, these results call for better characterization of race/ethnicity in EHRs to identify ethnic subgroup variation, as well as intervention studies to reduce lifestyle exposures that underlie the elevated risk for type 2 diabetes and hypertension development in South Asians.

scholarly journals To Arrange or Not: Marriage Trends in the South Asian American Community

2008 ◽  
Vol 31 (2) ◽  
pp. 153-181
Author(s):  
Farha Ternikar
Keyword(s):  
United States ◽  
New York ◽  
South Asian ◽  
Asian American ◽  
Media Coverage ◽  
Cultural Beliefs ◽  
New York Times ◽  
The United States ◽  
Social Practices ◽  
Arranged Marriage

The idea of the arranged marriage has always seemed “exotic” yet has fascinated the American public. Recent media coverage of arranged marriages is evident in popular periodicals such as the New York Times Online (August 17, 2000) and Newsweek (March 15, 1999). Foner highlights that the arranged marriage is an example of “the continued impact of premigration cultural beliefs and social practices” that South Asian immigrants have transported to the United States (Foner 1997, 964). She offers an interpretive synthesis by showing that “[n]ew immigrant family patterns are shaped by cultural meanings and social practices that immigrants bring with them from their home countries as well as by social, economic, and cultural forces in the United States” (Foner 2005, 157).

scholarly journals Impact of a Novel Emergency Department Forward Treatment Area During the New York City COVID-19 Surge

2021 ◽  
Vol 22 (4) ◽  
pp. 871-877
Author(s):  
Joshua Moskovitz ◽  
Kaushal Khambhati ◽  
Comilla Sasson ◽  
Jason D’Amore ◽  
Michael Jones ◽  
...  
Keyword(s):  
Emergency Department ◽  
New York ◽  
New York City ◽  
York City ◽  
Treatment Area ◽  
Hospital System ◽  
Number Of Patients ◽  
Lower Oxygen ◽  
Disproportionate Number ◽  
Public Hospital System

Introduction: Coronavirus disease 2019 (COVID-19) caused a disproportionate number of patients to seek emergency care at hospitals in New York City (NYC) during the initial crisis. Our urban emergency department (ED), a member of the NYC public hospital system had to process the increased volume while also differentiating our patients’ critical needs. We established a forward treatment area (FTA) directly in front of the ED to accomplish these goals from March 23–April 16, 2020. Methods: A clinical greeter evaluated patients 18 years and older who presented to the walk-in entrance of the ED where they were screened for COVID-19-like complaints. If they did not appear critically ill and could ambulate they were directed into the FTA. Clinical and non-clinical staff worked in concert to register, evaluate, and process patients with either a disposition of directly home or into the ED for further care. Results: A total of 634 patients were seen in the FTA from March 23–April 16, 2020. Of the 634 patients evaluated, 135 (21%) were referred into the ED for further evaluation, of whom 81 (12.7% of the total) were admitted. These patients were disproportionately male (91 into the ED and 63 admitted) and tended to have a higher heart rate (105.4 vs 93.7), a higher respiratory rate (21.5 vs 18.1), and lower oxygen saturation (93.9% vs 97.8%). Conclusion: A forward treatment area is an effective method to rapidly screen and process an increased volume of COVID-19 patients when resources are limited. This treatment area helped decompress the ED by being rapidly deployable and effectively screening patients for safe discharge home.

scholarly journals A study of the influence of ethnicity on serology and clinical features in lupus

Lupus ◽  
2016 ◽  
Vol 26 (1) ◽  
pp. 17-26 ◽  
Author(s):  
S A Morais ◽  
D A Isenberg
Keyword(s):  
Ethnic Groups ◽  
South Asian ◽  
East Asian ◽  
Renal Involvement ◽  
The Other ◽  
Age At Diagnosis ◽  
Neurological Involvement ◽  
Asian Patients ◽  
Younger Age ◽  
East Asian Patients

Objective The objective of this study was to review the links between ethnicity, serology and clinical expression in systemic lupus erythematosus (SLE) in a single cohort that was followed over a 36-year period. Patients and methods Patients with SLE treated at the University College London Hospitals (UCLHs) between January 1978 and December 2013 formed the cohort. We assessed the demographic, clinical and serological data. Standard methods were used for laboratory testing. The Student t test and Mann–Whitney U test were used for the continuous variables; the Fisher’s exact test was used for the categorical variables. Results We studied 624 SLE patients: There were 571 women (91.5%), with a mean age at diagnosis of 29.0 ± 6.5 years; and 53 men (8.5%), with a mean age at diagnosis of 29.4 ± 15.3 years. Ethnically, 369 of the patients were European, 100 were Afro-Caribbean, 77 were East Asian, 56 were South Asian and 21 were of mixed ethnicity. The East Asian patients developed the disease at a younger age than the other ethnic groups ( p < 0.0001). The Afro-Caribbean patients were less frequently associated with the presence of rash and photosensitivity, and the non-European patients were more likely to have alopecia and renal involvement. The South Asian patients were significantly associated with musculoskeletal and neurological involvement, serositis, Sicca syndrome and hematological features. The Afro-Caribbean patients had the highest prevalence of anti-Smith, anti-RNP, anti-Ro and anti-La antibodies. Anti-IgG anticardiolipin (aCL) antibodies were significantly associated with the non-East Asian groups; and hypocomplementemia was common in the East Asians. Rash, alopecia, mouth ulcers, serositis, neurological, joint and renal involvement were significantly associated with the presence of anti-Smith and anti-RNP antibodies in the Afro-Caribbean group. We also observed an association of joint involvement and the presence of anti-Ro and anti-La antibodies in this group. Conclusions The East Asian patients developed their SLE disease at a younger age than the other ethnic groups. Cutaneous involvement was more frequent in those who were not Afro-Caribbean. Serositis, joint and neurological involvement were more frequently diagnosed in the South Asian patients. Anti-ENA antibodies were frequently associated with the Afro-Caribbean patients.

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