Epidemiology of Diabetes among Asian Americans

The role of descriptive epidemiology in nursing science is very important as it helps to provide information that can be used by nurses to prevent the spread of disease, develop effective interventions, and engage in further research. A descriptive epidemiologic study is one that examines a specific population and identifies the amount and distribution of health and design within that population (Giroux, 2015). Descriptive epidemiology looks at variables, such as person, place and time—variables that affect the incidence of disease. Race, sex, age, socioeconomic status, geography, environment, and patterns of appearance are all factors that descriptive epidemiology will consider when attempting to classify a disease’s occurrence (Hsu, Araneta, Kanaya, Chiang & Fujimoto, 2015). The role of descriptive epidemiology in nursing is thus situated in the idea that it provides education, information, and a pathway to strategies for helping patients and preventing the spread of disease (Saggu, Rehman, Abbas & Ansari, 2015). This paper will provide a contemporary example of how a descriptive epidemiology is applied in public health nursing and identify the components used to analyze at-risk populations. For this paper, the chosen focus is diabetes among Asian-Americans.
Descriptive epidemiology is applied in public health nursing by addressing the 1) who, 2) what, 3) where and 4) when questions associated with disease among a certain population. For example, in contemporary medicine, understanding the spread of diabetes among specific populations helps nurses in the public health nursing sector to better know how to treat patients who are part of this population. Among Asian-Americans, Nguyen, Nguyen, Taylor-Fischer and Tran (2015) report that the problem of diabetes is increasing and this population has been shown to be at moderate risk by the Centers for Disease Control and Prevention. The problem with understanding the rate of incidence among this population, however, is exacerbated by the fact that Asian-American is itself a broad label that can be more effectively broken down into strict ethno-labels—i.e., Filipino Americans, Japanese Americans, Chinese Americans, and so on. Each group presents its own unique set of data. The Diabetes Prevention Program has undertaken the initiative to collect and analyze data from the various Asian-American population segments in hopes of providing nurses and health care providers with better information on incidence, health, risks, and possible interventions and preventive approaches to help this population reduce the threat of diabetes affecting their lives (Nguyen et al., 2015). In order to control and mitigate the negative effects of diabetes among Asian-Americans, descriptive epidemiology has been used to provide this information.
For the Asian-American population, it was long believed (wrongly) that diabetes would not be a major problem because of “the notion that Asian Americans are self-sufficient, well-educated, and have lower burdens of disease” (Nguyen et al., 2015, p. 544). However, this myth was proved incorrect thanks to descriptive epidemiologic studies that showed nearly 10% of all Asian-Americans are actually impacted by diabetes. At the same time, by aggregating the data among various ethno-groups, from Filipino-Americans to Japanese-Americans to Chinese-Americans and so on, researchers were masking the real disease burden among high risk groups and inflating the burden among low risk groups within that population (Nguyen et al., 2015). In other words, some Asian-American groups were actually more at risk for diabetes than others. Obtaining accurate information on population subgroups is an essential component of descriptive epidemiology as it allows for a more focused acquisition of knowledge regarding specific groups. Other components include assessing variables such as culture, daily eating and exercise habits, environment, and family background. As various ethno-groups within the Asian-American population have different cultural dimensions, ways of life, and environments, it is important that more attention be given to how the subgroups differ from one another so that truly at-risk groups are provide the preventive medicine they need.
Data on Asian-Americans regarding diabetes was not reliable until the heterogeneous nature of the group was realized by researchers who saw a need to evaluate the incidence and health of this population with closer attention paid to ethnicity as a major component. By disaggregating the data among this population, researchers were able to show the Filipinos were actually most at-risk for diabetes among six different ethno-groups within the Asian-American category, with prevalence rates of 15.8% among Filipino-American men and 9.4% among Filipino-American women (Nguyen et al., 2015). Japanese-Americans were next highest, followed by Korean, South Asian, Chinese and lastly Vietnamese-Americans, who showed only 2.5% prevalence among males and 2.1% prevalence among females. This finding represented a wide discrepancy within the overall population and showed that ethnic background and culture were particularly important in terms of one group being at greater risk for diabetes than another.
By disaggregating the data and identifying which specific ethno-groups were most at-risk for diabetes, nurses and health care providers working within the Diabetes Prevention Program were able to develop strategic intervention plans targeting these specific ethno-groups (mainly Filipino-Americans and Japanese-Americans) in order to help reduce the risk of diabetes development in their lives (Nguyen, 2015). More focus has been needed still, however, to provide even greater understanding of the differences among the various ethno-groups that form the Asian-American population. The components of descriptive epidemiology that would go into obtaining more useful information would include studies that examine factors such as Asian-Americans’ “social context of eating, shopping, cooking, household dynamics on food choices (particularly related to influences on traditionally high carbohydrate diets and unhealthy eating patterns), as well as feasibility, perceptions, barriers (i.e., social role strain), outliers, and motivators to exercising (perhaps by contrasting Asians who exercise and those who do not)” (Nguyen et al., 2015, p. 546). By addressing these factors, the who, what, where and when can be answered more effectively with regard to this population and more effective preventive medicine strategies can be developed and applied by nurses in the public health nursing sector. Components used to analyze at-risk populations like Filipino-Americans and Japanese-Americans have included this approach as well as approaches that link diabetes to body-mass index to determine the extent to which weight and obesity are factors in the spread of diabetes.
In conclusion, the importance of descriptive epidemiologic studies for nurses is that they allow for more variables and factors to receive attention by researchers so that a deeper understanding of the nature of the disease within the population can be understood. With this information, adequate treatment and intervention plans can be developed, and preventive medicine can be conducted so as to reduce the risk of the spread of the disease among the target population.
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