Native Hawaiians, Pacific Islanders face highest stroke risk nationwide: study

Native Hawaiian and Pacific Islander people have the highest rate of ischemic stroke in the U.S., according to a study published in Neurology on Aug. 27. Researchers found their risk exceeded that of all other racial and ethnic groups, with stroke incidence more than three times higher than that of white people.

The study, led by Dr. Fadar O. Otite of the State University of New York Upstate Medical University, analyzed hospital databases in Florida, Georgia, Maryland and New York with look-back periods of up to six years in Florida and New York and three years in Georgia and Maryland, using data from 2005 to 2020.

After adjusting for age and sex, the ischemic stroke incidence was 591 cases per 100,000 among Native Hawaiian or Pacific Islander people, compared to 292 among Black people, 180 among white people, 145 among Hispanic people and 108 among Asian people. Even when adjusted for years of hospitalization, Native Hawaiian or Pacific Islander people remained 3.3 times more likely than white people, nearly four times more likely than Hispanic people and more than five times more likely than Asian people to suffer an ischemic stroke.

In Florida, Native Hawaiian or Pacific Islander people had a lower stroke rate than Black people, while in Georgia, Maryland and New York their rates were higher. Dr. Otite said, “More research is needed into the reasons for this disparity so that it can be tackled appropriately.” He also underscored the need for better health data collection, adding, “These findings also lend support to the need for parsing out information on race and ethnicity in health care databases, where Asian people and Native Hawaiian or Pacific Islander people are usually combined into one large group.”

Data from the U.S. Department of Health and Human Services show this disparity is not new. In 2014, Native Hawaiian or Pacific Islander adults were nearly four times more likely than non-Hispanic white adults to experience a stroke and 30% more likely to die from one. The study noted that because only hospitalized cases were captured, the true burden of stroke among Native Hawaiian and Pacific Islander populations may be even higher.