Among individuals of South Asian descent, there is a significant pattern of disproportionately high cardiovascular disease compared to the general population. When looking at all patients with cardiovascular disease, South Asians also tend to have higher hospitalization and mortality rates. Researchers at Kaiser Permanente Northern California wanted to find out whether culturally tailored guidance can be effective in the South Asian population in improving heart health risk factors and decreasing harmful outcomes from cardiovascular disease. Do culturally relevant recommendations have increased efficacy in improving health outcomes in preventative medicine? Such a question could also be applied to other populations who have historically disproportionately high burdens of certain diseases, genetic conditions, or other health risk factors.
Image Source: Witthaya Prasongsin
In a cohort study done by Kaiser Permanente from 2006 to 2019, among a Northern Californian population of approximately 1500 South Asian patients, researchers observed the effects that a culturally tailored lifestyle and dietary educational program could have on patients’ health, cardiovascular disease outcomes, and metabolic values. The study was done in Santa Clara, California, a region with a concentrated population of South Asian individuals. The change in patients’ health was measured through follow-up appointments that tracked important metabolic values, including blood pressure, triglycerides, cholesterol, and HbA1c. The educational program consisted of a seminar with input and presentations from a cardiovascular physician, a dietitian, and a health educator. As a control, patients in this study were compared to another demographically computer-matched sample of Kaiser patients who did not participate in the program. The participants, with an average age of 42.5, filled out surveys, which revealed some percentage of existing risk factors, with 16% having type 2 diabetes and 22% having high blood pressure. The study found a significant improvement in blood pressure values, triglycerides, cholesterol, body mass index (BMI), HbA1c, and a reduction in mortality.
The researchers also mentioned other similar lifestyle intervention programs and cohort studies done in a population of South Asian patients in other regions that had mixed results. They acknowledged that their study also did not incorporate randomized intervention, resulting in some limitations in concluding that the program caused improved outcomes. They hypothesized that other, more subjective factors likely made a difference, but were not tracked in these studies, such as health beliefs, personal motivation, and discipline. The findings from this study emphasize the importance of consistent patient follow-ups and culturally sensitive and relevant guidance for health instead of generalized, cookie-cutter recommendations.
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