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Pacific Islander Adults Experience Significantly Higher Overall and Leading-Cause Death Rates than Asian American Adults in the U.S.

, by Maura Kate Costello, M.A.

Four graphs displaying leading-cause death rates among Asian Americans (sections with white background), and Pacific Islanders (sections with gray background. The first set of graphs shows data on females, age 20-84, while the second set of graphs shows data on males, age 20-84. Pacific Islander females and males experienced higher death rates in all categories compared with their Asian American counterparts. Enlarge

Pacific Islander individuals (gray background) experienced significantly higher leading-cause death rates compared to Asian American individuals (white background) from 2018-2020.

Among Pacific Islander individuals, all-cause and leading-cause death rates were significantly higher compared with Asian American individuals overall. This finding underscores the critical need to disaggregate health data and address health disparities in these distinct racial groups. Study findings were published in JAMA Internal Medicine on January 13, 2025.

Using national death certificate data for disaggregated Asian American and Pacific Islander adults aged 20-84 years, investigators analyzed differences in the death rates of these populations from 2018 to 2020. They found that Pacific Islander individuals experienced death rates two to 2.5 times higher than Asian American individuals overall across all causes, with the greatest disparities among younger adults aged 20-54 years. Among women, death rates for conditions such as chronic obstructive pulmonary disease, COVID-19, diabetes, and heart disease were five to 15 times higher among Pacific Islander women. Leading causes of death for both groups included cancer, heart disease, stroke, and COVID-19, but Pacific Islander populations experienced significantly higher mortality rates for these conditions. The research team was led by Jacqueline B. Vo, Ph.D., R.N., M.P.H., tenure track investigator in the Radiation Epidemiology Branch, and Jaimie Z. Shing, Ph.D., staff scientist in the Infections and Immunoepidemiology Branch, and included their mentee, Jazmyn Bess, M.S., iCURE scholar in the Clinical Genetics Branch.

With this study, Drs. Vo, Shing, and their colleagues demonstrate the need for tailored, culturally relevant health interventions for Pacific Islander populations, particularly to address disparities in chronic diseases and preventable deaths. Furthermore, the study highlights the importance of disaggregating Asian American and Pacific Islander data to provide accurate insights into health outcomes. Researchers should continue to disaggregate these groups to better understand the unique health challenges each faces and to address structural inequities, including barriers to healthcare access and insurance. 

Reference

Vo JB, et al. Leading causes of death among Asian American compared with Pacific Islander individuals, 2018-2020. JAMA Internal Medicine. 2025.

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