Numerous factors – including immigration status, socioeconomic status and access to healthcare – contribute to differences in heart disease and stroke risks for Asian-American people and may affect the many subgroups in this population differently, according to a new science report.

The American Heart Association scientific statement highlights evidence of the role social determinants of health play in cardiovascular health among Asian-American adults and identifies areas where more research is needed to reduce health disparities among them. The statement was published in the AHA journal Circulation.

Asian-American people are the fastest-growing ethnic group in the US, a population expected to reach 46 million, or 10 per cent of the US population, by 2060.

But studies show they have been persistently under-represented in medical research, in part because they are the least willing of any racial and ethnic group to participate. Issues with English-language proficiency and studies that are only conducted in English also lead to lower representation.

This can make it harder to fully understand the factors contributing to cardiovascular health for Asian-American subgroups, the statement’s authors found.

“Due to the small numbers of Asian-American recruited in research studies, even when Asian-American participants are included, they are frequently combined into a single ‘Asian’ category or grouped with Native Hawaiian and Pacific Islander communities, which results in the masking of clinically relevant differences in health among subgroups of people of Asian descent,” Dr. Nilay S. Shah, chair of the statement writing group, said in a news release.