Award Date

December 2017

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Health Sciences

First Committee Member

Paulo Pinheiro

Second Committee Member

Guogen Shan

Third Committee Member

Timothy Bungum

Fourth Committee Member

Ray Serafice

Number of Pages

43

Abstract

Filipinos in the US are 3.4 million, yet the main causes of death among this primarily immigrant population have not been well characterized nor compared with the mortality experience of their counterparts in the Philippines. Age-adjusted mortality rates were computed for the main causes of death for three populations: Filipinos living in the Philippines (FPHs), Filipinos living in California (FCAs), and non-Hispanic whites in California (WCAs). Regression-derived mortality rate ratios stratified by sex were used to compare the populations, using WCA as the referent population. Included causes of death were ischemic heart disease, stroke, cancer and chronic lower respiratory disease, as well as two common causes of death in the Philippines, pneumonia and tuberculosis. For cancer, the four most common cancer mortality sites and cervical cancer were examined.

A total of 858,388 FPH, 256,395 WCA, and 9,280 FCA decedents were analyzed. In the US, cancer was the leading cause of death for Filipinos of both sexes, while in the Philippines, it was fourth after ischemic heart disease, pneumonia and stroke. For all cancers combined, no significant differences in mortality were recorded between Filipinos in CA and in the Philippines (p>0.05); however, patterns varied by cancer site. For liver, prostate and cervical cancers, FPHs fared considerably worse than FCAs, while for lung cancer among women, FCA had a 56% (95%CI 1.20-2.02) higher risk of death than FPH.

Overall, mortality rates from the major causes of death are much lower among FCAs than FPHs, suggesting that Filipinos in CA benefit substantially from living in the US in terms of health outcomes and life expectancy. Access to a more developed health care infrastructure, effective prevention programs, and better treatment opportunities likely explain the lower mortality rates in the US for ischemic heart disease, stroke and infectious diseases. However, the differences in cancer between the two populations are not as striking as for other causes of death, with differences in the prevalence of risk factors, including obesity, smoking, fertility patterns, and Hepatitis B impacting cancer rates. Risk factor interventions in the US and enhancing the health infrastructure in the Philippines should result in health gains for Filipinos on both sides of the Pacific.

Keywords

Cancer; Filipino

Disciplines

Community Health and Preventive Medicine

Language

English


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