Karina M Kim

All Publications

• Disparities in Adult Asthma Outcomes Among Disaggregated Data Among Asian Americans in the National Health Interview Survey Journal of Allergy and Clinical Immunology: Global Alan, Z. 2025: 100458

  Abstract

  Asthma is a chronic lung disease affecting 8% of US adults, with significant disparities among racial and ethnic groups. The Asian American population is diverse, yet asthma research often aggregates data, potentially obscuring group-specific differences. Disaggregated data reveal that although Asian Americans overall appear to have lower asthma prevalence than non-Hispanic Whites, certain subgroups, like Filipino adults, have higher rates. Asthma outcomes are influenced by genetics, environmental exposures, and social determinants, although the specific impact of these factors remains unclear.The objective was to better describe asthma outcomes among disaggregated Asian American groups.We analyzed 2006-18 National Health Interview Survey data on asthma prevalence among non-Hispanic White and disaggregated Asian American adults. Logistic regression was used to calculate adjusted odds ratios (ORs) for Asian American asthma outcomes compared to non-Hispanic Whites, accounting for demographic, health, and socioeconomic factors.Asthma prevalence varied among adults: non-Hispanic White (n = 33,764), Chinese (n = 310, OR = 0.54), Filipino (n = 603, OR = 1.03), Asian Indian (n = 236, OR = 0.43), and other Asians (n = 601, OR = 0.61). Over half had poor asthma control: 62% non-Hispanic White, 53.5% Chinese (OR = 0.72), 50.2% Filipino (OR = 0.64), 54.8% Asian Indian (OR = 0.75), and 59.2% other Asian (OR = 0.82). Filipino adults showed higher asthma prevalence (OR = 1.37) but better control (OR = 0.74). Chinese (OR = 0.39) and Asian Indian (OR = 0.48) adults had fewer emergency department visits. Sociodemographic and health factors significantly affected symptoms, attacks, and emergency department visits.Asthma prevalence and control varied widely among Asian American populations. Sociodemographic and health factors influenced poor asthma control more than racial group.

  View details for DOI 10.1016/j.jacig.2025.100458

  View details for PubMedCentralID PMC12060444

• Disaggregated colorectal cancer mortality among Asian American subgroups between 2005-2020. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology Thakkar, Z., Khan, M. A., Wu, Y., Qi, X., Hung, G. A., Kikuta, N., Jamal, A., Bacong, A. M., Kim, K. M., Kim, G. S., Palaniappan, L. P., Srinivasan, M., Huang, R. J. 2025

  Abstract

  Colorectal cancer (CRC) is the second-leading cause of cancer death in Asian Americans. Asian Americans are a diverse, heterogenous population composed of groups with differing cancer risk factors. Few prior studies have analyzed CRC mortality by disaggregated Asian racial subgroup.Using 2005-2020 US national mortality records linked to American Community Survey one-year population estimates, we report age-standardized mortality rates per 100,000 person-years, standardized mortality ratios (SMR), and average annual percent change trends for the six largest Asian subgroups in a serial, cross-sectional study design. We compared these rates with Non-Hispanic Whites (NHWs). We stratified rates by sex, nativity, and CRC location (colon vs. rectum).Asian subgroups demonstrated substantial heterogeneity in CRC mortality. Relative to the NHW group, Asian Indian Americans had the lowest rate (female SMR 0.3, 95% CI 0.3-0.3; male SMR 0.3, 95% CI 0.3-0.3) and Japanese Americans the highest rate (female SMR 0.9, 95% CI 0.8-0.9; male SMR 0.9, 95% CI 0.9-1.0). Chinese, Filipino, Korean, and Vietnamese Americans demonstrated mortality between Asian Indian and Japanese. Over the study period, most Asian subgroups had stable or decreasing mortality. However, both Korean and Vietnamese CRC mortality increased over the period. By the end of the study period Korean Americans had the highest CRC mortality of any Asian subgroup.Asian subgroups demonstrate heterogeneity in patterns of CRC mortality, emphasizing the necessity of disaggregation in cancer research.Our study provides disaggregated Asian subgroup CRC mortality data, which may allow for targeted risk attenuation efforts.

  View details for DOI 10.1158/1055-9965.EPI-24-1688

  View details for PubMedID 40259799

• Evaluating the Reliability and Robustness of Racial and Ethnic Health Disparities in Cardiometabolic Disease in NHANES, NHIS, and BRFSS (2015-2021). Journal of the American Heart Association Thakkar, Z., Wu, Y., Khan, M., Qi, X., Hung, G. A., Kikuta, N., Jamal, A., Srinivasan, M., Huang, R. J., Kim, K., Kim, G., Palaniappan, L., Bacong, A. M. 2025: e040029

  Abstract

  The United States uses the National Health Interview Survey (NHIS), Behavioral Risk Factor Surveillance System (BRFSS), and National Health and Nutrition Examination Survey to monitor disease trends and inform clinical care/prevention research. These 3 surveys share similar national estimates. However, the consistency of each survey's estimates by race has not been examined. Here, we compare prevalence estimates and disparities in cardiometabolic diseases across 5 aggregated racial and ethnic groups.We examined the age- and fully-adjusted prevalence of cardiovascular disease and diabetes among non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian, and "Other" race respondents aged 30 years or older. Cardiovascular disease included self-reported physician diagnosis of heart attack, stroke, and coronary heart disease.Although overall national population estimates were similar, there was heterogeneity in estimates by survey. For heart attack and diabetes, each racial group had a higher prevalence in BRFSS than NHIS (eg, Heart Attack: Hispanic BRFSS: 3.4% [95% CI, 3.2-3.6], NHIS: 2.0% [95% CI, 1.8, 2.2]; non-Hispanic Black BRFSS: 3.8% [95% CI, 3.6, 3.9]; NHIS: 3.0% [95% CI, 2.7, 3.2]). Non-Hispanic Asian people had the lowest general cardiovascular disease prevalence across all 3 data sets (NHIS: 5.9%, National Health and Nutrition Examination Survey: 5.3%, BRFSS: 6.9%), while Other/multi-racial respondents had the highest prevalence (NHIS: 9.9%, National Health and Nutrition Examination Survey: 13.1%, BRFSS: 10.7%). However, the magnitude of these differences across data sets was small.Prevalence estimates for heart attack and diabetes were heterogeneous by race across surveys. These results highlight the importance of improving the representation of racially minoritized groups within national surveys to produce more precise estimates.

  View details for DOI 10.1161/JAHA.124.040029

  View details for PubMedID 40008548

• Association Between Sleep Duration and Cardiovascular Disease Among Asian Americans. Journal of the American Heart Association Nadarajah, S., Akiba, R., Maricar, I., Vohra, S., Jamal, A., Yano, Y., Srinivasan, M., Kim, G., Huang, R. J., Palaniappan, L., Kim, K., Elfassy, T., Yang, E. 2024: e034587

  Abstract

  Cardiovascular disease (CVD) prevalence varies widely among Asian American adults. The American Heart Association added healthy sleep to its metrics to define ideal cardiovascular health. Little is known about the association between sleep and CVD prevalence among Asian subgroups. We aim to examine the association between suboptimal sleep duration and CVD risk prevalence among Asian American subgroups.We used 2012 to 2018 National Health Interview Survey data to examine the association between suboptimal sleep duration and CVD prevalence. We included 6868 self-identifying Asian adults age >40 years (Asian Indian [n=1053], Chinese [n=1415], Filipino [n=1734], and Other Asian [n=2666] adults). Suboptimal sleep was defined as <7 or >9 hours per night. CVD was defined as self-reported stroke, heart attack, coronary artery disease, or angina. Logistic regression was used to calculate odds ratios and 95% CI to estimate the association between suboptimal sleep duration and CVD prevalence. Filipino and Other Asian participants with suboptimal sleep had the highest prevalence of CVD. Aggregated Asian American participants with suboptimal sleep duration had a higher prevalence of CVD (odds ratio [95% CI, 1.35 [1.09-1.68]) compared with those with optimal sleep duration. After stratification by race or ethnicity or both, a significant association persisted for Other Asian participants (1.77 [95% CI, 1.27-2.46]) but not among all other Asian American subgroups.Our study highlights the heterogeneity of CVD prevalence associated with suboptimal sleep duration among Asian American adults. Future studies should consider how different measures of sleep duration and quality affect CVD outcomes among disaggregated Asian American subgroups.

  View details for DOI 10.1161/JAHA.124.034587

  View details for PubMedID 39719431

• Feasibility and Acceptability of Universal Adult Screening for Chronic Hepatitis B in Primary Care Clinics. AJPM focus Chu, R. V., Sarnala, S., Doan, T. V., Jamal, A., Phadke, A., So, S., So, R., Pham, H., Chaudhary, J., Huang, R., Kim, G., Palaniappan, L., Kim, K., Srinivasan, M. 2024; 3 (6): 100240

  Abstract

  Two thirds of Americans infected with chronic hepatitis B are unaware of their infection. In March 2023, the Centers for Disease Control and Prevention recommended moving from risk-based to universal adult chronic hepatitis B screening. In April 2022, Stanford implemented chronic hepatitis B universal screening discussion alerts for primary care providers.After 6 months, the authors surveyed 143 primary care providers at 13 Stanford primary care clinics about universal chronic hepatitis B screening acceptability and implementation feasibility. They conducted semistructured interviews with 15 primary care providers and 5 medical assistants around alerts and chronic hepatitis B universal versus risk-based screening.Forty-five percent of surveyed primary care providers responded. A total of 63% reported that universal screening would identify more patients with chronic hepatitis B. Before implementation, 77% ordered 0-5 chronic hepatitis B screenings per month. After implementation, 71% ordered >6 screenings per month. A total of 66% shared that universal screening removed the stigma around discussing high-risk behaviors. Interview themes included (1) low clinical burden, (2) current underscreening of at-risk groups, (3) providers preferring universal screening, (4) patients accepting universal screening, and (5) ease of chronic hepatitis B alert implementation.Consistent with Centers for Disease Control and Prevention guidelines, implementing universal chronic hepatitis B screening in primary care clinics in Northern California was feasible, was acceptable to providers and patients, eased health maintenance burdens, and improved clinic workflows.

  View details for DOI 10.1016/j.focus.2024.100240

  View details for PubMedID 39582739

  View details for PubMedCentralID PMC11584556

• A QUALITATIVE EVALUATION OF A UNIVERSAL HEPATITIS B SCREENING ELECTRONIC MEDICAL RECORD REMINDER TOOL AT AN ACADEMIC PRIMARY CARE NETWORK Sarnala, S., Chu, R. V., Doan, T. V., Jamal, A., Phadke, A., Hang Pham, So, R., Huang, R., Kim, G. S., Palaniappan, L., Kim, K., Srinivasan, M. SPRINGER. 2023: S329

  View details for Web of Science ID 001043057201121