Younger and Sicker: Comparing Micronesians to Other Ethnicities in Hawaii

Abstract

Objectives: We compared the age at admission and the severity of illness of hospitalized Micronesians with 3 other racial/ethnic groups in Hawaii.

Methods: With Hawaii Health Information Corporation inpatient data, we determined the age at admission and the severity of illness for 162,152 adult, non-pregnancy-related hospital discharges in Hawaii from 2010 to 2012. We performed multivariable linear regression analyses within major disease categories by racial/ethnic group. We created disease categories with all patient refined-diagnosis related groups.

Results: Hospitalized Micronesians were significantly younger at admission than were comparison racial/ethnic groups across all patient refined-diagnosis related group categories. The severity of illness for Micronesians was significantly higher than was that of all comparison racial/ethnic groups for cardiac and infectious diseases, higher than was that of Whites and Japanese for cancer and endocrine hospitalizations, and higher than was that of Native Hawaiians for substance abuse hospitalizations.

Conclusions: Micronesians were hospitalized significantly younger and often sicker than were comparison populations. Our results will be useful to researchers, state governments, and hospitals, providers, and health systems for this vulnerable group.

FIGURE 1—

Average Age in Years in Overall Sample by Race/Ethnicity: Hawaii, 2010–2012 Note. Average age was ± 1 SD. The sample size was n = 162 152. Means across groups were significantly different at P < .001.

FIGURE 2—

Average Severity of Illness in Overall Sample by Race/Ethnicity: Hawaii, 2010–2012 Note. SOI = severity of illness. Average SOI was ± 1 SD. The sample size was n = 162 152. The 3M Health Information Systems SOI score range was 1–4, with higher scores indicating worse SOI. 3M designed this metric to be used specifically in all patient refined–diagnosis related groups disease categories, and thus overall SOI may not be a meaningful metric. We have included it here because the information on the Micronesian population is limited, and it thus allows a broad comparison of SOI with other hospitalized racial/ethnic groups. However, it should not be considered a definitive measure of SOI overall for any population group considering these caveats. Means across groups were significantly different at P < .001.