# Cardiovascular disease risk disparities between immigrants and native Koreans: a population-based study in Gwangju, Korea

## TL;DR

Immigrants in Korea have higher cardiovascular disease risk than native Koreans, especially among vulnerable groups, due to health and socioeconomic disparities.

## Contribution

This study provides population-based evidence of cardiovascular disease risk disparities between immigrants and native Koreans.

## Key findings

- Immigrants had higher rates of hypertension, diabetes, and unmet medical needs compared to native Koreans.
- Adjusted odds of elevated CVD risk were 1.47 for Framingham risk score and 1.49 for pooled cohort equations among immigrants.
- Disparities were most pronounced among women, older adults, low-income groups, and migrants from Central Asia, Russia, and Africa.

## Abstract

Korea is becoming a multiethnic society, with immigrants comprising nearly 5% of the population. Evidence on cardiovascular disease (CVD) risk among immigrants remains limited.

We conducted a population-based study of 582 immigrants in Gwangju and 2,328 age-matched and gender-matched native Koreans (2022-2023). Immigrant data were obtained from direct health assessments, while native Korean data were drawn from the Korea National Health and Nutrition Examination Survey. CVD risk was estimated using the Framingham risk score (FRS) and pooled cohort equations (PCE). Logistic regression was employed to compare the odds of elevated risk (10-year CVD risk ≥7.5%), adjusting for socio-demographic and behavioral factors.

Immigrants had a higher prevalence of hypertension (37.3 vs. 16.1%), diabetes (11.5 vs. 5.6%), poor self-rated health (69.6 vs. 61.3%), and unmet medical needs (30.9 vs. 8.9%), as well as lower rates of health checkups and cancer screening (all p<0.001), compared to native Koreans. Elevated CVD risk was more frequent in immigrants (FRS, 31.4 vs. 20.8%; PCE, 33.6 vs. 22.8%). The adjusted odds ratios (95% confidence intervals) were 1.47 (1.14 to 1.88) for FRS and 1.49 (1.07 to 2.08) for PCE. Disparities were greatest among women, adults ≥40 years, uninsured people, low-income groups, and migrants from Central Asia, Russia, and Africa.

Immigrants in Korea face substantially higher CVD risk than native Koreans, particularly within socioeconomically vulnerable subgroups. Targeted prevention and policies addressing structural barriers are urgently needed.