LAUSR

Key Points Question What is the association of county-level sociodemographic factors with mortality rates for Pacific Islander compared with Asian American adults? Findings In this cross-sectional study of 43 221 696 Asian American and 1 281 221 Pacific Islander adults, Pacific Islander adults had elevated all-cause, cancer, and heart disease mortality rates compared with Asian American adults across all county-level factors. The largest relative mortality differences occurred for individuals younger than 65 years, particularly among those living in counties with lower unemployment or higher educational attainment, median income, and population density. Meaning These findings suggest that Pacific Islander adults living in higher socioeconomic and more populated areas experience the greatest mortality disparities compared with Asian American adults living in the same areas.