Health Disparity Measurement Among Asian American, Native Hawaiian, and Pacific Islander Populations Across the United States

Kong, Carolyn Wang; Green, Jennifer; Hamity, Courtnee; Jackson, Ana

doi:10.1089/heq.2022.0051

Cited by 8 publications

(1 citation statement)

References 15 publications

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“…Koholokula et al [ 14 ] reported that NH/PI communities have been calling for better data collection and analysis via disaggregation of NH/PI data apart from AA data and for accuracy in public health reports and data surveillance systems, even prior to the COVID-19 pandemic. The extent of reach and addressing the needs of communities are often limited by inadequate data disaggregation [ 69 - 72 ]. The perspectives shared by participants in this study inform the continuing work of our research team partnership, and this uplifts voices and center stories regarding racialized experiences in accessing health care among multigenerational families within AA communities and NH/PI communities.…”

Section: Discussionmentioning

confidence: 99%

An Antiracism Community-Based Participatory Research With Organizations Serving Immigrant and Marginalized Communities, Including Asian Americans and Native Hawaiians/Pacific Islanders in the United States Pacific Northwest: Qualitative Description Study With Key Informants

Nguyen-Truong¹,

Waters²,

Richardson³

et al. 2023

Asian Pac Isl Nurs J

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Background Asian American (AA) community leaders, Native Hawaiian/Pacific Islander (NH/PI) community leaders, and allies in the United States Pacific Northwest expressed concern that there are families and children from AA communities and NH/PI communities who experience and witness acts of xenophobia and racism. This can cause racial trauma. The long-time practice of aggregating AA and NH/PI data contributes to erasure and makes it challenging to advance health equity, such as allocating resources. According to AAPI Data’s long-awaited report in June 2022, there are over 24 million AAs and 1.6 million NHs/PIs in the United States, growing by 40% and 30%, respectively, between 2010 and 2020. Philanthropic investments have not kept up with this substantive increase. The National Academies of Sciences, Engineering, and Medicine emphasized the need for effective partnerships to advance the health and well-being of individuals and communities in antiracism and system-level research. Objective The aim of this community-based participatory research qualitative description study was to identify perceptions and experiences regarding racial discrimination, race-based stress, and racial trauma; intergenerational healing and resiliency; and sharing the body with science from key informants of an academic and community partnership to inform antiracism coalition work. This partnership includes academic researchers and community leaders from community-based organizations and a health care organization serving immigrant and marginalized communities, including AAs and NHs/PIs in the United States Pacific Northwest. Methods In total, 10 key informants joined 1 of 2 participatory group discussions via videoconference for 2 hours in 2022. We used a semistructured and open-ended group interview guide. A qualitative participatory group-level assessment was conducted with the key informants and transcribed. Interpretations and meanings of the main points and the main themes were reflected upon, clarified, and verified with the key informants in real time. The field note–based data transcripts were manually coded using conventional content analysis. Reflexivity was used. Results There were 6 main themes: prejudice plus power in racism definition and working in solidarity to counter lateral oppression/false sense of security, microaggression as multilayers, “not assimilationist by nature” and responding differently to white superiority, intergenerational- and identity-related trauma, what is healing among People of Color and through a lens of resiliency and intergenerational connection and knowledge, and mistrust and fear in the research and health care systems surrounding intentions of the body. Conclusions The themes highlight the importance of internal and intergenerational healing from racial trauma and the need for solidarity among communities of color to combat white supremacy and colonization. This work was foundational in an ongoing effort to dismantle racism and uplift the community voice through a cross-sector academic and community partnership to inform antiracism coalition work.

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Section: Discussionmentioning

confidence: 99%

An Antiracism Community-Based Participatory Research With Organizations Serving Immigrant and Marginalized Communities, Including Asian Americans and Native Hawaiians/Pacific Islanders in the United States Pacific Northwest: Qualitative Description Study With Key Informants

Nguyen-Truong¹,

Waters²,

Richardson³

et al. 2023

Asian Pac Isl Nurs J

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Unmasking Suicidal Ideation for Asian American, Native Hawaiian, and Pacific Islander Youths Via Data Disaggregation

Lui,

Ye,

Gee

et al. 2024

JAMA Netw Open

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ImportanceSuicide is one of the leading causes of death for Asian American, Native Hawaiian, and Pacific Islander adolescents, but because these individuals are analyzed in aggregate, potentially important differences in suicide risk are obscured.ObjectiveTo disaggregate Asian and Native Hawaiian or Pacific Islander adolescents into racial and ethnic subgroups and compare risks of suicidal ideation between and within the subgroups.Design, Setting, and ParticipantsThis cross-sectional study used pooled data from 4-year public high school students (9th and 11th grade) participating in the 2017-2018 and 2018-2019 California Healthy Kids Survey. Data were analyzed between January 5, 2023, and March 31, 2024.ExposuresSelf-reported race and ethnicity, including American Indian or Alaska Native, Asian, Black, Hispanic or Latinx, Native Hawaiian or Pacific Islander, and White, and 9 Asian and Native Hawaiian or Pacific Islander subgroups, including Asian Indian, Chinese, Filipino, Japanese, Korean, Native Hawaiian or Pacific Islander, other Asian, Southeast Asian (ie, Cambodian, Hmong, Laotian), and Vietnamese.Main Outcome and MeasuresPast-year suicidal ideation was the primary outcome. Analyses compared an aggregated Asian and Native Hawaiian or Pacific Islander group with subgroups disaggregated by ethnicity and by monoethnic or monoracial, multiethnic, and multiracial identifications. Logistic regression models were used to test between- and within-group differences.ResultsAmong 547 816 California adolescents in 9th or 11th grade surveyed (50.3% girls), 77 735 (14.2%) identified as Asian or Native Hawaiian or Pacific Islander. The prevalence of suicidal ideation was 17.5% (95% CI, 17.1%-17.9%) among adolescents in the combined Asian and Native Hawaiian or Pacific Islander group. After disaggregation into subgroups, prevalence of suicidal ideation ranged from 13.3% (95% CI, 12.3%-14.4%) for monoethnic Asian Indian adolescents to 21.2% (95% CI, 20.4%-21.9%) for monoethnic Filipino adolescents. Multiethnic and multiracial identity was associated with elevated risk of suicidal ideation for all groups, from 2.3 percentage points (from 21.2% [95% CI, 20.4%-21.9%] among monoethnic to 23.5% [95% CI, 22.8%-24.2%] among multiracial Filipino adolescents) to 9.4 percentage points (from 13.7%, [95% CI, 13.0%-14.4%] among monoethnic to 23.1% [95% CI, 22.1%-24.1%] among multiracial Chinese adolescents). Compared with a mutually exclusive approach, an additive model allowing for self-report of multiple identities had the best fit and showed a higher prevalence of suicidal ideation among multiethnic and multiracial Asian and Native Hawaiian or Pacific Islander adolescents compared with monoethnic Chinese adolescents.Conclusions and RelevanceThe results from this cross-sectional study provide evidence for disaggregation of heterogeneous ethnoracialized groups as a data equity strategy that may illuminate hidden disparities in adolescent suicidal ideation risk. Further research is imperative to understand suicide risk among Asian, Native Hawaiian, and Pacific Islander adolescents who identify with multiple ethnic or racial groups.

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Disparities in Cancer Mortality among Disaggregated Asian American Subpopulations, 2018–2021

Zhu,

Lai,

Park

et al. 2024

J. Racial and Ethnic Health Disparities

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Federal, state, and institutional data collection practices and analyses involving Asian Americans as a single, aggregated group obscure critical health disparities among the vast diversity of Asian American subpopulations. Using from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Underlying Causes of Death database, we conducted a cross-sectional study using data on disaggregated Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, other Asians) between 2018 and 2021. We examine deaths from 22 cancer types and in situ, benign neoplasms, identified using ICD-10 codes C00-C97 and D00-D48. Overall, our study comprised 327,311 Asian American decedents, with a mean age of death at 70.57 years (SD=2.79), wherein females accounted for approximately half of the sample (n=36,596/73,207; 49.99%). Notably, compared to the aggregated Asian American reference group, we found higher proportions of deaths from total cancers among Chinese (25.99% vs. 22.37% [ref]), Korean (25.29% vs. 22.37% [ref]), and Vietnamese (24.98% vs. 22.37% [ref]) subgroups. In contrast, total cancer deaths were less prevalent among Asian Indians (17.49% vs. 22.37% [ref]), Japanese (18.90% vs. 22.37% [ref]), and other Asians (20.37% vs. 22.37% [ref]). We identified further disparities by cancer type, sex, and age. Disaggregated data collection and analyses are imperative to understanding differences in cancer mortality among Asian American subgroups, illustrating at-risk populations with greater granularity. Future studies should aim to describe the association between these trends and social, demographic, and environmental risk factors.

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Health Disparity Measurement Among Asian American, Native Hawaiian, and Pacific Islander Populations Across the United States

Cited by 8 publications

References 15 publications

An Antiracism Community-Based Participatory Research With Organizations Serving Immigrant and Marginalized Communities, Including Asian Americans and Native Hawaiians/Pacific Islanders in the United States Pacific Northwest: Qualitative Description Study With Key Informants

An Antiracism Community-Based Participatory Research With Organizations Serving Immigrant and Marginalized Communities, Including Asian Americans and Native Hawaiians/Pacific Islanders in the United States Pacific Northwest: Qualitative Description Study With Key Informants

Unmasking Suicidal Ideation for Asian American, Native Hawaiian, and Pacific Islander Youths Via Data Disaggregation

Disparities in Cancer Mortality among Disaggregated Asian American Subpopulations, 2018–2021

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