US Health Care Relies on Filipinxs While Ignoring Their Health Needs

Abstract

In the US, Filipinxs are the third largest Asian subgroup and have represented a crucial part of the country's health care workforce since the mid-20th century. Although the 2.9 million Filipinxs in the US represent about 1% of the population, approximately 1 of 4 Filipinx working adults are frontline health care workers. 1 The COVID-19 pandemic has exacted a disproportionate toll on Filipinx communities in the US and on Filipinx health care workers, specifically. The absence of disaggregated race/ethnicity data for COVID-19 has masked how the pandemic has affected Filipinxs in the US.Policy makers and researchers must recognize that these disparities are not limited to COVID-19 but are a critical example of how data aggregation under a single Asian category has hidden the health needs of the Filipinx population. Missing in the Data, Missing in Policy DiscussionsAggregate race/ethnicity data for COVID-19 cases and deaths mask the disproportionate burden on Asian subgroups, including Filipinxs in the US, leaving these disparities unrecognized and unaddressed. Asians comprise nearly 6% of the US population but only about 3% of COVID-19 cases and 4% of its deaths, suggesting that Asian Americans are not disproportionately affected by COVID-19. Yet a different picture has emerged for Filipinxs in Hawaii, the only state which publicly reports disaggregated Asian data: Filipinx residents comprise 16% of the population but 22% of COVID-19 deaths. 2 Similar analyses are not possible nationally or in any other state. While some states may collect data on Filipinxs, these data are typically restricted and only available through public information requests. For example, Filipinxs comprise 42% of COVID-19 deaths among Asian adults (18-64 years) in California 3 despite making up just 20% of the state's nonelderly Asian adult population. 1 No other Asian subgroup accounted for more than 15% of deaths (Figure ). 3 Author affiliations and article information are listed at the end of this article.

Variation in Usual Source of Care in Asian American, Native Hawaiian, and Other Pacific Islander Adult Medicaid Beneficiaries

“…Further, there were concerns that AANHPI people would forego necessary care because of substantial increases in reported acts of racism and anti-Asian xenophobia during the pandemic and further exacerbate inequities in access to care 40–42. Studies indicated that aggregated AANHPI data masked variation in infection, hospitalization, and mortality rates by subgroups 40,43–45. Disaggregated data also revealed heterogeneity in self-reported discrimination and concern for physical assault by subgroup during the pandemic 46.…”

Willingness to Receive the COVID-19 Vaccine in California: Disparities by Race and Citizenship Status

“…For instance, a recent study found that exposures to immigration enforcement, such as avoidance of health and social services due to immigration fears or experiences of detention or deportation, were associated with a lower likelihood of accepting the COVID-19 vaccine among a sample of undocumented young adults in CA [ 27 ]. Alternatively, some Latinx people may have a general mistrust due to discrimination by medical providers or histories of racial discrimination [ 22 , 28 , 29 ]. Thus, although vaccine willingness may be slightly higher among non-citizen Latinx compared to US-born and naturalized Latinx people, structural barriers may ultimately affect the actual uptake of the COVID-19 vaccine.…”

Variation in National COVID-19 Mortality Rates Across Asian Subgroups in the United States, 2020

“…Furthermore, greater occupational risks to SARS-CoV-2 exposure among Filipinos may also partially explain their greater relative COVID-19 mortality burden among Asians. For instance, Filipinos are vastly overrepresented in healthcare professions such as nursing [60], and approximately a quarter of Filipino adults are frontline healthcare workers [32]. As such, Filipinos were overrepresented among Asians who were providing direct medical care to COVID-19 patients during the early stages of the pandemic before vaccines were developed.…”

“…While limited research has uncovered disparities in COVID-19 mortality outcomes among specific Asian subgroups in specific geographic regions and contexts, such as Hmongs in Minnesota [30], Chinese and South Asians in New York City [31], and Filipinos in California [32], little to no attention by national media outlets and public health officials has been given to vulnerable Asian subgroups [33]. To date, there has not been a national-level analysis of COVID-19 mortality outcomes between Asian subgroups in the U.S. To this end, I utilized final multiple cause of death data for 2020 that were released in December 2021 and population projections from the U.S. Census Bureau's Current Population Survey Annual Social and Economic Supplement ASEC for 2020 to calculate crude, age-adjusted, and sex-stratified national COVID-19 mortality rates for the six major Asian origin subgroups (Asian Indians, Chinese, Filipino, Japanese, Korean, Vietnamese), as well as a catch-all seventh category that comprises the remaining less-populous Asian subgroups (Other Asians), contrasting them with the corresponding mortality rates of other racial/ethnic groups.…”