Asian Americans and Pacific Americans (AAPI) are the fastest growing racial/ethnic group, encompassing 25% of all foreign-born people in the U.S. and projected to reach nearly 34 million by 2050. But Asian health research is drastically underfunded, representing only .3% of all NIH grants awarded. Recent research, including studies led by Stanford faculty, has found that people with roots in China, Japan, Korea, Vietnam, India, the Philippines, and the Pacific Islands among other countries have widely divergent risk profiles and often very different responses to common medications. Throughout the COVID-19 pandemic, the lack of disaggregated AAPI data made it impossible to identify which AAPI groups had the highest infection and lowest vaccination rates.
An EMS (Ethnic Media Services) briefing recently shared the latest data on AAPI health indicators, delving into the underlying contributors to such differences and exploring why a one-size-fits-all approach to health care falls short and may even lead to inadvertent harm.
Dr. Bryant Lin, Co-founder of Stanford Center for Asian Health Research and Education (CARE), primary care physician, researcher, and educator lamented that the diversity of the Asian community is often missed. Asians are of diverse origins and are not a monolith. He shared the case of a 74-year-old patient who suffered from gout to whom he prescribed medication popularly used to treat this condition. This patient suffered a severe reaction called DRESS a reaction that had not been documented or mentioned anywhere for Asians and which also affects African Americans who suffer the same skin reactions. Even though it affects Asians it is particularly more prevalent in Chinese Americans which shows the benefits of understanding the importance of such studies.
Dr. Winston Wong, Chair of the National Council of Asian Pacific Islander Physicians, member of the COVID-19 Health Equity Task Force for the US Department of HHS Office of Minority Health X emphasized the importance of disaggregation of Asians and Pacific Islanders. He stressed the importance for media and ethnic media to play a key role in representing the data and what stories are told. Media plays a big role in advocacy through the stories they tell. The lack of data however has a profound impact on the community and disaggregation in particular. He shared that the covid pandemic had illustrated this glaring shortcoming at the beginning of the pandemic. His organization had gone to the CDC and in the first six months, Asian Americans did not identify as a separate group and neither did the Pacific Islanders. In some states, they were identified as ‘other’ which is a label of anonymity and numbers that do not count. This is not just about precision but informing policy orders and for those responsible for healthcare to know what is going on, particularly to the race in question and what covid was doing in the Asian and Pacific Islander communities. For instance, even though New York reported that the Chinese were the most hospitalized and died from covid complications, this was never reported as a headline. It also happened across other states and other Asian demographics which never made it to the headline. Based on race or socio-cultural activities black Americans and Latinos were reported accurately but so was the case of micro Asians in Arkansas. He concluded that Asians, Pacific Islanders, and native Hawaiians should be at least reported as separate groups so that their needs could be met and their lived experiences therefore should be factored in the classification of data.
Dr. Van Ta Park, Professor at UCSF, School of Nursing, working on an NIH/NIA R24 grant on how to address the gap and reduce disparities in research participation among AAPI shared light on the importance of data this aggregation to combat Health disparities among AANHPI populations because there is not enough data on these communities.
Thu Quach, PhD, who has been appointed President of Asian Health Services shared their work in reflecting the importance of disaggregation. As a resettled Vietnamese Refugee family the tedious journey faced amidst prejudice and language barriers shaped her. She emphasized the number of languages in the Asian Community to show diversity. Asian Health Services has been comparing the fears faced by the Asian Community during the pandemic. Asians as we know have been unfairly targeted and victimized. Without disaggregation, for instance, data showed that the Asian demographic was not as affected by covid; however, factoring disaggregation, it revealed that the Vietnamese Community had one of the highest rates among all groups. Factors such as crowded communities and low-wage jobs which caused them to get less protection from covid-19 were responsible.
Dr. Lin emphasized the role of media to push more lenses to inform media and policy as well. Dr. Wong emphasized the importance of understanding the inequities of care which was similar to what the LGBTQ experiences in coming out. Asians also need a safe environment for people to come out and identify themselves for proper data collection.
Finally, Dr. Park observed Improvement in data disaggregation at the NIH. She however said it will take time and resources.