Breaking Down Health Data is Essential for AAPI Health Equity

Action is needed today!

You can support the Massachusetts Data Equity Bill by contacting your state legislator today to ensure equitable representation, visibility, and inclusion through data collection and reporting. The bill has won support from the Massachusetts House of Representatives, was reported favorably by the Joint Committee on State Administration and Regulatory Oversight and has been referred to the committee on House Ways and Means. We must urge our state legislators to follow through on their commitment toward health equity and to prioritize data equity for all in the Commonwealth.

Seeing all Asian Americans and Pacific Islanders (AAPIs) as one monolithic race neglects the myriad of histories and lived experiences of this diverse community. Misrepresenting AAPIs as one group in health data and research makes key differences and inequalities that exist among AAPIs invisible.

To break this cycle, Massachusetts State Representative Tackey Chan (D – 2nd Norfolk) sponsored Bill H.3115: Ensuring equitable representation in the Commonwealth. Also known as the Data Equity Bill, this bill would require government agencies that collect demographic data on race and ethnicity to also collect disaggregated data of ethnic subgroup breakdowns for Asian, Pacific Islander, Latino, Black and African American, and White groups. This is a necessary step toward equitable representation and visibility of our underserved and underrepresented communities.

Lack of disaggregated data on Asian Americans in Massachusetts

Public data should represent the public!

Major public health data systems in Massachusetts lack detailed race/ethnicity data and clump AAPIs into one group. For example, the Massachusetts Youth Risk Behavior Survey and the County Health Rankings & Roadmaps for Massachusetts groups AAPIs into the two categories Asian and Native Hawaiian or Other Pacific Islander. Similarly, the statewide report on cancer and mortality only reports on Asians. The BRFSS Questionnaire asks about AAPI subgroup ethnicity, yet the results report on Asians as a whole.

Advocates in Southeast Asian communities in Massachusetts have been pushing for data disaggregation in health and education for almost three decades. Asian Pacific Islanders Civic Action Network (APIsCAN) is currently leading the campaign to pass the bill.Karen Chen, the Executive Director of the Chinese Progressive Association and a member of the steering committee of APIsCAN, reports that the main reason why APIsCAN supports this bill is because good data is fundamental to equity and inclusion. “If we want public resources to go to the public good, then the government has to have good data on its residents,” Chen explained. 

Breaking Down Data Reveals Disparities in AAPI Health

Asian Americans are the fastest growing racial and ethnic group in Massachusetts, increasing by over 42% from 2010 to 2020, according to the 2020 Census. Grouping AAPIs, a community of approximately 50 different ethnic groups, and comparing those data with other races and ethnicities, is dangerous as it hides significant social, economic, and health inequities and disparities within the group. Importantly, structural inequities including income, poverty, and education, lead to health disparities in the health status and burden of disease across different ethnic sub-populations of AAPIs. 

Income and Poverty. For example, income and poverty among Asian Americans differ significantly across subgroups. UMass Boston’s Institute for Asian American Studies reported that there are substantial differences in household and per capita incomes among Asian American subgroups in Massachusetts. Looking at the largest five subgroups of Asian Americans in the state (Chinese, Indian, Vietnamese, Cambodian, and Korean), Indian Americans have higher incomes than the other four subgroups, and per capita incomes for Vietnamese and Cambodian Americans lag significantly. While Asian Americans as a whole represent the highest earning racial and ethnic group in the country, the individual and family poverty rates for Asian Americans are higher than the rates for white, non-Hispanics. Chinese Americans had the highest individual poverty rate at 17.5% compared to Indian Americans at 7.2% and the total Massachusetts population at 10.3%, and family poverty rates for Vietnamese Americans were highest at 12.6%, compared to Indian Americans at 3.6% and the total population at 7.0%.

Education. Solely looking at aggregated data on educational attainment of Asian Americans wrongfully ignores significant differences in education for certain subgroups. Researchers at UMass Boston found that 38% of Asian Americans have a graduate or professional degree as compared to 21% for white, non-Hispanics. However, disaggregated data shows significant differences in educational attainment among Asian American subgroups, revealing that 30.9% of Cambodian Americans and 28.7% of Vietnamese Americans have less than a high school diploma, as compared to 9.2% of the total Massachusetts population.

COVID-19. The experiences of AAPIs during the COVID-19 pandemic also vary greatly among subgroups. Data from the 2021 Covid Community Impact Survey revealed that in Massachusetts, Asian respondents as a whole reported working outside of the home at significantly lower rates than White, non-Hispanic respondents. However, disaggregated data revealed that over 70% of Cambodians were working outside of the home, putting them at increased risk of infection during the pandemic.

Urgent Action is Needed

MyDzung Chu, Director of Tufts CTSI’s Addressing Disparities in Asian Populations through Translational Research (ADAPT) Coalition, also supports the Data Equity Bill:

“Data drives critical funding and policy decisions, interventions, and resource allocation. Without accurate and disaggregated data reflecting our diverse Asian and Pacific Islander populations, our most vulnerable residents and communities continue to be made invisible. A clear example of this is the lack of data on COVID-19 infection and vaccination rates for specific communities of color in Massachusetts, which then delays the timeliness and effectiveness of our public health response in these communities and further exacerbates their risk of COVID.”

Breaking Down the Model Minority Myth

Asian Americans are often stereotyped as the “model minority,” characterized as part of a high-achieving, hardworking, and superior monolithic group. Pushing the model minority narrative makes invisible the diverse stories and challenges experienced within the group. The myth masks the long history of racism that AAPIs have faced and are still facing today through oppressive acts such as colonialism, war, and racist policies.

As an Asian American myself, I fell into this myth and ignored the stories of my parents who were refugees of the Vietnam War, oftentimes feeling ashamed of our struggles because we did not live up to the expectations that society had ascribed to us.

Breaking down AAPI health data depicts a different story that captures the inequities that persist among Asian Americans and provides a counterpoint to the model minority myth. Supporting health equity requires accurately measuring and reporting the experiences of our diverse communities. We must use that data to respond appropriately through targeted policies and interventions to address specific community needs.

Support Data Equity as a Solution

As public health professionals, health care providers, and health researchers, we must recognize the structural racism that persists and challenge the biases that we hold around AAPIs. We must instead see that there is great heterogeneity in social, economic, and health status experienced by members of this diverse community. Contact your legislator today to act on this critical bill.