Why Are We Going Backward? Barriers to Disaggregated Racial Information in Federal Data Sets

Jamal, Armaan; Srinivasan, Malathi; Kim, Gloria; Huang, Robert J.; Palaniappan, Latha

doi:10.2105/ajph.2023.307339

Cited by 5 publications

(2 citation statements)

References 2 publications

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“…National survey data, such as the National Health and Nutrition Examination Survey, National Health Interview Survey, or Behavioral Risk Factor Surveillance System, may not provide comprehensive data about Asian and Pacific Islander groups with adequate sample sizes. 37 , 38 Second, outcome data in the EHR are not subject to the same reporting biases as survey data. Third, our study augments EHR data by providing linked survey and health behavior data.…”

Section: Discussionmentioning

confidence: 99%

Obesity Disparities Among Adult Single-Race and Multiracial Asian and Pacific Islander Populations

Bacong,

Gibbs,

Rosales

et al. 2024

JAMA Netw Open

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ImportanceDespite increasing numbers of multiracial individuals, they are often excluded in studies or aggregated within larger race and ethnicity groups due to small sample sizes.ObjectiveTo examine disparities in the prevalence of obesity among single-race and multiracial Asian and Pacific Islander individuals compared with non-Hispanic White (hereafter, White) individuals.Design, Setting, and ParticipantsThis cross-sectional study used electronic health record (EHR) data linked to social determinants of health and health behavior data for adult (age ≥18 years) members of 2 large health care systems in California and Hawai’i who had at least 1 ambulatory visit to a primary care practitioner between January 1, 2006, and December 31, 2018. Data were analyzed from October 31, 2022, to July 31, 2023.ExposureSelf-identified race and ethnicity provided in the EHR as a single-race category (Asian Indian, Chinese, Filipino, Japanese, Native Hawaiian only, Other Pacific Islander, or White) or a multiracial category (Asian and Pacific Islander; Asian, Pacific Islander, and White; Asian and White; or Pacific Islander and White).Main Outcomes and MeasuresThe main outcome was obesity (body mass index [BMI] ≥30.0), based on last measured height and weight from the EHR. Logistic regression was used to examine the association between race and ethnicity and odds of obesity.ResultsA total of 5229 individuals (3055 [58.4%] male; mean [SD] age, 70.73 [11.51] years) were examined, of whom 444 (8.5%) were Asian Indian; 1091 (20.9%), Chinese; 483 (9.2%), Filipino; 666 (12.7%), Japanese; 91 (1.7%), Native Hawaiian; 95 (1.8%), Other Pacific Islander; and 888 (17.0%), White. The percentages of individuals who identified as multiracial were as follows: 417 (8.0%) were Asian and Pacific Islander; 392 (7.5%), Asian, Pacific Islander, and White; 248 (4.7%), Asian and White; and 414 (7.9%), Pacific Islander and White. A total of 1333 participants (25.5%) were classified as having obesity based on standard BMI criteria. Obesity was highest among people who identified as Asian, Pacific Islander, and White (204 of 392 [52.0%]) followed by those who identified as Other Pacific Islander (47 of 95 [49.5%]), Native Hawaiian (44 of 91 [48.4%]), and Pacific Islander and White (186 of 414 [44.9%]). After accounting for demographic, socioeconomic, and health behavior factors, people who identified as Asian, Pacific Islander, and White (odds ratio [OR], 1.80; 95% CI, 1.37-2.38) or Pacific Islander and White (OR, 1.55; 95% CI, 1.18-2.04) had increased odds of obesity compared with White individuals. All single-race Asian groups had lower odds of obesity compared with White individuals: Asian Indian (OR, 0.29; 95% CI, 0.20-0.40), Chinese (OR, 0.22; 95% CI, 0.17-0.29), Filipino (OR, 0.46; 95% CI, 0.35-0.62), and Japanese (OR, 0.38, 95% CI, 0.29-0.50).Conclusions and RelevanceIn this study, multiracial Asian and Pacific Islander individuals had an increased prevalence of obesity compared with many of their single-race counterparts. As the number of multiracial individuals increases, it will be important for clinical and public health systems to track disparities in these populations.

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Section: Discussionmentioning

confidence: 99%

Obesity Disparities Among Adult Single-Race and Multiracial Asian and Pacific Islander Populations

Bacong,

Gibbs,

Rosales

et al. 2024

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

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“…The NSDUH primarily offers interviews in English and Spanish. 29 NSDUH interviewers may use language-assistance tools to facilitate interviews in other languages when necessary. However, given the linguistic diversity within the Asian-American population, the lack of language options beyond English can hinder the participation and accurate representation of individuals who are not proficient in English.…”

Section: Examination Of Funding Landscape Of Asian-american Sud Researchmentioning

confidence: 99%

Urgent need for substance use disorder research among understudied populations: examining the Asian-American experience

Choi,

Lim,

Kwon

et al. 2023

Health Affairs Scholar

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Substance use disorder (SUD) among Asian Americans is understudied. Our review of NIH-funded projects reveals a striking underrepresentation of research focused on SUD in this population, possibly perpetuated by the pervasive societal myth that Asian Americans are a healthy community. Moreover, the limited availability and disaggregation of data on SUD among Asian Americans further hinder our understanding of prevalence rates, treatment utilization, and associated disparities – thereby limiting opportunities for prevention and intervention. In light of these findings, our review serves as a crucial call to action, emphasizing the urgent need for increased research efforts and resources to address the significant gaps in knowledge and inform effective interventions for addressing SUD among Asian Americans.

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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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Why Are We Going Backward? Barriers to Disaggregated Racial Information in Federal Data Sets

Cited by 5 publications

References 2 publications

Obesity Disparities Among Adult Single-Race and Multiracial Asian and Pacific Islander Populations

Obesity Disparities Among Adult Single-Race and Multiracial Asian and Pacific Islander Populations

Urgent need for substance use disorder research among understudied populations: examining the Asian-American experience

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

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