"Aren't all Asian Americans healthy?" asked my cab driver as I was telling him about what I did for a living, working at Asian & Pacific Islander American Health Forum (APIAHF), promoting equitable health policies for Asian Americans, Native Hawaiians, and Pacific Islanders. I countered, but he wasn't convinced.
Even the data shows that, in the aggregate, Asian Americans and Pacific Islanders are among the healthiest Americans.
But, as the recently released report by the Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS) on the health of "non-Hispanic Asian Americans" revealed, this is not true when the analysis is done by specific Asian subgroups. In the analysis of data from the National Health Interview Survey, the largest annual study of health status in the country, certain Asian American ethnicities suffer lower health status and challenges, when the data is analyzed by specific ethnicities.
In the recent report, all Asian Americans together have indicators that are better than the US general population. But when we look closer, while Chinese Americans have indicators that are very much better than the general US population, Vietnamese Americans have some of the greatest health challenges, especially compared to the general US population as well as compared to specific other Asian American ethnicities.
We do know, from other studies, that Chinese Americans fare better on a number of factors when compared to other Asian groups, such as Southeast Asians, certain South Asians such as Bangladeshi Americans and Pakistani Americans, and Pacific Islanders. This is true for socioeconomic status, educational attainment, and, sadly, health status.
And, in widely-read periodicals, such as The New Yorker, there has been analysis of these "two Asian Americas":
There are now, in a sense, two Asian Americas: one formed by five centuries of systemic racism, and another, more genteel version, constituted in the aftermath of the 1965 law. These two Asian Americas float over and under each other like tectonic plates, often clanging discordantly. So, while Chinese-Americans and Indian-Americans are among the most prosperous groups in the country, Korean-Americans, Vietnamese-Americans, and Filipino-Americans have lower median personal earnings than the general population. Over-all Chinese-American prosperity obscures the higher-than-average poverty rate for Chinese-Americans. In 2000, Asian-Americans were more likely to have college degrees than other adults in America, but also five times as likely as whites to have fewer than four years of education.
Under President Obama's administration, especially through the Affordable Care Act (ACA), there have been advancements in the collection and reporting of what we in the field refer to as "disaggregated data" — data split up into smaller groups. For race and ethnicity, this means that we need to collect, analyze, report on, and share data which specifies by ethnic subgroups (e.g., Chinese American, Japanese American, Vietnamese American, etc.), rather than reporting on data as if Asian Americans, Native Hawaiians, and Pacific Islanders were one massive group. Specifically, Section 4302 of the ACA set new standards for how data would be collected, by ethnicity, for Asian Americans, Hispanics, and Native Hawaiians, and Pacific Islanders.
The recent report is one in a series of NCHS reports. NCHS has been a key partner with my organization, APIAHF, for nearly all of our 30 years. Through this partnership, NCHS has been able to make great strides in disaggregating its collection of data. For example, through APIAHF's advocacy, the National Health And Nutritional Examination Survey (NHANES) — the most detailed survey in the country on health behaviors and biometrics — has been oversampling for Asian Americans since 2010 and has committed to continuing this important methodology. The NHANES results drive much of what we know about what we eat as Americans and the kind of health behaviors we have. Knowing this for Asian Americans helps us know how to support the healthiest lifestyles for all Asian Americans, both Asian Americas.
While this report provides some important data, it is only a small sampling of data that NCHS collects. We hope that NCHS will continue to release additional disaggregated data on Asians and Pacific Islanders so we can continue to identify and reduce health disparities. We at APIAHF continue to stand ready as a partner to NCHS for such important work.
While we would love to say that all Americans enjoy health and well-being at the same standard, unfortunately, we are far from that goal. APIAHF will continue to advocate for and work with partners, such as NCHS, to get and analyze the data, so that we can all work towards this goal of health and well-being for all.
Kathy Ko Chin is president and chief executive officer of the Asian & Pacific Islander American Health Forum.