Disaggregation Reveals Disparities

The term “model minority” lauds Asian Americans as a group that has successfully overcome discrimination through studiousness and hard work. Since the term’s introduction in the 1960s, the model minority myth continues to permeate US society. In one broad brush stroke, the myth paints all US Asian populations as paragons of educational and economic success.

The tendency to clump all Asian individuals together also plays out in health research. One pervasive narrative claims Asian populations are healthier than members of other races. Research tells us Asian individuals have longer life expectancy, lower infant mortality rates, and are less likely to smoke compared to other racial groups. The CDC even reports that Covid-19 hospitalization and death rates among Asian populations are similar to non-Hispanic white populations.

Health research that treats all Asian American communities as a single homogeneous population obscures disparities among its many subpopulations. A study by Alexander Adia and colleagues pulls back this curtain to expose the nuance in Asian American health data. The researchers analyzed information from Filipino, Vietnamese, Chinese, Japanese, and Korean adults collected between 2011 and 2017 by the California Health Interview Survey. They measured multiple health indicators, including self-reported health status, disability, obesity, and distress.

Analyzing health data by subpopulations is valuable for uncovering disparities.

When analyzed as a single group, Asian Americans were almost twice as likely to be obese and have diabetes compared to non-Hispanic white populations. This finding alone shatters the myth that Asian Americans are the healthiest minority. However, disaggregating the data revealed large health disparities across Asian Americans. The team found Filipino populations had the worst health outcomes among all ethnic subgroups. The likelihood of being obese and having diabetes was nearly three-fold higher among Filipino individuals compared to non-Hispanic white populations.

Adia and team also examined differences in health service access. Asian Americans, as a collective, were similar to white populations when it came to medical visits and having a continuous source of health care. However, this finding did not hold across ethnic subgroups. Korean individuals were almost 2.5 times more likely to have no usual source of care and Chinese individuals were less likely to have visited a doctor within the past year compared to non-Hispanic white populations. These disparities in healthcare access are likely worsening. Upticks in anti-Asian attacks and racism since the Covid-19 pandemic deter or outright prevent many people of Asian heritage from seeking care.

Analyzing health data by subpopulations is valuable for uncovering disparities. This disaggregation is only achievable when health surveys have high participation rates. Purposeful oversampling from specific ethnic groups can ensure that representation in health surveys matches the true population make-up. Furthermore, delivering health surveys in multiple languages can increase participation among ethnic minorities.

Ever since the US embraced the model minority myth, Asian Americans have been treated as a collective example of good health. Today, effective public health interventions require disaggregated data to improve the health of ethnic subpopulations.

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