Invisible Asian Americans in Public Health Research

By Vera Hsiang, W.B. Ray High School, Corpus Christi, Texas, USA

Summary

Health policy leaders rely on public health research findings for their decision-making. In the US, research funding and clinical studies for Asian Americans are hard to come by. The model minority stereotype can hide their healthcare and social needs. Subsets of their diverse population may face particular health risks that are missed without more focused studies. Gatekeepers like grant funders and journal reviewers should recognize that the lack of Asian American health-related data is a health inequity problem. More research funding and dedication to outreach programs can increase awareness of Asian American health. Making Asian Americans more visible in public health research can better guide policymakers and ensure their well-being. 

---

What we do not know may temporarily shield us from harm but only delay the inevitable. Undiagnosed medical conditions from high blood pressure to depression can result in serious health issues over time. Early detection and treatment prevent complications and ensure better outcomes. Identifying individuals at risk and strategies tailored to take care of them depend on published research studies. As scientists publish their findings, public health officials and policymakers work to safeguard lives. Many of these scientists are Asian Americans, who make up the fastest-growing ethnic group in the US. Coming from more than 20 countries of origin, their diverse background lends to unique health risks and healthcare needs (Budiman & Ruiz, 2021). Yet our scientific community risks compromising their well-being by not providing enough clinical data to health policy leaders. 

Researchers who study public health collect data, analyze it, and make conclusions. Policymakers then act on this information to create regulations that aims to improve public health. However, they require adequate data to do this. For Asian Americans, health officials do not have an accurate picture of their well-being or battles with disease and mental health. A US Department of Health and Human Services search of the National Library of Medicine’s database discovered that Asian Americans were mentioned in just 0.01 percent of articles from 1966 to 2000 (Ghosh, 2003). The National Institutes of Health (NIH), the largest biomedical research funder in the US, has made it a priority to focus on diverse population studies. However, a 2019 Journal of American Medical Association investigation found that only 0.17 percent of the NIH-funded studies on Asian Americans (Đoàn et al., 2019). 

A grant proposal to examine mental health challenges for Asian American families was rejected by the NIH (Yee, 2021). Three reviewers’ feedback stated that Asian Americans’ struggles were “not as bad as for Blacks and Latinos”. Co-investigator of the study, David Takeuchi, confirmed that these comments are actually quite common and not limited to just healthcare topics. Takeuchi submitted a paper underscoring the poor academic performance of Asian Hawaiians. His peer reviewer said “Too bad this is about Asian Americans. If this had a Black sample, we might think about publishing it” (Yee, 2021). Takeuchi’s paper was never published. 

Even when Asian Americans are studied, they are often merged in with other groups. A national study highlighting racial disparities in air pollution exposures analyze Asian Americans under the category White (Tessum et al., 2019). Even when the Asian American category exists, a one-size-fits-all approach can hide disparities. For instance, while the overall Asian American poverty rate is 10 percent, Pew Research Center data shows that this value is 25 percent for Mongolian and Burmese populations (Budiman & Ruiz, 2021). The absence of detailed and nuanced information can result in worsening inequalities for vulnerable subpopulations.  

Raising awareness among researchers, funders, and publishers is the key to addressing this health inequity. Calling for research and attention on Asian Americans does not need to take away resources from other minority communities. Rather, efforts to reduce social and health inequities must also include Asian Americans. As part of its UNITE initiative to end structural racism in health research, the NIH should hire more staff and grant reviewers with experience in Asian American issues (NIH, 2023). 

Since different Asian American ethnic groups speak a variety of languages, outreach efforts will need to be altered for this. Having the right tools and resources to collect data will require funding. President Biden’s proposed 2024 budget calls for a $100 million increase for the Centers for Disease Control and Prevention’s Climate and Health Program; this extra money can modernize public health data collection nationwide (American Public Health Association, 2023). To address possible language barriers, funds can go toward translating its climate and health page and brochures to various languages in the Asian American community. 

The model minority myth has had far reaching impacts on the health of Asian Americans. Research on Asian Americans as a group, and research which highlights the nuance between subgroups, is extremely rare. Scientists who are researching the topic have faced numerous barriers to gaining funding and publication. We need to break the vicious cycle of lack of data and misconception that Asian Americans do not require aid. Given how difficult it is to provide services for individuals we do not know or understand, it is time we understand these Americans too. Let us make this invisible group visible. 

References

American Public Health Association. (2023, March 14). Biden’s proposed 2024 budget bolsters public health. American Public Health Association. Retrieved June 26, 2023, from https://www.apha.org/News-and-Media/News-Releases/APHA-News-Releases/2023/2024-Budget 

Budiman, A., & Ruiz, N. (2021, April 29). Key facts about Asian Americans, a diverse and growing population. Pew Research Center. Retrieved June 25, 2023, from https://www.pewresearch.org/fact-tank/2021/04/29/key-facts-about-asian-americans/ 

Collage, S. (2019, January 29). Researching in laboratory. flickr. Retrieved June 26, 2023 from https://www.flickr.com/photos/162008605@N08/46863100352/sizes/l/ 

Đoàn, L.N., Takata, Y., Sakuma, K.K., & Irvin, V.L. (2019, July 24). Trends in Clinical Research Including Asian American, Native Hawaiian, and Pacific Islander Participants Funded by the US National Institutes of Health, 1992 to 2018. JAMA Netw Open. 2(7):e197432. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2738623  

Ghosh, C. (December 2003). Healthy People 2010 and Asian Americans/Pacific Islanders: Defining a Baseline of Information. Am J Public Health. 93(12): 2093–2098. 

doi: 10.2105/ajph.93.12.2093 

National Institutes of Health. (2023, May 17). Launching New UNITE E Initiatives. U.S. Department of Health & Human Services. Retrieved June 24, 2023, from https://www.nih.gov/ending-structural-racism/launching-new-unite-e-initiatives 

Tessum, C., Apte, J.S., Goodkind, A.L., Muller, N.Z., Mullins, K.A., Paolella, D.A., Polasky, S., Springer, N.P., Thakrar, S.K., Marshall, J.D., & Hill, J.D. (2019). Inequity in consumption of goods and services adds to racial–ethnic disparities in air pollution exposure. PNAS, 116(13), 6001-6006. https://doi.org/10.1073/pnas.1818859116 

Yee, A. (2021, July 8). Research on Asian Americans and Pacific Islanders Is Being Stifled. Scientific American. Retrieved June 25, 2023, from https://www.scientificamerican.com/article/research-on-asian-americans-and-pacific-islanders-is-being-stifled/