This guest post is written by Elizabeth Krause
Asian Pacific American Heritage Month is ripe with opportunity to elevate health issues that confront Asian American Pacific Islanders (AAPIs). But how do we know what the priority health issues are?
For people whose job it is to study these issues, the conventional wisdom is to turn to population level health data. Unfortunately, there are numerous health data voids for AAPI groups in Connecticut.
In population health reports broken out by race and ethnicity, I have become accustomed to seeing one of three scenarios:
A) At best, there are enough AAPI data to lump people from many Asian and Pacific Island nations together. The result often deceptively suggests that Asian Americans are the model minority when it comes to health. Sub-populations with very positive health outcomes get intermingled with sub-populations with some of the worst health outcomes and the aggregate is a generally rosy picture that belies sobering nuances.
B) We are lumped into the “other” category with our sister small populations such as Native Americans and people of multiracial background. Do “other” data ever really give us good information that can be applied for practical purposes?
C) Asterisks appear in lieu of data points – “*insufficient numbers”
Which brings me to the figurative counterpart to the literal counting conundrum- what is really being communicated when AAPI groups are lumped together, lumped with other others, or omitted all together?
The subliminal, but powerfully consistent message is that Asian Americans are not a priority population. In other words, “we could not count you and therefore you do not count.”
I have been schooled in population health data collection, reporting, and what it all costs. I understand the challenges. In Connecticut, while AAPI residents compose the fastest growing racial/ethnic group, we still have small numbers with a lot of within group diversity and geographic dispersion. This makes oversampling and data disaggregation challenging and expensive with diminishing returns. It is a fact that people are trying their best with available resources and it is a fact that we can do better still.
What to do? What to do?
1) We can encourage data collection initiatives to use creative and economical sampling methods to help augment data gaps – shoe leather epidemiology, community based participatory research, qualitative methods. Until AAPIs are no longer an afterthought in Connecticut, we must keep reminding those whose job it is to count us that we do count.
2) We can learn from health data from cities with sizable AAPI populations. Now, data from Honolulu will clearly not reflect the picture in Norwich 100%, but we have some common ground from which action should spring. I am consistently inspired by Public Health Seattle & King County’s work.
3) We can have more culturally sensitive conversations about osteoporosis, dementia, cancer, TB, HepB, depression, post traumatic stress, underutilization of health services, linguistically appropriate services, type II diabetes, and assisting aging parents. An absence of data does not equal an absence of health issues. Community leaders, health care providers, researchers, and our lived experiences can and do inform us.
4) We must add our voice to the growing REL (racial, ethnic, language) data movement. While some understandably argue that it’s time to stop measuring health disparities in order to shift into problem solving orientation, it’s fortunately not an either or.
What follows when poet Elizabeth Barrett Browning asks, “how do I love thee?” Even non- poetry aficionados know, it is “let me count the ways.”
Moving forward, all who are invested in health justice for AAPI communities can begin by helping us to literally and figuratively count the ways.
Elizabeth Myung Sook Krause is a Connecticut Health Foundation senior program officer. A Korean adoptee who grew up in Seattle and San Francisco, she had to move to Connecticut in order to connect with her ‘Asianness’ thanks to the great people at APAC and NAAAP-CT. Connect with Elizabeth on Twitter.
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