OP-ED | There’s More Than One Side To Asian Disaggregation Debate
Recently, CTNewsJunkie published an editorial from a ninth grader opposed to collecting race, ethnicity, and language (REL) data for the Asian American population, suggesting that disaggregating the data creates an unnecessary ethnic divide. Khmer Health Associates find this argument misguided, particularly in the field of healthcare. Southeast Asian Americans present a good case in point — they are among the many subgroups that disappear under the pan-ethnic label of “Asians.”
Connecticut is home to approximately 22,000 Southeast Asian Americans, most of them refugees of war, torture, starvation, forced labor, sexual violence and genocide. We know from smaller epidemiological studies — not data collected by the state or federal government — that most Southeast Asian American refugees have multiple chronic medical conditions.
Studies of Cambodian refugees in California, for example, found substantially higher rates of hypertension, hyperlipidemia, and diabetes relative to the U.S. population. Nearly 90 percent of a random sample of Californian Cambodians experienced poor or fair health status, compared to only 18 percent of the overall Asian American Pacific Islander (AAPI) population, and 19 percent of all adults. Disability rates are higher too, and one study found that Post-Traumatic Stress Disorder rates of a random sample of Cambodians were at 67 percent, with past-year depression rates at 51 percent.
These health disparities of a smaller ethnic subgroup are totally missing from public view — they are rendered invisible under the larger racial category of “Asian.” This lack of disaggregated REL data is not only an “Asian” problem. With more than 48 subgroups, the AAPI categories may include the most variant, and numerous, subgroups. This is reflected in recent legislation in states like California or Rhode Island.
But there is a strong argument that disaggregated REL data should extend beyond the AAPI communities. Many other subgroups are embedded within the broad REL categories such as “Hispanic” or “African American.”
Currently, Health Equity Solutions in Hartford is proposing standardized and expanded race, ethnicity and language data collection from all state agencies engaged in or impacting health. Such data collection is necessary to unmask health disparities and promote positive health outcomes for all of Connecticut’s residents. KHA supports this proposal.
Data drives policy and the allocation of resources. Data shapes the planning, implementation, and delivery of services to all specific ethnic groups. The same is true for seeking funds for research on health problems suffered by minority subgroups. All grant proposals start out with a needs assessment, and without disaggregated data to describe the nature and scope of a problem, researchers on smaller ethnic subgroups cannot justify a need for funding. Thus, resources are rarely allocated to solve problems experienced by smaller subgroups. Like Southeast Asian Americans, they remain virtually unseen.
The failure to disaggregate REL data means that the problems of smaller groups such as Southeast Asian Americans are never detected, addressed, or solved. Many policy makers and providers accept wholesale the Model Minority Myth: no one needs to worry about the health and well-being of Southeast Asian Americans because Asians are doing well. Without data, it is impossible to track progress in resolving health disparities.
The lack of disaggregated data on smaller subgroups represents a tremendous health disparity for Southeast Asian Americans. This is also a harsh reality for many other smaller subgroups who are struggling to achieve health and well-being. The disparities experienced by individuals in smaller subgroups, such as Southeast Asian Americans, represent an injustice, in both the education and health arena, but particularly in the latter. Having good health is essential to an individual’s well-being. It is a condition to full participation in life’s activities, in the arenas of work, family, and community.
Good health allows an individual to engage in activity, be productive in the workplace, stay active in economic and family life, and participate in the democratic process. Ill health acts as a barrier to all of those opportunities for a good life. Without sufficient data about the ill health of smaller subgroups, resources will never be allocated to address that ill health — needless suffering and premature death will continue to be status quo.
Collecting sufficient REL data does not undermine the principles of equality and equity. Rather, collecting sufficient REL data is based upon, and motivated by, a desire to ensure equality and equity. The REL data will be used not to exclude, or to divide subgroups, but to ensure that individuals from all ethnic backgrounds get a fair chance to pursue the American dream. Without experiencing good health, and obtaining an education, their chance is not a “fair” one, but an illusion.
Theanvy Kuoch is the executive director of Khmer Health Advocates (KHA) in West Hartford, Connecticut. The organization promotes the health of Cambodian refugees in Connecticut, Western Massachusetts and Rhode Island.
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