How Collecting and Reporting More Detailed Data Can Advance Health Equity for Native Hawaiian, Pacific Islander, and Asian American Communities

During Asian American, Native Hawaiian, Pacific Islander Heritage Month in May, we honor the contributions of Asian American, Native Hawaiian, and Pacific Islander people in the United States. CDC’s Office of Health Equity (OHE) recognizes the importance of promoting health and well-being and reducing health disparities in these populations. A key strategy in this effort is to ensure the availability of detailed data that accurately reflects the experiences of these diverse communities.

Members of Native Hawaiian, Pacific Islander, and Asian American communities speak many different languages and come from diverse cultural, social, economic, and historical backgrounds which can result in a wide range of health outcomes. Data collected among specific subpopulations can help us effectively identify the health needs of these populations and to partner with and empower communities to reduce health disparities.

Data from many health surveys and research studies represent Native Hawaiian, Pacific Islander, and Asian American populations as a single group by combining (or “aggregating”) data into one statistical category. This category contains many distinct subgroups whose experiences can differ from the larger group. When attempts are made to separate these groups, subgroup numbers can be too small to be reported due to privacy guidelines or concerns about statistical reliability. These challenges often mean that data are either lacking or do not provide an accurate representation of the experiences of specific populations. When data are lacking for a population, it is difficult to know whether disparities exist, and it becomes more challenging to identify opportunities to partner with communities and tailor approaches to improve community health and well-being.

Scientists at CDC recognize the importance of incorporating health equity principles into science to protect health and improve lives for all communities. Consideration of the social contexts and the need for detailed and accurate data are a couple of ways to promote health equity science to better serve Native Hawaiian, Pacific Islander, and Asian American communities. The collection and sharing of relevant data for communities is best achieved when communities are engaged throughout the process, beginning with seeking input regarding the health needs and priorities of communities, codeveloping the methods and strategies to address these issues, and empowering communities to translate data and knowledge into public health action.

During the COVID-19 pandemic, OHE and other CDC scientists collaborated with community partners and the Hawai‘i State Department of Health to separate (or “disaggregate”) COVID-19 data. The findings, published in Morbidity and Mortality Weekly Report (MMWR), revealed marked disparities in COVID-19 case and mortality rates in Hawai‘i during the first year of the pandemic, especially among Native Hawaiian, Pacific Islander, and Asian persons; disparities were not apparent in the aggregate data. The disaggregation of COVID-19 data using more detailed race categories was advocated for by local Native Hawaiian and Pacific Islander community leaders and a grassroot coalition of organizations responding to the needs of their communities. With data showing which subpopulations were most affected, community organizations were able to partner with the department of health to create culturally and linguistically tailored response and prevention strategies. These data also facilitated constructive collaboration between the health department and community health workers living and working in the affected communities.

OHE has continued its collaboration with community partners and the Hawai‘i State Department of Health post-pandemic, by, for example, collaborating with Papa Ola Lōkahi in developing OHE’s Partner Webinar Series: Health Equity Science and Data for Action on March 28, 2024.

Chantelle (Tellie) Eseta Matagi, Director of Health Innovation and Initiatives for Papa Ola Lōkahi and coauthor of the MMWR, presented in the webinar. Matagi shared, “When these communities do not see themselves accurately represented in the data, it hinders efforts to address their unique health needs and disparities effectively. Without accurate data, it is challenging to identify and understand the specific health concerns and challenges faced by these communities.”

The health equity science webinar featuring the disaggregation of race data in Hawai‘i was timely as the updated OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity were released by the Office of Management and Budget on March 28, 2024. Among the revisions to the standard was a requirement that federal agencies collect “additional detail beyond the minimum required race and ethnicity categories for most situations, to ensure further disaggregation in the collection, tabulation, and presentation of data when useful and appropriate,” (read more on the briefing).

Matagi further emphasized the importance of prioritizing health equity in science and data collection, as doing so can “ensure that all communities, including Native Hawaiians, Pacific Islanders, and other marginalized groups, are accurately represented. This includes actively involving community members in the data collection process, diversity in hiring practices, incorporating culturally sensitive methodologies, and disaggregating data to capture the diversity within these communities.”

How do you plan to use health equity science and data to identify effective partnerships and address community health needs?