Health differences for Filipinxs are obscured by data aggregation



As some nurses across the country are quitting their jobs instead of following vaccination regulations, some Hospitals are hiring nurses in the Philippines to fill their staffing gaps. This will only add to the strain that Filipino nurses and other Filipino health workers bear in the United States.

Since the beginning of the pandemic, it has become clear that social and economic factors shaped by the history of structural racism in the United States have led to disproportionate deaths among racial and ethnic minority groups due to Covid-19. In the conversation, the experiences of the Asian-American communities, and particularly the Filipinx, were lost.

While official numbers show that Asian Americans have lower death rates from Covid-19, the few states where data are broken down by Asian ethnicity show a significantly higher proportion of Filipinxs who contracted and died from the disease. In Hawaii, Filipinxs make up 16% of the population but more than 20% of Covid-related deaths. In California, where Filipinxs make up 20% of non-elderly Asian adults, they account for 42% of Covid deaths in this category.


As several colleagues and I recently argued in JAMA health forum, the lack of disaggregated Covid-19 data for Asian Americans has contributed to these disparities and hampered an equitable response for Filipinxs.

As a Filipino American health care worker, I am not surprised by the shocking Covid-19 numbers in my community. Growing up in the United States, I heard many times that the healthcare sector, especially nursing, offered stable, well-paying jobs. I had relatives in the United States and the Philippines who were trained as nurses. When I went to college and joined a Filipino organization, having a family member in nursing was part of the members’ shared cultural and diasporic experience.


However, the connection between U.S. nursing and the Philippines is no accident. the Nursing schools established in the United States in the Philippines during the American colonial period from 1898 to 1946 and implemented an immigration policy that recruited Filipino-trained nurses to the United States to fill the labor shortage. That story still resonates today as nurses from the Philippines die biggest part by US nurses trained internationally. You are too more likely to work in intensive care unitswhere the most severe Covid-19 patients are treated.

So when the Covid-19 pandemic began in March 2020, I had the uneasy feeling that Filipinxs would be disproportionately affected. the first nurse dying of Covid-19 in Los Angeles was Filipinx, and shortly afterwards more and more Stories popped up on the plight of Filipino health care workers.

However, the overarching narrative was that Asian Americans were better off during the pandemic and were less likely to die of Covid-19 compared to black and Latin American communities. This misguided perception prevailed because there was a lack of data that could provide a more complete picture.

Even now, 20 months into the pandemic, the lack of disaggregated data remains an ongoing problem for Asian Americans. It has been left to NGOs and the media to raise awareness of the burden of Covid-19 on the Filipino community. For example, the transnational feminist organization AF3IRM used media reports to report the poignant deaths of Filipino nurses and other health workers Online tribute to The National Nurses United too published a report This shows that Filipinxs account for an estimated 26% of Covid-19 nurse deaths, while they account for 4% of nurses nationwide.

Why have the effects of Covid-19 on Filipinx and other Asian communities been ignored despite being one of the fastest growing racial groups in the US? A strong explanation is that Model minority mythsuggesting that Asian immigrants do well on social, economic, and health indicators due to beneficial and desirable cultural traits such as hard work and a strong work ethic. On closer inspection, the model minority myth disintegrates as it reflects an aggregated average. For example, despite a relatively higher median income, income inequality is within Asian Americans higher than in other racial or ethnic groups. For the past half century, the myth of the model minority has masked the injustices of the Asian-American community while reinforcing anti-black racism.

In health care and public health, the model minority myth has been oversimplified that Asian Americans are not exposed to health problems or inequalities. By treating multiple groups alike, health care institutions ignore the diversity of immigrant communities’ experiences in a vast geographic area and ultimately their unique health needs. The problems are not limited to Covid-19: Analyzes examining itemized health data for Americans of Asian origin have also shown that Filipinxs face high rates of chronic illness, such as high blood pressure or diabetes, which also increase the risk of severe Covid-19.

Failure by government institutions and public health authorities to collect detailed and disaggregated data on race / ethnicity has resulted in differences in Covid-19 mortality among Filipinxs being neglected and neglected.

The way forward is for health organizations and public health monitoring systems to invest in processes and infrastructure to collect detailed, self-reported racial and ethnic data that includes diverse Asian races. To achieve this, three specific steps should be taken. First, states should enact laws similar to California’s AB-1726 oblige the state health authorities to collect itemized data. Second, healthcare providers should seek expertise from community partners with experience in best practices for data disaggregation. For example, the American Health Forum for Asian and Pacific Islands has a long history of Support such efforts. Third, as a forum recommends, electronic health record providers should also work to ensure that their products enable the collection of disaggregated data.

While these steps don’t cover all of the actions that can promote data disaggregation, they are a start. Failure to collect disaggregated data on Asian Americans should no longer be viewed as an oversight, but as an active choice that directly contributes to structural racism in the US healthcare system.

Collecting and publishing detailed disaggregated data on Asian Americans can require new investments, workflows, and training. But as other data collection efforts, such as those in Hawaii and California, have shown, the rapid availability of this information ensures that resources can go to communities in need. In addition, improving the level of detail and quality of data collected on race and ethnicity is consistent with the provisions of the Affordable Care Act and ongoing national efforts to improve the quality of health care for all.

As the pandemic continues to challenge US public health and health systems, health equity must be a central part of the response. For Filipinxs, US health care work has been an enduring legacy of American colonialism, the health consequences of which were predictably evident during the Covid-19 pandemic. Ensuring that disaggregated health data on race and ethnicity are collected is a necessary step in promoting justice now and in the future.

Carlos Irwin A. Oronce is a family doctor, research fellow at the UCLA David Geffen School of Medicine and the VA Greater Los Angeles Healthcare System in Los Angeles, and elected President of the Filipinx / a / o Community Health Association. The views expressed here are his alone and do not necessarily reflect those of his employers.


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