Health disparities for Filipinxs are disguised by data aggregation – Boston, Massachusetts

Boston, Massachusetts 2021-10-11 04:35:41 –

NS■ Some nurses across the country choose to quit their jobs rather than comply with vaccine obligations. A few hospital The Philippines is looking for nurses to fill the staff gap. It only adds to the burden on Filipino nurses and other Filipino healthcare professionals in the United States.

Since the outbreak of the pandemic, the social and economic factors formed by the history of structural racism in the United States have caused a disproportionate number of deaths among racial and ethnic minority groups by Covid-19. It is clear enough. What was lost in the conversation was the experience of the Asian-American community, especially the Filipinos.

While Official number It shows that Asian Americans have a low mortality rate from Covid-19. In some states, where data are categorized by Asian ethnicity, the proportion of Filipinos who have the disease and die of the disease is rising sharply. In Hawaii, Filipinos make up 16% of the population, but more than 20% of Covid-related deaths. In California, Filipinos make up 20% of non-aged Asian adults. They account for 42% of Covid’s deaths In that category.


As I recently discussed with some colleagues JAMA Health ForumThe lack of decomposed Covid-19 data for Asian Americans has contributed to these disparities and has hindered the impartial response of Filipinos.

As a Filipino American healthcare professional, I’m not surprised by the shocking number of Covid-19 in my community. Growing up in the United States, I often hear about how healthcare, especially nursing, provides stable, high-paying jobs. There were relatives trained as nurses in both the United States and the Philippines. When I went to college and joined a Filipino organization, getting my family to care was part of the cultural and diaspora experience shared by the members.


But the connection between US nursing and the Philippines is not a coincidence. NS Nursing school established in the United States During the American colonial era from 1898 to 1946, he implemented immigration policy in the Philippines and hired Philippine-trained nurses in the United States to fill the labor shortage.Filipino nurse Largest share Of internationally trained US nurses.they again Most likely to work with ICU settings, The most severe Covid-19 patients are treated.

So when the Covid-19 pandemic began in March 2020, I was worried that Filipinos would be disproportionately affected by it. NS First nurse A Filipino died in Covid-19 in Los Angeles shortly thereafter. more When more story Appeared About the plight of Filipino healthcare workers.

Still, the inclusive story was that Asian Americans were doing better during the pandemic and were less likely to die in Covid-19 compared to the black and Latin American communities. This misconception took hold because of the lack of data that could provide a more complete picture.

Twenty months after the pandemic began, the lack of fragmented data on Asian Americans continues to be a persistent problem. It is entrusted to non-governmental organizations, Media To draw attention to Covid-19’s burden on the Filipino community. For example, the cross-border feminist organization AF3IRM used media coverage to track the deaths of Filipino nurses and other health care workers. Online tribute National Nurses United Publish the report Filipinos account for 4% of nurses nationwide, while accounting for an estimated 26% of nurse Covid-19 deaths.

Covid-19’s impact on Filipinos and other Asian communities is ignored, even though Covid-19 constitutes one of the fastest growing racial groups in the United States Why? One strong explanation is Model minority mythThis suggests that Asian immigrants are functioning well in social, economic and health indicators due to favorable and desirable cultural characteristics such as diligence and strong work ethic. Upon further scrutiny, the model minority myth collapses because it reflects the aggregated average.For example, despite the relatively high average income, the income disparity of Asian Americans is taller than Than other racial or ethnic groups. Over the last half century, model minority myths have masked the inequality faced by the Asian-American community while strengthening anti-Black species discrimination.

In health care and public health, model minority myths have perpetuated the oversimplification that Asian Americans do not face health problems or disparities. By treating multiple groups in the same way, healthcare institutions ignore the diversity of experiences of migrant communities across vast geographic areas, and ultimately their unique health needs.The problem is not limited to Covid-19: An analysis examining the decomposed health data of Asian Americans also revealed it. Filipinos face a high rate of chronic illnessIt also increases the risk of severe Covid-19, such as high blood pressure and diabetes.

Due to the failure of government agencies and public health authorities to collect detailed and fragmented racial / ethnic data, the Covid-19 mortality gap between Filipinos was ignored and no longer addressed.

The future path is for healthcare institutions and public health surveillance systems to invest in processes and infrastructure to collect detailed self-reported racial and ethnic data, including different Asian ethnic groups. To achieve this, you need to perform three specific steps.First, the state needs to enact the following legislation: AB-1726 in California Require state public health departments to collect fragmented data. Second, healthcare providers need to seek the expertise of community partners who have experience in data decomposition best practices. For example, the American Health Forum in the Asia-Pacific Islands has a long history. Support such efforts..Third, as a forum recommendationElectronic health record vendors must also be involved in ensuring that their products enable the collection of fragmented data.

These steps do not include all the actions that can facilitate the decomposition of your data, but they are a starting point. The inability to collect fragmented data on Asian Americans should no longer be considered an oversight, but a positive choice that directly contributes to structural racism in the US healthcare system.

Indeed, collecting and publishing detailed decomposition data about Asian Americans may require new investments, workflows, and training. However, as other data collection efforts such as Hawaii and California have shown, this information is readily available to ensure that resources are sent to communities in need. In addition, improving the details and quality of data collected on racial and ethnicity in health is the provision of the Affordable Care Act and ongoing national efforts to improve the quality of health care for all. Is consistent with.

Health fairness must be a central part of the response as the pandemic continues to challenge the US public health and health system. For Philippine, medical activity in the United States is a permanent legacy of American colonialism, and its health effects occurred as expected during the Covid-19 pandemic. Ensuring that fragmented racial and ethnic health data is collected is a necessary step in promoting current and future equity.

Carlos Irwin A. Oronce is a primary care physician, researcher at the UCLA David Geffen School of Medicine and the VA Greater Los Angeles Healthcare System in Los Angeles, and chairman-elect of the Filipinx / a / o Community Health Association. He is the only view expressed here and does not necessarily reflect the view of his employer.

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