By Suchi Rudra
It’s a fairly troubling practice—but it’s been going on for years.
Due to the lack of a solid database on Asian Americans, data taken from Asian people living in Asia have long been used in studies and surveys regarding Asian Americans. For example, the Center for Disease Control (CDC) has only begun to use Asian American data for its national health survey in the last two years.
There are many reasons for the lack of Asian American health data. A 2010 study by researchers at the NYU Center for the Study of Asian American Health explored the array of challenges present in the data collection and analysis efforts undertaken by national surveys and studies, including:
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Use of inconsistent methods to classify Asian subgroups and use of non-standardized definitions of “Asian American”, both of which make data comparability difficult
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Lack of or limited subgroup categorizations for Asian Americans
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Limited data collection in Asian languages—most surveys are only in English or Spanish
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Small sample sizes and oversampling of Asian American or ethnic subgroups
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Inaccurate collection of data from Medicare beneficiaries. The study states that while Medicare data have proven to be a rich source of information about racial, ethnic, and socioeconomic disparities in health and health care among beneficiaries, an analysis of 2002 Medicare administrative data shows that only 52 percent of Asian beneficiaries were identified correctly.
George L. King, M.D, research director and chief scientific officer at Joslin Diabetes Center in Boston, MA, says that this critical lack of Asian American health data can have damaging effects.
King says that most pharmaceutical companies are using studies on Asians in Asia to register in the US due to the fact that recruiting volunteers for clinical drug trials is much simpler and cheaper in Asia.
But this is a problem, King said.
“The reason that many of us want to make sure Asian Americans are included is that the environment in the US is not the same as in Asian countries, and this can easily alter health conditions and diseases, and especially responses to drugs,” King explains.
King says that doses of drugs may be different for Asian Americans than they are for other ethnic groups in the US due to differences in physiology. Dosage can even differ between Asian Americans and Asians in Asia.
US health care policy could also discriminate against Asian Americans because of incorrect data. Medicare coverage for obesity counseling, for example, requires a body mass index (BMI) of 30—however, King points out, “the obesity standard for Asian Americans is around 25, because Asian Americans develop obesity-related health problems at a lower BMI than other ethnic groups. Thus, most Asian Americans will not benefit from this rule.”
The NYU researchers list oversampling, bilingual interpreters and pooling data sets as some of the possible solutions to the Asian American data collection problem. And there are multiple efforts currently underway to understand why Asian American populations are developing diabetes at a low BMI. Researchers are working with the CDC to obtain a comprehensive picture of health in Asian American populations and health instructions are being developed for the prevention and care of Asian American populations with diabetes or at risk for diabetes.
However, increased funding and a greater awareness of this issue are still key.
“We have to increase awareness of this problem, and make sure that when projects are being planned in government and industry, the Asian American populations are included. But this will take extra efforts and possibly cost,” King says.