Using Data to Address Health Inequities Iyanrick John Senior - - PowerPoint PPT Presentation

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Using Data to Address Health Inequities Iyanrick John Senior - - PowerPoint PPT Presentation

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Using Data to Address Health Inequities Iyanrick John Senior Policy Strategist February 12, 2019 About APIAHF The Asian & Pacific Islander American Health Forum is one of the oldest and largest national organizations focused on Asian

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Using Data to Address Health Inequities

Iyanrick John Senior Policy Strategist February 12, 2019

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About APIAHF

The Asian & Pacific Islander American Health Forum is one of the oldest and largest national organizations focused on Asian American, Native Hawaiian, and Pacific Islander health equity. Since 1986, APIAHF has worked to influence policy, mobilize communities, and strengthens programs and organizations to improve the health

  • f Asian Americans, Native Hawaiians, and Pacific Islanders.
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“The Asian/Pacific Island minority, in aggregate, is healthier than all racial/ethnic groups in the United States…Yet specific problems do exist among various subgroups of this

  • population. ”
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“Today, Asian-Americans are among the most prosperous, well-educated, and successful ethnic groups in America. What gives? It couldn't possibly be that they maintained solid two-parent family structures, had social networks that looked after one another, placed enormous emphasis on education and hard work, and thereby turned false, negative stereotypes into true, positive ones, could it?” New York Magazine, 2017

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History of Invisibility in Data and Research

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Asian American Population in the U.S.

Source: 2015 American Community Survey Data

  • 500,000

1,000,000 1,500,000 2,000,000 2,500,000 3,000,000 3,500,000 4,000,000 4,500,000 5,000,000

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  • 100,000

200,000 300,000 400,000 500,000 600,000 Fijian Chamorro Marshallese Micronesian Native Hawaiian Palauan Samoan Tongan

Native Hawaiian and Pacific Islander Population in the U.S.

Source: 2015 American Community Survey Data

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States with the Largest Asian American Populations (2017)

  • 1. California (6.6 million)
  • 2. New York (1.9 million)
  • 3. Texas (1.5 million)
  • 4. New Jersey (966,000)
  • 5. Illinois (807,000)
  • 6. Washington (804,000)
  • 7. Hawaii (797,000)
  • 8. Florida (738,000)
  • 9. Virginia (671,000)
  • 10. Pennsylvania (519,000)
  • 1. Indiana (+48%)
  • 2. Utah (+47%)
  • 3. Texas (+43%)
  • 4. North Carolina (+41%)
  • 5. Oklahoma (+39%)
  • 6. Georgia (+38%)
  • 7. South Carolina (+37%)
  • 8. Ohio (+35%)
  • 9. Tennessee (+35%)
  • 10. Arizona (+33%)

Source: Comparison of 2010 and 2017 American Community Survey Data

States with Greatest Increase in State’s Asian American Population (2010 to 2017)

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Arizona Asian American Population

18.4 19.2 23.2 8 8.6 12 7.6 11.1 10 8.5 14.5 17.3 33 33 25.3 32.5 28.8 28.4 5 10 15 20 25 30 35 40 45 50 Asian Indian Chinese Filipino Japanese Korean Vietnamese % of Asian Pop % Uninsured % LEP

Source: 2015 American Community Survey Data

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Limited English Proficiency Among Asian Americans

78.9% 70.4% 51.5% 48.6% 44.1% 40.6% 39.1% 38.3% 36.7% 36.6% 36.4% 34.5% 33.0% 27.2% 26.9% 26.5% 20.9% 20.3% 17.8% 14.8% 31.0% 32.3% 9.2% 6.0% 3.1% 6.0% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%

Bhutanese Burmese Nepalese Vietnamese Bangladeshi Chinese Taiwanese Cambodian Hmong Korean Mongolian Laotian Thai Indonesian Pakistani Malaysian Sri Lankan Asian Indian Filipino Japanese Asian Latino NHPI AI/AN Black White

Source: 2015 American Community Survey Data

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Below Poverty

13% 27% 28% 21% 24% 13% White Black AI/AN NHPI Latino Asian

Source: 2015 American Community Survey Data

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Below Poverty

13% 27% 28% 21% 24% 13% 39% 34% 28% 26% 26% 25% 25% 22% 21% 19% 17% 17% 17% 16% 15% 15% 15% 14% 13% 11% 10% 9% 8% 8% 7% White Black AI/AN NHPI Latino Asian Burmese Bhutanese Mongolian Nepalese Hmong Malaysian Bangladeshi Tongan Samoan Native Hawaiian Cambodian Pakistani Thai Chinese Guamanian Vietnamese Indonesian Korean Taiwanese Sri Lankan Melanesian Fijian Japanese Asian Indian Filipino

Source: 2015 American Community Survey Data

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Bachelor’s Degree or Higher

31% 19% 19% 16% 14% 50% White Black AI/AN NHPI Latino Asian

Source: 2015 American Community Survey Data

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Bachelor’s Degree or Higher

31% 19% 19% 16% 14% 50% 75% 74% 59% 57% 55% 54% 53% 53% 50% 48% 48% 44% 43% 27% 25% 19% 17% 17% 17% 16% 15% 14% 14% 11% 11% White Black AI/AN NHPI Latino Asian Taiwanese Aisan Indian Mongolian Sri Lankan Malaysian Korean Pakistani Chinese Japanese Filipino Indonesian Thai Nepalese Vietnamese Burmese Melanesian Native Hawaiian Hmong Cambodian Guamanian Fijian Samoan Laotian Bhutanese Tongan

Source: 2015 American Community Survey Data

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Decrease in Uninsured for Selected Asian American Subgroups Since Passage of the Affordable Care Act

Race/Ethnicity 2011 2013 2015 Asian 14.7 13.9 7.5 Asian Indian 12.0 10.4 5.7 Cambodian 19.6 18.9 9.3 Chinese 13.6 13.0 6.8 Hmong 16.3 15.6 8.1 Japanese 7.8 7.4 3.9 Korean 22.5 20.5 10.3 Laotian 18.6 15.7 10.0 Vietnamese 19.9 18.5 8.8

Source: American Community Survey 1-Year Data

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APIAHF Study on Asian American Small Business Owners (2013)

Source: 2009 American Community Survey Public Use Microdata Sample Data 2007-2009 American Community Survey 3-Year Estimates

14% 12% 13% 22% 12% 11% 19% 19% 23% 22% 8% 12% Vietnamese Thai Pakistani Korean Japanese Chinese Uninsured Small Business Ownership

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Leading Causes of Death, Total U.S Adults vs. Asian or PI Adults

Source: Heron M. Deaths: Leading causes for 2009. National vital statistics reports; vol 61 no 7. Hyattsville, MD: National Center for Health Statistics. 2012.

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Percent of U.S. Adults with Selected Conditions for Major Asian Subgroups, 2004-2006

5.6 6.9 9.2 5.1 3.9 4.4 9 6.5 12.2 17.1 26.8 20.9 25.2 21.6 17 21.2 21.7 24.9 2.4 2 1.6 2.5 1.9 2.4 3 3.7 4.6 2.3 1.8 2.9 3.1 8.2 6.2 8.9 14.2 4.9 6.1 4 6.7 7.5 6.4 5.9 4.5 4.5 2.8 2.2 5.9 2.9 4.2 2.8 5 10 15 20 25 30 Chinese Filipino Asian Indian Japanese Vietnamese Korean Other Asian and NHOPI All Asian and NHOPI White Heart Disease Hypertension Stroke Cancer Diabetes Hepatitis

Source: Barnes PM, Adams PF, Powell-Griner E. Health characteristics of the Asian adult population: United States, 2004-2006. Adv Data 2008;22:1–22

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PolicyLink Project on Race and Ethnicity Data

  • Research Reviews on American Indian & Alaska Native, Asian

American, Native Hawaiian & Pacific Islander, Latino, Black, and White populations

  • Three Convenings in Los Angeles, Atlanta, and Washington, D.C.
  • Final Report: “Counting a Diverse Nation: Disaggregating Data on

Race and Ethnicity to Advance a Culture of Health” (2018) http://www.policylink.org/our-work/community/health-equity/data- disaggregation

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Federal Level Efforts to Advance Data Equity

  • 1988 – APIAHF begins partnership with NCHS to improve AA and

NHPI data collection in federal health surveys

  • 1997 – Update of OMB standards to separate AA from NHPI
  • 2006 – First NHIS oversample of Asian Americans
  • 2010 – Passage of the ACA including Section 4302 data standards
  • 2011 and 2017 – APIAHF leads in introduction of Health Equity and

Accountability Act

  • 2014 – First NHPI National Health Interview Survey
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2011 HHS Standards Resulting from ACA Section 4302

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Opportunity to Revise 1997 OMB Standards

  • First opportunity in 20 years to update race and ethnicity data

standards

  • Over 3,600 public comments from 47 states submitted to OMB
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2015 Census National Content Test Standards

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Health Insurance Marketplace Data Highlight

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State Level Data Advocacy

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State Level Opposition

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Opportunities to Address Health Inequities

  • Improve systems and train staff to better collect race, ethnicity, and

primary language data

  • Use race, ethnicity, and primary language data to focus outreach

and education activities

  • Engage in partnerships to address identified disparities
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Additional Resources

  • PolicyLink Page on Data Disaggregation -

http://www.policylink.org/our-work/community/health-equity/data- disaggregation

  • 2015 National Content Test: Race and Ethnicity Analysis Report -

https://www.census.gov/programs-surveys/decennial-census/2020- census/planning-management/final-analysis/2015nct-race-ethnicity- analysis.html

  • PRAPARE Tool Page - http://www.nachc.org/research-and-

data/prapare/

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Iyanrick John ijohn@apiahf.org 415-568-3305

Follow Us Online: www.apiahf.org www.facebook.com/apiahf www.twitter.com/apiahf www.twitter.com/APIAHFpolicy http://www.youtube.com/APIAHF