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Impact on Asian or Pacific Islander (API) Health Research
API Health Data Needs
In December 1991, the grants program held an agenda-setting workshop to provide an opportunity for approximately 85 leading experts in minority health and minority health statistics to assist in setting research priorities that address the critical issues affecting current and future efforts to collect and analyze data on racial and ethnic minority populations. These experts agreed that several factors affect the amount and quality of data available for planning necessary public health programs. For APIs, health data are often aggregated, ignoring major differences between 25 or more subgroups. Sampling problems also exist with both national surveys and special studies. Sample sizes of APIs in national surveys are too small to draw reliable conclusions, but studies that do oversample tend to focus on high density areas, producing data that is inadequate and unrepresentative of all APIs. Problems also exist with State data since racial/ethnic categories are not standardized on vital statistics records. Furthermore, procedures for classifying by race/ethnicity are inconsistent and often arbitrary.
Improving API Health Statistics
Guided by the goals documented in "Setting a Research Agenda: Challenges for the Minority Health Statistics Grants Program," the grants program has taken major steps in addressing the health data needs of APIs. Its projects have made more baseline data available, existing resources more useful, and methods of collecting and analyzing data more accurate.
Analyzing existing data:
Since
California is one of the only States to record vital statistics on smaller
API populations, research for an Asian American Health Forum (AAHF) FY
1991 (Ponce) project focused on analyzing these data.
Through
the development of a minigrants program, a project with the Public Health
Foundation (PHF) funded five State Centers for Health Statistics to
analyze existing data and improve State data infrastructures. Utilizing
the 20 health status indicators in Healthy People 2000 Objective 22.1,
California, Michigan, and Rhode Island included APIs in their research.
Using special studies for smaller areas and population subgroups:
FY
1991-92 AAHF (Ponce) subgrants projects examined elderly Chinese, Asian
Indian, Samoan, Korean, Thai, Filipino, Vietnamese, Pakistani, Cambodian,
and Laotian populations. These projects provided baseline data for these
subgroups, which are rarely studied in national health surveillance
systems.
A
Northern California Cancer Center (NCCC) project examined and developed
surveys for Chinese and Vietnamese Americans.
A
FY 1992 AAHF (Shinagawa) project examined several rare subgroups
(Cambodians, Laotians, Hmongs, Hawaiian Americans, Samoans, Guamanians,
and Tongans) and children of interracial and interethnic couples.
Increasing access to existing data:
A
FY 1992 AAHF (Shinagawa) project forced NCHS to evaluate the accessibility
of the National Health Interview Survey (NHIS). As a result, the Health
Resources and Services Administration (HRSA), the Bureau of the Census,
and NCHS began a collaborative project to geocode the survey. This
enhancement of the NHIS will allow more studies to be done on small
populations in the future.
The
FY 1991 AAHF (Ponce) project compiled an inventory of national and
regional health databases available on API health. It includes detailed
profiles of each database.
A
project with the University of Nebraska Medical Center developed a
database on access to care studies on rural minority populations,
including APIs.
A
project with the University of North Carolina at Chapel Hill (UNC-CH) is
developing the Minority Health Research Catalog and the Minority Health
Database Catalog. The research catalog is the first annotated bibliography
of literature on studies, analyses, and methods for conducting research on
minority populations, and the database catalog is the most expansive
inventory of national and subnational data sets available for minority
health research. To maximize access to these catalogs, they are available
via the World Wide Web on the UNC-CH
Department of Biostatistics Home Page.
Improving data sets for access to care studies. The University of Nebraska Medical Center compiled an annotated bibliography for its database and synthesized the information into composite summaries listing the issues addressed, the databases used, the methodologies employed, and the areas identified for further research.
Developing protocol to reduce racial misclassifications. The FY 1992 AAHF (Shinagawa) project evaluated existing classification methods of multiracial and multiethnic individuals by comparing the NCHS Linked Birth-Death data set with 1990 census records.
Developing culturally sensitive data collection tools/techniques. Using focus group and think-aloud methodologies, the NCCC project utilized methods drawn from cognitive psychology to develop surveys that more accurately reflect the health attitudes, feelings, and behavior of Chinese and Vietnamese Americans. Surveys were also translated, and focus groups were conducted by native speakers.
Improving sampling frames and techniques:
The
FY 1991 AAHF (Ponce) project funded two subgrants that focused on
developing sampling methods. A University of Connecticut project examined
populations who utilize alternative health care sources and are,
therefore, overlooked by traditional health data sources. A University of
California at Los Angeles project tested two sampling methods for
conducting telephone surveys.
A
project with the Western Consortium for Public Health developed the
sample-resample method for estimating the prevalence of health disorders
among minority populations. This sampling method is particularly useful in
working with sparse and/or incomplete data.
Elaborating the impact of race, ethnicity, and socioeconomic status on the health of APIs. A project with Harvard University is examining APIs in its analysis of how race/ethnicity and socioeconomic status are related to cancer incidence rates.
Improving dissemination efforts. Using its strong ties to the API community, the FY 1991 AAHF (Ponce) project published reports for all its research for dissemination.
Building Partnerships between Researchers and API Communities
The grants program recognizes the need to build trust between researchers and the communities they study, and, the need to ensure that communities benefit from any research that is completed. Involving communities in all stages of the research process has become a priority of the program, including efforts to increase the pool of API researchers.
Training and Educational Opportunities for Current and Future API Researchers:
The
UNC-CH project developed the Summer Public Health Research Institute on
Minority Health (SPHRI-MH) in order to allow current and future
researchers to explore innovative research strategies and methodologies
relevant to minority health research. NCHS, CDC provided scholarships for
minority graduate students to attend the institute.
The
NCCC project recruited and trained Chinese and Vietnamese American
research assistants to play a key role in conducting and disseminating
research results within their communities.
NCHS,
CDC held two workshops to enhance the skills of researchers in minority
health statistics. In March 1994, "Research Issues to Address
Minority Health Data Needs" was held to build proposal development
and writing skills of unfunded, but approved, applicants from the FY 1992
competitive solicitation. In January 1995, a technical assistance workshop
was held to prepare potential applicants for future grants program
solicitations.
Community Participation in Research:
The
NCCC project used methodologies that required going into the Chinese and
Vietnamese American communities to recruit focus group and think-aloud
participants. These methods collect qualitative data directly from the
community, providing insight into factors affecting cross-cultural
research.
The
University of Nebraska Medical Center project organized a workshop that
brought researchers and community leaders together to discuss problems and
needs in rural minority health research.
Researchers
on the FY 1992 AAHF (Shinagawa) project continually worked with
community-based health care consultants. Early in the research stage,
researchers and community members were also brought together to discuss
issues relevant to the project.
The
Harvard University project has enlisted a Community Advisory Board, which
includes members of organizations concerned about the health of APIs, to
assist in interpreting and disseminating project results.
Projects Addressing API Health Data Needs:
James Dimas, M.P.A., Public Health Foundation (PHF), "State Data Analysis: Year 2000 Health Status Indicators and Minority Health": California Center for Health Statistics, $50,000; Michigan Office of the State Registrar and Division of Health Statistics, $50,000; Rhode Island Office of Health Statistics, $50,000 (FY 1992).
Carol D'Onofrio, Dr.Ph., Northern California Cancer Center (NCCC), "Improving Health Surveys for Multi-Ethnic Populations," $195,245 (FY 1992).
Lloyd Edwards, Ph.D., University of North Carolina at Chapel Hill (UNC-CH), "Assessment of Statistical Materials and Methods for Minority Health Research," $321,855 (FY 1993-94).
Ernest B. Hook, M.D., Western Consortium for Public Health, "Sample Resample Methods for Minority Statistics," $69,729 (FY 1992).
Nancy Krieger, Ph.D., Harvard University, "Social Class, Race/Ethnicity and the Incidence of Cancer," $92,392 (FY 1995).
Keith Mueller, Ph.D., University of Nebraska Medical Center, "Improving Health Services Research Related to Rural Minorities," $115,251 (FY 1991).
Ninez Ponce, Asian American Health Forum (AAHF), "A Research Plan to Advance the Understanding of the Health of Asian and Pacific Islanders," $450,000 (FY 1991).
Zibin Guo, Ph.D., University of Connecticut, "Sources of Bias in health Status Statistics among Elderly Chinese and Asian Indians in Flushing, New York," $19,400 (FY 1991-92).
Greg Loos, Ph.D., and Penny Hatcher, R.N., International Health Program, School of Public Health, University of Hawaii, "Pilot Health Behavior Research Study, Preventive Health Practices of American Samoans: Socio-Cultural Values Influencing Patterns of Child Immunization," $40,000 (FY 1991-92).
Toshiaki Sasao, Ph.D., and Steven Lopez, Ph.D., National Research Center on Asian American Mental Health, University of California, Los Angeles, "Assessing Health Status and Health Risk Behaviors in the Korean American Community," $40,000 (FY 1991-92).
Don Wong, M.D., San Francisco General Hospital Nursery and Perinatal Service, "Maternal Characteristics, Newborn Growth Parameters, and Low Birth Weight in the Asian and Pacific Islander Populations," $40,000 (FY 1991-92).
Larry H. Shinagawa, Ph.D., AAHF, "Classifying Asian and Pacific Islanders and Estimating their Health," $167,510 (FY 1992).
This page last reviewed January 11, 2007
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