Capturing Racial/Ethnic Diversity in Population-Based Surveys: Data Disaggregation of Health Data for Asian American, Native Hawaiian, and Pacific Islanders (AANHPIs)

As the fastest-growing racial/ethnic group in the U.S., Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) make up about 7% of the U.S. population. AANHPIs represent more than 50 ethnic groups and speak over 100 different languages, but national health data rarely collect information needed to disaggregate AANHPI into smaller groups to capture this diversity. This study reviewed AANHPI disaggregated data collection methods in large, U.S. population-based surveys, summarized disaggregated data reporting practices in the peer-reviewed literature, and conducted key informant interviews with 23 members of the National Network of Health Surveys who lead state/local and national surveys to identify challenges to data collection. We found that while large national surveys may include AANHPI subpopulation in data collection, sample sizes are often too small to permit meaningful data analysis. In our interviews, barriers cited included the lack of stakeholder interest, inadequate funding, lack of space on questionnaires, as well as methodologic challenges, such as the inability to obtain an adequate sample size and poor questionnaire design. Survey administration efforts to improve disaggregated health data are challenging, but when done, have led to a proliferation of new population-representative knowledge on the health of AANHPI subgroups. This study provides evidence of the population health value of disaggregating AANHPI data to identify the needs of vulnerable subpopulations. It also advances the field by offering key informants’ insights in overcoming implementation challenges.