Authors examine how changes in federal health data infrastructure affect states’ capacity to advance data equity and how policymakers can respond. They review across state data disaggregation legislation, draw on the California Health Interview Survey (CHIS) as a model case, and synthesize evidence on data interoperability, governance, and dissemination.

Findings: Some states are already moving beyond federal minimums on race and ethnicity data collection. For example, Connecticut, Oregon, and Massachusetts have enacted expansive laws collecting detailed subgroups; Illinois, New York, and New Jersey have added Middle Eastern and North African and other categories across all state agencies. Colorado and Oregon extend collection to sexual orientation, gender identity, and disability status. Authors offer examples from California's recent legislation and show how CHIS operationalizes such mandates. They also identify persistent constraints, including incomplete demographic fields in administrative data, workforce and interoperability gaps, and the need for governance frameworks and data firewalls that safeguard privacy.

Authors conclude that state-led data infrastructure will help build effective public health practice. The aim is not 50 incompatible systems but an ecosystem of comprehensive and inclusive systems that are more granular, responsive, and community-accountable. For such an ecosystem to function, the systems must still communicate, which depends on shared standards and definitions that keep data comparable across states and over time. Realizing this vision requires diversified funding, cross-agency coordination, strong governance, and active roles for researchers, philanthropy, and communities, so that progress in measuring disparities endures across changing policy environments.

The U.S. has recently made progress in collecting better data on race, ethnicity, and gender identity to ensure all communities are fairly represented in research and policy. However, new executive orders from President Trump in 2025 have halted many of these efforts, including stopping data collection on transgender people and removing key datasets from public websites. These actions threaten the availability of accurate, inclusive data that supports health, equity, and civil rights.

Authors explain what’s at stake and offer suggestions to encourage and protect robust data collection that represents everyone. While legal challenges are underway, state and local groups, along with researchers, are stepping up to protect and continue this vital work to reflect and protect data that reflects the nation's full diversity.
 

The U.S. Office of Management and Budget (OMB) categorizes Filipino Americans as Asian; however, many may not identify as such, opting instead for "other" or Pacific Islander (PI). This study examines the extent to which Filipino Americans select PI or "other" rather than Asian, using a large population-based survey of Californians.

Authors analyzed data from the 2019, 2020, and 2021 California Health Interview Survey (CHIS), the largest state health survey in the U.S. that includes write-in prompts for detailed race and ethnicity data. The focus was on participants who identified as Pacific Islanders and wrote in 'Filipino,' those who selected 'Asian' and specified 'Filipino,' and respondents who chose 'other' and wrote in 'Filipino.'

Findings: The analysis included 1,859 Filipino respondents, revealing that 8.8% identified as Pacific Islander, 85.2% as Asian, and 6.1% as "other." Those identifying as PI were more likely to also identify as Latino/Hispanic, be older, and possess U.S. citizenship compared to those identifying as Asian.

Disaggregating Filipino Americans from the broader Asian category in surveys is vital for accurately identifying the community's unique needs. Authors recommend incorporating open-ended write-in prompts in surveys that ask respondents to first identify their broader race category (e.g. Asian). These prompts help identify and reclassify Filipino respondents who may have identified as PI. Such prompts are also important for other racial/ethnic communities who may be uncertain about how to categorize themselves. Ongoing, dynamic community-driven research is essential for understanding identities and effectively categorizing Filipino Americans and other communities.
 

This study explores the association between climate change stress and psychological distress and suicide ideation among adolescents in California and factors associated with climate change stress.  Study authors use cross-sectional data from the 2021 and 2022 California Health Interview Survey (CHIS) to explore differences between adolescents reporting climate change stress or not. Association between climate stress and psychological distress and suicide ideation were explored.

Findings: In this study, 38.1% of California’s adolescents report climate change stress. Adolescents who report this stress are more likely to be female, gender nonconforming, white, from higher-income families, have adverse childhood experiences, frequently use social media, be involved in their community, and feel civic efficacy. Climate change stress is associated with 2.395 greater odds of psychological distress in the past month and 1.853 greater odds of suicide ideation in the past year.