Addressing the Interlocking Impact of Colonialism and Racism on Filipinx/a/o American Health Inequities (Health Affairs)
Summary: Within the monolithic racial category of “Asian American,” health determinants are often hidden within each subgroup’s complex histories of indigeneity, colonialism, migration, culture, and socio-political systems. Although racism is typically framed to underscore the ways in which various institutions (for example, employment and education) disproportionately disadvantage Black/Latinx communities over white people, what does structural racism look like among Filipinx/a/o Americans (FilAms), the third-largest Asian American group in the United States? Authors argue that racism defines who is visible. They discuss pathways through which colonialism and racism preserve inequities for FilAms, a large and overlooked Asian American subgroup. Authors bring to light historical and modern practices inhibiting progress toward dismantling systemic racial barriers that impinge on FilAm health.
Authors encourage multilevel strategies that focus on and invest in FilAms, such as robust accounting of demographic data in heterogeneous populations, explicitly naming neocolonial forces that devalue and neglect FilAms, and structurally supporting community approaches to promote better self- and community care.
Authors suggest active changes in data collection infrastructure and processes as a public commitment of investment to address FilAm health disparities. These actions are not sufficient, but they are necessary steps in the broader process of appropriately reframing the narrative of FilAm health. More importantly, disaggregating data will facilitate the allocation of appropriate resources to evaluate efforts that contribute to systemic changes, encourage actions that identify and dismantle racism and colonial processes, and establish accurate methods and measures to understand FilAm health inequities. Continued aggregation reinforces myths that FilAms are overall healthy, well represented in upstream decision-making processes, and well accounted-for in the current understanding of structural racism among immigrants and communities of color.
Authors recommend that U.S. institutions refocus future investments and resources to community-partnered practices that identify and reduce mechanisms linking systemic factors to their cumulative effects on FilAm health outcomes, such as prioritizing community needs, implementing equitable resource sharing, allowing community-led efforts, and empowering communities through capacity building and interdisciplinary research participation.
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