Centering Health Equity in Population Health Surveys (JAMA Health Forum)

​Summary: Disaggregation of race/ethnicity in population health surveys was pivotal to understanding the vast differences between the Asian and Native Hawaiian and Pacific Islanders (NHPI) experience. A study using the National Health Interview Survey to compare NHPI populations with Asian populations showed that NHPI individuals have significantly higher rates of cancer, asthma, psychological distress, hypertension, heart disease, and unhealthy body weight. More recently, these vulnerabilities of the NHPI population captured by state population health surveys unfortunately manifested in coronavirus disease 2019 (COVID-19) mortality data. In some states, NHPI individuals suffered disproportionately from COVID-19 deaths than any other racial/ethnic group. If not for the advocacy work to create the NHPI category, the burden of disease shouldered by NHPI people would be hidden in the data. With available data, the NHPI community leaders have been mobilizing efforts informed by the NHPI COVID-19 Data Policy Lab Dashboard to protect the further spread of COVID-19 in NHPI communities.

Researchers and community-based partners and advocates rely on population-based survey data to address specific health needs. Centering equity in population surveys means that there is an explicit measurement objective to eliminate health inequities. The California Health Interview Survey (CHIS) offers an example of how population health surveys can effectively gather and analyze data about small racial/ethnic groups to inform policy and programming. The CHIS is coproduced by community-based partners through advisory committees, including one that is explicitly tasked with improving the value of the survey across multicultural populations. With organizational commitment and community accountability, population health surveys will have the equity objective front and center and the quality of insights to formulate policies improving population health will improve.

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• Journal Article: Centering Health Equity in Population Health Surveys