US Health Care Relies on Filipinxs While Ignoring Their Health Needs (JAMA Health Forum)

​Summary: In the U.S., Filipinxs are the third largest Asian subgroup and have represented a crucial part of the country’s health care workforce since the mid-20th century. Although the 2.9 million Filipinxs in the U.S. represent about 1% of the population, approximately 1 of 4 Filipinx working adults are frontline health care workers. The COVID-19 pandemic has exacted a disproportionate toll on Filipinx communities in the U.S. and on Filipinx health care workers, specifically. The absence of disaggregated race/ethnicity data for COVID-19 has masked how the pandemic has affected Filipinxs in the U.S. Policymakers and researchers must recognize that these disparities are not limited to COVID-19 but are a critical example of how data aggregation under a single Asian category has hidden the health needs of the Filipinx population.

Findings: Aggregate race/ethnicity data for COVID-19 cases and deaths mask the disproportionate burden on Asian subgroups, including Filipinxs in the U.S., leaving these disparities unrecognized and unaddressed. Asians comprise nearly 6% of the U.S. population but only about 3% of COVID-19 cases and 4% of its deaths, suggesting that Asian Americans are not disproportionately affected by COVID-19. Yet a different picture has emerged for Filipinxs in Hawaii, the only state which publicly reports disaggregated Asian data: Filipinx residents comprise 16% of the population but 22% of COVID-19 deaths. Similar analyses are not possible nationally or in any other state. While some states may collect data on Filipinxs, these data are typically restricted and only available through public information requests. For example, Filipinxs comprise 42% of COVID-19 deaths among Asian adults (18–64 years) in California despite making up just 20% of the state’s nonelderly Asian adult population. No other Asian subgroup accounted for more than 15% of deaths.

Data aggregation has not only obscured the disproportionate effect of COVID-19 on specific racial/ethnic subgroups, but it has also hampered the ability to monitor for preexisting risk factors contributing to higher mortality among subgroups. Efforts to identify health disparities among Filipinxs often rely on data from the California Health Interview Survey because, to the authors' knowledge, it is the only large-scale health survey in the U.S. that disaggregates Filipinx data and therefore allows robust analyses.

Without disaggregated data for Asian subgroups, Filipinxs have been ignored in public health planning efforts, perpetuating health disparities within a community that has shouldered a disproportionate share of the frontline health care work. While the increased availability of COVID-19 vaccines will provide an end to the pandemic, policymakers should take concrete steps to ensure an equitable recovery that will also prepare the country for a more equitable response to future health challenges. 

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• Journal Article: US Health Care Relies on Filipinxs While Ignoring Their Health Needs