U.S. Department of Health & Human Services

Advancing AANHOPI Health Equity Practices

Posted on May 26, 2021 by LCDR Lusi Martin-Braswell, Public Health Analyst, Office of Minority Health

Lusi Martin-Braswell

Growing up in Tonga, it was all but impossible not to recognize a lack of access to education, health, and economic opportunities within my Pacific Islander family and community. These experiences have inspired me to support and promote health equity in vulnerable groups as part of my professional career and personal interests.

As we celebrate Asian American and Pacific Islander Heritage Month this May, it is useful to take a look back. Historically, the U.S. Census Bureau grouped persons of Asian ancestry into the category "Asian Pacific Islander." During the 1990 census, the standards for collecting race/ethnicity data were under scrutiny because the categories outlined in the federal Office of Management and Budget (OMB) Directive No. 15 did not reflect the nation's changing demographics. In 1997, OMB issued a federal register notice, Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity, which separated the Asian and Native Hawaiian or Other Pacific Islander (NHOPI) ethnicities into their own separate categories. As a result of this distinction, public health practitioners would better understand risk factors, disease prevalence, and lived experiences for each group. The revised OMB directive defines the two ethnic groups as follows:

  • Asian. A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
  • NHOPI. A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Although OMB released these data standards, it is important to note that some entities continue to lump the two ethnic groups under “Asian Pacific Islander.” During the COVID-19 pandemic, UCLA data researchers found that only 20 states provided COVID-19 data about NHOPIs Exit Disclaimer. This is a serious problem as it is difficult to understand and justify the need to intervene and/or allocate resources for specific groups during public health crises.

In President Biden’s Proclamation on Asian American and Native Hawaiian/Pacific Islander Heritage Month, 2021, he noted that AAHOPI “communities face systemic barriers to economic justice, health equity, educational attainment, and personal safety. These challenges are compounded by stark gaps in Federal data, which too often fails to reflect the diversity of AAHOPI communities and the particular barriers that Native Hawaiian, Pacific Islander, Southeast Asian, and South Asian communities in the United States continue to face.”

As seen in the figures below, when available data among ethnic groups are considered separately, we see stark differences in risk factors between AAs and NHOPIs.

Snapshot of Health Profile Measures

Figure 1
Figure 1
Figure 1
Figure 1

Adapted from the Office of Minority Health, Policy and Data, Health Profiles by Population.

As we continue to advance cultural competency under the Biden Administration’s Executive Order on Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, I present three important considerations for public health colleagues and researchers working/partnering to improve health in AAHOPI communities:

  1. Asians and NHOPIs are distinct ethnic groups with varying cultures, lived experiences, and unique challenges that deserve their own attention.
  2. Representation from Asian and NHOPI ethnic groups is critical to developing the best approaches to address health issues in their respective communities.
  3. Follow federal guidance to disaggregate data among ethnic groups as a critical step in better understanding health inequities and underlying factors that may be exacerbating health disparities.

For more information about Asian American and Pacific Islander Heritage Month, please visit the OMH observance page.


  1. Revision to the Standards for the Classification of Federal Data on Race and Ethnicity https://obamawhitehouse.archives.gov/omb/fedreg_1997standards. Accessed on April 26, 2021.

Combating Racism Advances Health Equity

Posted on March 11, 2021 by Juliet Bui, Public Health Advisor

Juliet Bui

Maybe you’ve seen the videos on social media. A 52-year-old Chinese American woman assaulted in New York City. An 84-year-old Thai American man pushed to the ground so violently in San Francisco that he dies from his injuries. Both incidents in recent weeks are part of an alarming increase of attacks on Asian Americans and Pacific Islanders (AAPIs) in the United States since the beginning of the COVID-19 pandemic last year.

Renowned civil rights lawyer Bryan Stevenson says that to address racial inequality, we have to confront our history. In the context of health inequities, we should acknowledge that hate, stigma, racism, discrimination, conscious and implicit bias, and microaggressions have played—and continue to play—a role in contributing to poor health and health outcomes for racial and ethnic minority populations, and in exacerbating health disparities.

While the nation battles the COVID-19 pandemic, disturbing reports of attacks, harassment and hate-motivated incidents are forcing AAPI communities to battle racism and bigotry that threaten their physical safety and mental wellbeing.

This is not the first time the AAPI community has experienced racism during a public health crisis. The 2003 SARS outbreak saw a rise in anti-Asian rhetoric and action, driven by similar myths and misdirection of blame toward AAPIs as are being perpetuated now. These are just a few examples of the violence and abuse against racial and ethnic minority and other marginalized groups that have persisted throughout our country’s history. Not only are actions motivated by intolerance inherently wrong, but there is also evidence that suggests that they can affect the health and mental health of individuals and their communities.

On January 26, President Biden issued the Memorandum Condemning and Combating Racism, Xenophobia, and Intolerance against Asian Americans and Pacific Islanders in the United States. The memorandum calls for federal government to combat and prevent racism, xenophobia, and intolerance against AAPIs. The memorandum includes a directive for the Secretary of Health and Human Services, in coordination with the COVID-19 Health Equity Task Force, to consider issuing best practices for advancing cultural competency, language access and sensitivity toward AAPIs in the context of the federal COVID-19 response. On January 20, the Administration also issued the Executive Order on Advancing Racial Equity and Support for Underserved Communities Through the Federal Government. This executive order calls for a comprehensive federal approach to advancing equity for all, including people of color and others who have been historically underserved, marginalized, and adversely affected by persistent poverty and inequality.

Federal activities aligned with the memorandum and executive order will not only address immediate equity needs related to COVID-19 response and recovery efforts, but also will have the great potential to support sustained federal efforts beyond the pandemic to combat interpersonal and structural racism and to advance inclusion for people of all races, national origins, and ethnicities. Of critical importance to the Office of Minority Health (OMH) at the U.S. Department of Health and Human Services, another promising outcome will be the advancement of health equity, as the federal government works to improve cultural competence, improve access to quality health care, and mitigate the adverse effects of racism on health and wellbeing. OMH calls on everyone in the nation to join the federal government in condemning and combating racism—it is the right thing to do as a nation, and for our health.

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