University of California, Irvine.
University of Chicago.
J Health Polit Policy Law. 2022 Apr 1;47(2):159-200. doi: 10.1215/03616878-9517177.
Data on the health and social determinants for Native Hawaiians and Pacific Islanders (NHPIs) in the United States are hidden, because data are often not collected or are reported in aggregate with other racial/ethnic groups despite decades of calls to disaggregate NHPI data. As a form of structural racism, data omissions contribute to systemic problems such as inability to advocate, lack of resources, and limitations on political power. The authors conducted a data audit to determine how US federal agencies are collecting and reporting disaggregated NHPI data. Using the COVID-19 pandemic as a case study, they reviewed how states are reporting NHPI cases and deaths. They then used California's neighborhood equity metric-the California Healthy Places Index (HPI)-to calculate the extent of NHPI underrepresentation in communities targeted for COVID-19 resources in that state. Their analysis shows that while collection and reporting of NHPI data nationally has improved, federal data gaps remain. States are vastly underreporting: more than half of states are not reporting NHPI COVID-19 case and death data. The HPI, used to inform political decisions about allocation of resources to combat COVID-19 in at-risk neighborhoods, underrepresents NHPIs. The authors make recommendations for improving NHPI data equity to achieve health equity and social justice.
美国原住民和太平洋岛民（NHPIs）的健康和社会决定因素数据被隐藏了，因为尽管几十年来一直呼吁将 NHPIs 数据分类，但数据往往没有被收集或与其他种族/族裔群体的报告汇总在一起。作为一种结构性种族主义形式，数据遗漏导致了无法倡导、缺乏资源和政治权力受限等系统性问题。作者进行了数据审核，以确定美国联邦机构如何收集和报告分类的 NHPIs 数据。他们使用 COVID-19 大流行作为案例研究，审查了各州报告 NHPIs 病例和死亡的情况。然后，他们使用加利福尼亚州的社区公平指标——加利福尼亚健康场所指数（HPI）——来计算该州针对 COVID-19 资源目标社区中 NHPIs 代表性不足的程度。他们的分析表明，虽然全国范围内 NHPIs 数据的收集和报告有所改善，但联邦数据差距仍然存在。各州的报告严重不足：超过一半的州没有报告 NHPIs COVID-19 病例和死亡数据。HPI 用于为有风险社区的资源分配决策提供信息，以对抗 COVID-19，但它对 NHPIs 的代表性不足。作者提出了改善 NHPIs 数据公平性的建议，以实现健康公平和社会正义。
