MGH Guides: Asian American Native Hawaiian and Pacific Islander Health Resources: Representing AANHPI Health in Medical and Scientific Literature

Research Challenges

One of the most predominant challenges surrounding doing research around the AANHPI communities is a lack of dis-aggregated data.

PubMed’s Medical Subject Headings (MeSH) use the Federal Register’s Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity to help identify the main headings for research on various races and ethnicities. The Standards haven’t been updated since 1997 when they made the decision to split the Asian and Pacific Islander category into two separate categories: “Asian” and “Native Hawaiian or Other Pacific Islander” (Executive Office of the President et al., 1997).

In Riti et al. (2021), small sample sizes can be part of the reason for only providing statistics on an aggregated scale. Through their interviews (Riti et al., 2021), it was also found that financial constraints (not being able to refine specific subcategories), limited stakeholder interests, and a lack of consistency and best practices were additional reasons why researchers did not dis-aggregate the data. Additional methodological issues in Asian American research come in the form of a lack of specification of subgroups and inconsistent definitions of Asian Americans (Islam et al., 2010).

Asian Americans and Pacific Islanders often reported language barriers, mistrust in the outcome of the study, and concern for their legal status as reasons not to participate in research studies (George et al., 2014). George et al. also noted that Asian Americans specifically identified lack of social support and acculturation as reasons for not participating in studies. Pacific Islanders were concerned that their communities would be misrepresented due to participants selecting Native Hawaiian, while participants would have been better represented by other racial and ethnic groups, while residing in Hawaii.

The Mutually Reinforcing Cycle Of Poor Data Quality And Racialized Stereotypes That Shapes Asian American Health
In this article we describe the poor-quality data infrastructure and biases on the part of researchers and public health professionals, and we highlight examples from the health disparities literature. We provide recommendations on how to implement systems-level change and educational reform to infuse racial equity in future policy and practice for Asian American communities.
“Community 101 for researchers”: an online training program to build capacity for ethical community-engaged research with Native Hawaiians and Pacific Islanders
To address the history of unethical research and community distrust in research among Native Hawaiian and Pacific Islander communities, we developed the “Community 101 for Researchers” training program, which was launched in 2014 to enhance the capacity of researchers to engage in ethical community-engaged research. The purpose of this paper is to describe the development of this training program as well as its reach and feedback from participants.

Library Database Search Terms

If you want to start searching for content on AANHPI communities, you can use the following terms to get started on your search:

PubMed

In PubMed, there are several terms that you could use: "Asian"[Mesh], "Asian American Native Hawaiian and Pacific Islander"[Mesh], “Pacific Island People "[Mesh], “Asian People”[MeSH], or "Native Hawaiian or Other Pacific Islander"[Mesh]. The Asian, Asian People, Pacific Island People, and Native Hawaiian and other Pacific Islander MeSH term looks at those with Asian, PI, or NHPI ancestry, while the AANHPI term would be best for researching those communities in the United States. You can also add in synonyms to focus in on specific communities, such as Hmong, Samoan, or Chamorro.

Please note: “Race and ethnicity terms, as used in the federal government, are self-identified social construct and may include terms outdated and offensive in MeSH to assist users who are interested in retrieving comprehensive search results for studies such as in longitudinal studies.” - PubMed

An example search string that you could use could be: (“Pacific Island People "[Mesh] OR "Native Hawaiian or Other Pacific Islander"[Mesh] OR "Asian American Native Hawaiian and Pacific Islander"[Mesh]) AND asthma

CINAHL

CINAHL also has a few options to choose from:

(MH "Asians+") - which includes subheadings of Central Asians, East Asians, Filipinos, Pacific Islanders, and more
(MH "Australasians+") - which covers Australians and New Zealanders
(MH "Native Hawaiians")

An example of using these subject headings could be: ((MH "Asians+") OR (MH "Native Hawaiians") OR (MH "Australasians+")) AND (cochlear implant or cochlear implants or cochlear implantation)

Writing About Race, Ethnicity, and Making Equitable Content

The Reporting of Race and Ethnicity in Medical and Science Journals
For many years and increasingly in the last year, JAMA and the JAMA Network journals have published many important articles addressing disparities and racism in medical education, research, and health care and highlighting initiatives to help address deep-rooted inequities. In these articles, as in others, terminology, usage, and word choice are critically important, especially when describing people and when discussing race and ethnicity. Inclusive language supports diversity and conveys respect. Language that imparts bias toward or against persons or groups based on characteristics or demographics must be avoided.
5 Tips for Equity and Inclusion in Medical Writing and Editing
Dr Genevieve Walker provides guidance on how to be more equitable and inclusive in your medical writing and editing.