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JAMA Forum

Health Equity Matters for Asian Americans, Native Hawaiians, and Pacific Islanders

Achieving health equity remains a compelling vision for our diverse nation. But doing so requires clear understanding of health outcomes for all major American populations and their subgroups. In the case of Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs)—who comprise the fastest growing racial/ethnic group in the United States—fundamental data challenges have long hampered progress. However, the last decade has witnessed some forward motion.

In 2015, the US population included 21 million Asian Americans and 1.5 million Native Hawaiians and Pacific Islanders. By 2065, the Asian American population alone is projected to almost triple to 62 million (from 6% of the US population to 14%). Many studies have treated AANHPIs as an aggregated group, which has blurred differences, led to misleading extrapolation of findings for 1 subgroup to the entire population, or omitted information altogether. Of note, this group encompasses more than 50 different ethnicities, 100 languages, and half the globe—from the US territories in the Pacific to New England. Two-thirds of Asian Americans are foreign-born and 15% represent more than one race. High-average household incomes and educational attainment for AANHPIs as a group mask stark differences across subgroups, with the Pacific Islander population ranking among the least educated and most impoverished in the nation.

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