Over the past decade, the number of Native Hawaiian and Pacific Islander children grew faster in Placentia than in any other Orange County community.
Also, over roughly the same period, Nepalese and Mongolians accounted for the fastest growth within Orange County’s Asian population while two other subgroups, Fijians and Native Hawaiian, saw big jumps in their communities.
If those data nuggets sound random and unconnected, that’s because they are.
While Orange County is one of the nation’s most Asian-centric communities — with about 22 percent of the county’s 3.2 million people identifying as Asian — the idea of “Asian” is far more complex than can be covered by a single box on a census. The term encompasses people from dozens of countries and cultures who are subject to wildly different economic, social and even physical forces.
Public health experts say those differences matter.
“Data is black and white sometimes,” said Regina Chinsio-Kwong, the county’s health officer, during a Sept. 12 meeting at the South Coast Chinese Cultural Center in Irvine.
The meeting of community leaders centered on recent policy briefs from the Orange County Asian and Pacific Islander Task Force and the UC Irvine Joe C. Wen School of Population and Public Health. And though those policy briefs offered many examples of differences between groups who are listed as Asian but are, in fact, distinct cultures, health experts said they also offered a shared bottom line: Detailed, community-specific information about Asian-American, Native Hawaiian and Pacific Islanders is essential to ensure the unique health needs of those particular groups.
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On a national level, that’s already happening.
The federal government recently revised its federal data collection standards to break down large racial groups like Asian American and Pacific Islander into subgroups, such as Pakistani, Hmong and Samoan. Most available datasets clump those subgroups together, which requires researchers to do additional work to break them down.
But that standard hasn’t yet trickled down to local public health agencies. And Cevadne Lee, a research manager at UC Irvine, said incomplete data at the local level can mask some important trends.
For example, though federal data suggests Asian people, overall, are less likely than other racial and ethnic groups to not have health insurance, that’s not necessarily true for Cambodians and Koreans in Orange County. Also, federal data says Asians, overall, are less likely to suffer from Alzheimer’s disease. But in Orange County, Alzheimer’s is the third leading cause of death for Japanese-Americans.
Melenaite Fifita, a research associate and Tongan patient navigator at UCI, said the COVID-19 pandemic exposed some data gaps that led to tangible impacts on the county’s Pacific Islander community.
At one point during the pandemic, the Orange County Health Care Agency reported a 100% vaccination rate among Pacific Islanders. But Fifita — who knew that community leaders were conducting funerals every week for Pacific Islanders who had died of COVID — believed that the number was too high.
But it also was the only number the county had to work with.
Ellen Guevara, a spokesperson for OC Health, said that at the time the county agency was using the best data available, which came from 2021 Claritas’ Census population data for the Native Hawaiian and Pacific Islander population in Orange County. Vaccination rates were calculated with what individuals reported upon receiving a vaccine, Guevara said, which led to overestimating the percentage of vaccinated Native Hawaiian and Pacific Islanders during much of 2021 and 2022.
“This highlights the issue of reliability in calculating rates for a small population where data can be incomplete, rapidly evolving and can result in inaccurate analysis of local vaccination rates,” she said.
Since then, community leaders and researchers have started to work with the health care agency to disaggregate Native Hawaiian and Pacific Islander subgroups from the Asian and Pacific Islander category.
Fifita said the updated data revealed Native Hawaiian and Pacific Islander people suffered higher death rates from COVID-19 than any other racial group in the county. And, when armed with better information, the county health care agency vaccinated 50 Pacific Islander faith-based leaders. The county also created a team that made COVID-19 testing more accessible to Asian Americans and Pacific Islanders by including faith-based organizations as testing and vaccination sites.
National data also says Asian Americans generally have lower cancer risk than other racial and ethnic groups but local, disaggregated data says something different. In fact, cancer and heart disease are the top two causes of death for most Asian Americans and Pacific Islanders. And in Orange County, from 2020 through 2022, cancer was the No. 1 cause of death for Chinese, Korean, Laotian, Thai, Vietnamese, Filipino, Indonesian, Taiwanese and Hawaiians.
Stereotypes about health in the Asian community can be a powerful — sometimes harmful — force.
For example, county health leader Chinsio-Kwong, a breast cancer survivor, said she wasn’t aware that she was at risk for that disease because most public-facing datasets say Asians are low-risk. While Chinsio-Kwong is now cancer-free, she recently lost an aunt, who was diagnosed with metastatic breast cancer.
Lee, from UC Irvine, suggested that the data problem has yet to be fixed.
“Pacific Islander and Asian American racial and ethnic data continues to remain either uncollected or aggregated in overly broad groups and does not allow for the needs of subgroups to be visible,” she said.
“These data collection deficiencies result in policy and budget decisions that are made with incomplete information.”
The Sept. 12 gathering drew Asian American elected officials from all across the county, including Buena Park Councilmember Joyce Ahn, Irvine Councilmember Tammy Kim and Fullerton Mayor Fred Jung.
As a whole, Asian communities consist of some 50 distinct ethnic groups who speak over 100 languages. According to data unveiled Thursday, 40 AANHPI ethnic groups call Orange County home, the top five being Vietnamese, Chinese (except Taiwanese), Filipino, Korean and Asian Indian.
