Understanding the Representation of Asians and Asian Americans Within Academic Otolaryngology Leadership.

OBJECTIVE: Elucidate the representation of Asian and Asian Americans in academic otolaryngology and the influence of race on promotion and leadership opportunities. STUDY DESIGN: Retrospective analysis of the Association of American Medical Colleges Faculty Administrative Management Online User System. SETTING: Full-time otolaryngology faculty from all US medical schools from 2020 to 2023. METHODS: Faculty demographics, tenure, and rank were collected. Descriptive statistics, Fischer's exact test, Rank Equity Index (REI), and multivariable logistic and ordinal regressions were used to characterize our cohort and assess the impact of race on academic advancement and leadership, defined as promotion to tenure or full professorship. RESULTS: Asians comprised 20.53% of 9056 faculty over 4 years. Asians were most likely to hold tenure-eligible positions (n = 600, 30.74%) but were significantly less likely than non-Asians to be tenured (43.00% vs 48.65%, P = .015). Asians were slightly above parity in promotion from assistant to associate professor (REI = 1.09) but below parity in promotion from associate professor to professor (REI = 0.78). Relative to whites, Hispanics, and African Americans, Asians reported the lowest associate/professor and assistant/professor REIs. On multivariable regressions, Asian race was not associated with decreased odds of tenure-eligible positions but was associated with decreased odds of tenure (odds ratio [OR] = 0.77, 95% confidence interval [CI] = [0.64-0.93]) and rank promotion (OR = 0.82, 95% CI = [0.74-0.90]). CONCLUSION: Despite strong overall representation in otolaryngology, Asians are less likely to receive promotion, tenure, or full professorship relative to other racial groups. Future efforts should emphasize equitable advancement opportunities to ensure a diverse otolaryngology leadership.

Devil among us or inside us? Exploring the relationships of internalized racism and suicidal ideation among US Asian adults.

OBJECTIVES: Prior research shows that perceived racism was associated with higher risks of suicidal ideation among US Asians. Nevertheless, the relationship between internalized racism and the suicidal risks of US Asians has not been adequately researched. In addition, as an important social institution, religion has been left out of the studies of racism and suicide for US Asians. This study is aimed at filling in these gaps and contributing to a better understanding of internalized racism, religion, and the mental health of US Asians. DESIGN: This study surveyed 970 Asian or Asian American adults living in the United States. Survey participants were recruited using Qualtrics online panel samples between April and June 2024. Quotas were set for key demographic variables, such as sex and ethnicity, following the national census. RESULTS: The main results suggest that even after controlling important mental health measures such as anxiety and loneliness, higher internalized racism was still tied to higher risks of suicidal ideation. The effect of internalized racism was not only robust but also stronger than other mental health measures as well as perceived external racism. Finally, the deleterious internalized racism effect on suicidal ideation was stronger among US Asians, who attend religious services more often. CONCLUSION: Internalized racism exerts a fairly strong and robust effect on suicidal ideation among US Asians. This deleterious effect is also interactive with the religious characteristics of US Asians. Healthcare providers, community workers, and religious leaders may want to take internalized racism into consideration in their future service to the US Asian community.

Healthcare Professionals' Views of Supportive Care Needs for Chinese, Korean, and Vietnamese Americans with Metastatic Cancer.

The supportive care needs of people with metastatic cancer, particularly Asian Americans, are understudied. Distinct psychosocial support needs may exist across ethnocultural groups with Confucian-heritage values and norms. Cultural factors may shape how adults approach their oncologic care. This qualitative study represents the perspectives of 15 experienced healthcare professionals about the supportive care needs of Chinese-, Korean-, and Vietnamese-heritage (CKV) adults with metastatic solid cancers. Reflexive thematic analysis was conducted with transcripts from three semi-structured focus groups and five parallel-format individual interviews. Inductive coding and iterative theme development resulted in four themes describing the types of needs (basic, care-related, mental health, relational trust) that should be met for CKV patients with metastatic cancer, which may fall through the gaps when the healthcare system and patient's differing cultural contexts collide. In conclusion, greater involvement of psychosocial care specialists with cultural expertise is essential to promote patients' and families' well-being, prevent care disparities, and better support the healthcare team. Systemic changes that increase workforce diversity, reduce language and insurance barriers, and allow healthcare professionals to build relational trust with patients, are needed to improve quality of life for CKV patients with metastatic cancer.

FOBism Unveiled: Quantifying Assimilative Racism within Asians in the United States.

FOB (fresh-off-the-boat) is a term used to refer to unassimilated immigrants or sojourners, which has created a divide within the Asian community. In this study, we coined the term FOBism, a form of internalized racism (or appropriated racial oppression) that intersects with assimilation, and we developed a measure of FOBism. We created a 14-item, 3-factor FOBism Scale and evaluated its psychometric properties among a sample of 296 Asians in the United States. Exploratory structural equation modeling (ESEM) was utilized to select items and evaluate the factorial validity. Results yielded a strong factor structure, internal consistency reliability, and construct validity. Construct validity was demonstrated through FOBism scores' positive correlations with measures of within-group discrimination and internalized racism, and negative associations with an Asian cultural orientation. The FOBism Scale is a promising measure that could be used as an assessment tool and to raise awareness of the phenomenon.

COVID-19 vaccine booster willingness among Asian Americans: Influence of racial discrimination and social determinants.

Uptake of COVID-19 vaccine booster doses is an important public health topic of study to prevent morbidity and mortality in underserved U.S. populations. However, limited research exists on COVID-19 vaccine booster use and willingness - including its associated factors - among Asian Americans (AA): the fastest growing racial group in the U.S. This study collected survey data from 447 AA adults from three large AA subgroups: Chinese, Korean, and Filipino. Data were collected as part of a community-driven county-wide needs assessment conducted in collaboration with AA community organizations in Riverside County, California. Data indicated that nearly 24% of AA participants received at least four doses of the COVID-19 vaccine, with 36% expressing definite willingness to receive future booster doses. Participants reported experiencing an average of 1.6 instances of racial discrimination across their lifetime. Ordered logistic regression and marginal effects analysis revealed ethnicity, education, racial discrimination, preexisting health conditions, and the number of prior COVID-19 vaccine doses received significantly predicted willingness to receive future vaccine doses. The study suggests that key social factors such as racial discrimination may play an important role in influencing public health efforts to promote vaccine uptake in diverse Asian American populations.

Differential prevalence of psychiatric disorders and mental health characteristics associated with lifetime suicide attempts in the Asian American and Pacific Islander adult population.

BACKGROUND: Asian American and Pacific Islander (AAPI) adults are an understudied group in terms of their mental health and mental healthcare needs. This has been complicated by the difficulty of recruiting adequate national samples of AAPI adults for research. OBJECTIVE: This study aimed to analyze national data to examine the lifetime prevalence of major psychiatric disorders among AAPI adults relative to non-AAPI adults, as well as to identify and compare sociodemographic and clinical characteristics associated with lifetime suicide attempts among AAPI and non-AAPI adults. METHODS: Cross-sectional data on 36,109 adults, including 1801 AAPI adults, from the National Epidemiological Survey of Alcohol and Related Conditions-III (NESARC-III), were analyzed with a series of chi-square and logistic regression analyses. RESULTS: We found a significantly lower lifetime prevalence of mental health disorders in the AAPI versus the non-AAPI population nationally, including 2% of AAPI adults reporting lifetime suicide attempts as compared to about 5% of non-AAPI adults. Female sex and a history of major depressive disorder diagnosis were associated with lifetime suicide attempts in the AAPI and non-AAPI populations. Several unique factors were associated with having a history of suicide attempts in only the AAPI population, including a military service history and a diagnosis of panic disorder. DISCUSSION: Our analysis demonstrated the significant sectors of the AAPI population that merit research, support, and intervention, including the AAPI veteran population. This study identifies several characteristics among AAPI adults that may make them particularly vulnerable to psychiatric problems and suicide risk, which may inform targeted prevention and efforts to provide culturally competent care to this population.

The role of ethnic enclaves and neighborhood socioeconomic status in invasive breast cancer incidence rates among Asian American, Native Hawaiian, and Pacific Islander females in California.

PURPOSE: Few studies have examined whether the incidence rates of invasive breast cancer among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations differ by the neighborhood social environment. Thus, we examined associations of ethnic enclave and neighborhood socioeconomic status (nSES) with breast cancer incidence rates among AANHPI females in California. METHODS: A total of 14,738 AANHPI females diagnosed with invasive breast cancer in 2008-2012 were identified from the California Cancer Registry. AANHPI ethnic enclaves (culturally distinct neighborhoods) and nSES were assessed at the census tract level using 2007-2011 American Community Survey data. Breast cancer age-adjusted incidence rates and incidence rate ratios (IRRs) were estimated for AANHPI ethnic enclave, nSES, and their joint effects. Subgroup analyses were conducted by stage of disease. RESULTS: The incidence rate of breast cancer among AANHPI females living in lowest ethnic enclave neighborhoods (quintile (Q)1) were 1.21 times (95% Confidence Interval (CI) 1.11, 1.32) that of AANHPI females living highest ethnic enclave neighborhoods (Q5). In addition, AANHPI females living in highest vs. lowest SES neighborhoods had higher incidence rates of breast cancer (Q5 vs. Q1 IRR = 1.30, 95% CI 1.22 to 1.40). The incidence rate of breast cancer among AANHPI females living in low ethnic enclave + high SES neighborhoods was 1.32 times (95% CI 1.25, 1.39) that of AANHPI females living in high ethnic enclave + low SES neighborhoods. Similar patterns of associations were observed for localized and advanced stage disease. CONCLUSION: For AANHPI females in California, incidence rates of breast cancer differed by nSES, ethnic enclave, when considered independently and jointly. Future studies should examine whether the impact of these neighborhood-level factors on breast cancer incidence rates differ across specific AANHPI ethnic groups and investigate the pathways through which they contribute to breast cancer incidence.

Ethnic disparities in perceived racism, patient-provider communication and healthcare utilization: Asian Americans.

BACKGROUND: Race is a consequential sociocultural cue in healthcare contexts. Racism is associated with health disparities by influencing patient-provider communication and utilization of healthcare services. OBJECTIVE: This study aimed to investigate how Asian American subgroups differ in their perception of everyday racism, internalized racism, and perceived racism in healthcare settings and whether these perceptions predict their interactions with their health care providers and their utilization of healthcare services. METHODS: An online survey study was conducted. ANOVA tests were employed to compare the differences in perceptions of everyday racism, internalized racism, and perceived racism in the healthcare system among Filipino (N = 310), Japanese (N = 242), Chinese (N = 287), Asian Indian (N = 304), Korean (N = 199) and Vietnamese (N = 151) participants. Multiple regression analyses assessed whether perceptions of everyday racism, internalized racism, and perceived racism in the healthcare system predicted healthcare service utilization and patient-provider communication among the Asian subgroups sampled. RESULTS: There were significant group differences in perceived everyday racism (F = 8.56, p < .001), internalized racism (F = 3.46, p < .01), perceived racism in healthcare (F = 4.57, p < .001). Perceptions of racism and socioeconomic variables were found to predict patient-provider communication and utilization of healthcare services disparately across various Asian subgroups. For instance, the perception of everyday racism was a significant predictor of patient-provider communication for each of the subgroups, excluding the Vietnamese participants. Internalized racism was a significant predictor only for Filipino and Chinese participants. Surprisingly, perceived racism in healthcare was not a predictor for any of the subgroups. CONCLUSION: Findings highlight the complex interplay of sociodemographic factors and perceived racism in shaping patient-provider communication and healthcare service utilization within the Asian American community. Implications are suggested for addressing the unique challenges faced by different Asian American subgroups and for promoting equitable healthcare access and fostering positive patient-provider relationships among the Asian American subgroups.

Exploring the intersectionality of race and gender on the incidence of and response to microaggression experienced by Asian American women medical students.

BACKGROUND: Discrimination faced by Asian American trainees in medical school include those reported by female trainees. This study aims to characterize the microaggressions faced by Asian American woman medical students. METHODS: We use a mixed methods approach to characterize the experiences of Asian Americans in United States (US) medical schools through an anonymous online survey and participation in focus groups. RESULTS: Among our 305 participants, 65.9 â€‹% were women. More women experienced microaggressions than men (p â€‹< â€‹0.001). Compared to men, women reported significantly higher rates of supervisors having higher expectations of them, implying they were submissive, and describing them as too quiet. Women felt that their experiences with microaggressions were entangled with being Asian and a woman, but could not distinguish which identity was being targeted. CONCLUSION: The intersectionality of being Asian American and a woman in medical training has not been explored. We found that this duality intensified experiences of microaggressions.

Anti-Asian American, Native Hawaiian, and Pacific Islander Racism in Academic Pediatrics: Recommendations for Training, Research, and Clinical Practice.

This paper discusses how anti-Asian American, Native Hawaiian, and Pacific Islander (AANHPI) racism affects pediatric training, research, and clinical practice. Extant research shows that racism and discrimination are social determinants of health that impact AANHPI populations, including youth. AANHPI youth face significant health disparities and a wide range of barriers to health care access. However, AANHPIs tend to be seen by clinicians and depicted in training as monolithic, high achieving, and a relatively low priority in terms of pediatric workforce recruitment and training and pediatric research. After a brief discussion of US policies that have explicitly aimed to exclude, punish, or imprison AANHPIs, the paper explains AANHPI racism and its consequences. The paper then describes evidence of anti-AANHPI racism in pediatrics and offers recommendations for training, research, and clinical practice.

A longitudinal investigation of parenting, depression, and counseling use among Asian American adolescents.

INTRODUCTION: Asian American adolescents are equally or more likely to experience depression but less likely to seek treatment for depression than adolescents from other racial and ethnic groups in the US. The current study examined the long-term effects of parental care, parental control, and parental closeness on depression and counseling use among Asian American adolescents. METHODS: Using data from the National Longitudinal Study of Adolescent Health (Add Health), we conducted a cross-lagged path analysis with 270 Asian American adolescents (48.1% female; 51.9% male). The study used data from Waves I, II, and III (1994-2002) with participants' mean ages ranging from 14 to 23. RESULTS: Findings indicated that the cross-sectional relationships between parenting characteristics and depression were stronger than the longitudinal relationships suggesting that parenting practices may be a stronger proximal, rather than distal, predictor of depression. Specifically, parental closeness was associated with less depression in early and mid-adolescence (age 12-18), but the relationship changed direction in young adulthood (age 18-26). Additionally, a significant interaction suggested that parental care was related to fewer depressive symptoms for those who reported high, compared to low, parental control in mid-adolescence (age 14-18). Furthermore, high parental care was associated with more counseling use at high levels of control. However, high parental care was associated with less counseling use at low levels of parental control in early adolescence. CONCLUSION: These results highlight the importance of understanding parenting characteristics using longitudinal designs when examining the development of depression and help-seeking behaviors among Asian American adolescents.

Separateness or wholeness: a qualitative study of the experiences of Asian American female sexual minorities.

This study explored the intersection of race, gender, and sexuality as they pertain to experiences of Asian American female sexual minority (AAFSM) students attending Midwestern universities in the United States through an intersectional lens. The study utilized intersectionality as a theoretical framework, a data generation tool, and a methodological approach to guide the study. The results showed that the participants experienced constructed objectifications, which included gendered, racial, and sexual objectification. The findings also revealed that participants' race, gender, and sexual orientation were contextualized based on the situation. Further, participants devalued their Asianness, womanhood, and LGBTQness owing to the lack of positive representation in the curriculum. The analyzed data can be best categorized as the lack of intersectional representations in curricula, contextualized race, gender, and sexuality, and reported experiences of constructed objectifications. Discussions provided an inclusive campus environment for participants who were AAFSMs. These discussions also provided meaningful suggestions for educators, administrators, policymakers, and stakeholders to foster an equal and equitable educational environment for students with multiple marginalized identities.

Disparities in timely surgery among Asian American women with breast cancer.

BACKGROUND: We investigated the likelihood of timely surgery for breast cancer patients among diverse Asian subgroups. METHODS: We analyzed the National Cancer Database from 2010 to 2019 and included White and Asian women diagnosed with stage I-III breast cancer. Patients with multiple cancers, patients who received chemotherapy, and those diagnosed and treated at different hospitals were excluded. The primary outcome was timely surgery within 8 weeks of diagnosis. Race was the primary independent variable. Asian Americans were stratified by geography. RESULTS: A total of 716,701 women were analyzed, with 3.5% Asians. Delayed surgery was experienced by 13.2% of women. Adjusted analysis indicated no difference in receiving timely surgery between all Asians and Whites. However, Southeast Asians were less likely to undergo timely surgery compared to Whites (OR 0.75, 95% CI 0.67-0.84). CONCLUSIONS: Variations among Asian ethnicities emphasize the need to explore treatment patterns to address disparities in breast cancer care.

Profiles of racial discussions and associations with parent sociocultural factors and internalized racism in Asian American families.

While Asian American parents are key contributors in racially socializing their children, past research indicates that issues of race are not frequently discussed among Asian American families. Moreover, there is limited research on how Asian American parents' sociocultural factors predict the amount and ways they talk about race to their children. We conducted latent profile analyses among 150 Asian American parents' (Mage = 42.36, range = 26-65 years) racial discussions, and the profiles' association with parents' sociocultural factors (i.e., enculturation, acculturation, internalized racism, collectivism, and loss of face) were examined. Four distinct profiles were identified with distinct levels of awareness of discrimination, avoidance of outgroups, minimization of race, and promotion of equality messages. Findings underscore the importance of Asian American parents engaging in nuanced racial discussions with their children, highlighting the need for culturally responsive interventions, educational programs, and policy initiatives to support families in navigating complex racial landscapes and fostering positive youth outcomes.

Gendered Racial Microaggressions and Depressive Symptoms Among Emerging Adult Asian American Women: Racial/Ethnic Differences Among Asian and White Romantic Partners.

Discrimination can contribute to adverse mental health outcomes among individuals in romantic partnerships. However, research has yet to examine how differences in partner race/ethnicity can shape the link between gendered racial microaggressions, an intersectional form of discrimination, and depressive symptoms among Asian American women. Accordingly, we assessed the link between gendered racial microaggressions and depressive symptoms, and whether partner race/ethnicity (White vs. Asian) moderated the link. Using a sample of 156 Asian American women (Mage = 26.5, SD = 5.33), we conducted multiple regressions to assess the main effects between four gendered racial microaggression stress subscale factors and depressive symptoms. We then examined partner race/ethnicity as a moderator in these associations. All four gendered racial microaggression stress subscale factors of ascribed submissiveness, assumptions of universal appearance, Asian fetishism, and media invalidation significantly predicted greater depressive symptoms. However, only Asian fetishism experiences maintained a significant and positive association with depressive symptoms for Asian American women with White male partners. The association between Asian fetishism and depressive symptoms was no longer significant for Asian American women with Asian male partners. Results indicate that Asian fetishization may be a uniquely oppressive experience for Asian American women with White partners that can contribute to greater depressive symptoms. These findings demonstrate an increased need for the development of critical consciousness in individual and couples counseling sessions to help Asian American women and their romantic partners identify and mitigate the negative effects of gendered racial microaggressions.

Cultural and social barriers to hope in gastrointestinal cancer patients.

Background: Hope is correlated with quality of life and overall survivorship among patients with cancer. We aimed to identify sociodemographic and clinical determinants of hope among patients with gastrointestinal (GI) cancer. Methods: Patients with GI cancer seen in radiation oncology between 10/2022 and 6/2023 were surveyed with the Adult Hope Scale (AHS) questionnaire, which assesses hope based on goal-setting and goal-striving beliefs. Linear regression and Pearson's/Spearman's correlation coefficients were used to evaluate associations between AHS scores and demographic or disease variables. Results: One-hundred and forty-five (71.1% response rate) patients were included in the analysis. Most (75%) patients were symptomatic from disease, and Asian American and Pacific Islander (AAPI) patients accounted for 30.3% of our cohort. Identifying as AAPI or needing an interpreter for clinic visits was significantly associated with lower AHS scores, and more AAPI patients required interpreter assistance compared to non-AAPI patients (P=0.04). Being divorced, unemployed, or female was also linked to less hope. No other differences in hope were found. Conclusions: Sociodemographic rather than prognostic clinical factors were predictive of hope among patients with GI cancer. Interventions to contextualize psychosocial risk factors have the potential to improve quality of life and oncologic outcomes.

Trends and Disparities in Mental Health Use Among Asian American Sub-groups, 2013-2019.

OBJECTIVE: The objective of this study was to characterize and compare national estimates of mental healthcare use among White and Asian American groups to provide an update using post Affordable Care Act data. METHODS: We analyzed yearly cross-sectional data from the 2013-2019 Medical Expenditure Panel Survey, including White (n = 112,590) and Asian American (n = 10,210) individuals, and examined rates of mental healthcare use for Asian (overall), Asian Indian, Chinese, Filipino, and Other Asian individuals relative to White individuals. Using multivariable logistic regression models and predictive margin methods, we estimated overall Asian disparities and Asian subgroup disparities compared to White group rates in mental health care (outpatient, specialty, psychotropic medication) among adults with and without elevated risk for mental illness. Regression models were adjusted for variables related to need for treatment, demographic, and socioeconomic status variables. RESULTS: Asian individuals had lower rates of mental healthcare use than White individuals. Unadjusted results and adjusted regression model predictions are consistent in identifying wide disparities in mental health care treatment across risk for mental illness, Asian subgroups, and types of treatment. CONCLUSIONS: Asian Americans have significantly lower rates of mental healthcare use than White Americans, even among those with elevated risk for mental illness. There is small variation by Asian subgroups but disparities persist across subgroups and types of treatment. Our results imply interventions are needed to improve linguistically, culturally, and ethnically tailored outreach and engagement in treatment services, as well as examining treatment and its effectiveness for Asian American individuals living with psychological distress.

A Pathway to Positive Youth Development: Unpacking the Asian American Youth Paradox and Cultural Orientations among Filipino American and Korean American Youth.

This study used longitudinal survey data of Filipino American and Korean American youth in the Chicago Metropolitan area (N = 786, MAGE = 15.00, SD = 1.91 at Wave 1 in 2014) to examine whether and how a set of organized predictors (i.e., universal predictors of youth outcomes and cultural orientations) independently and collectively explains internalizing and externalizing problems and academic performance. The results were that universal predictors such as youth antisocial beliefs, peer antisocial behaviors, and the quality of parent-child relations, were extensively predictive of youth outcomes in the expected directions. The magnitudes of universal predictors were largely unchanged when bilinear and multidimensional cultural orientation variables were accounted for together. The magnitudes of cultural orientation variables were slightly attenuated in full models but showed independent associations with youth outcomes. Specifically, English and heritage language proficiencies were protective of externalizing and internalizing problems. Behavioral practices in respective cultures increased youth problems. In addition, ethnic identity, although beneficial to mental health, can increase externalizing problems. The findings of this study provide insights into understanding the mixed outcomes among Asian Americans and important empirical evidence that can inform intervention programs to prevent youth problems, ultimately toward a pathway to positive youth development among Asian American youth.

Mental health needs and barriers to service in the Chinese American community: insights gained from focus groups.

OBJECTIVES: Mental health remains an unmet need among Chinese Americans. This study aims to identify specific needs and strategies that may address the needs. DESIGN: A total of 55 Chinese Americans consented and participated in online focus groups conducted in either Chinese or English using nominal group technique. Participants discussed the following questions, achieved themes, and provided ranking of themes in importance for each: (1) In general, what do people in the Chinese American community think about mental health or emotional well-being? (2) What have you found to be helpful for accessing mental health or emotional well-being services or care in the Chinese American population? And (3) What actions would you suggest to improve mental health and emotional well-being in the Chinese American population? RESULTS: Across the focus groups, we observed high consistency of top ranked themes including lack of knowledge and awareness, negative impression, lack of Chinese-speaking providers, and that the most helpful factor toward access to care was education and increased awareness. Seminars and trainings was the top actionable suggestion. CONCLUSION: The findings are consistent with previous findings and continue to show that Chinese Americans need more education and training and that providers who can speak the language and understand the culture would be very helpful to increase access to care. This study emphasizes addressing mental health disparities in the Chinese American community through awareness, tailored interventions, and barrier removal. Promoting equal access also underscores the need for ongoing assessment and responsive strategies.

The effects of Asian American Pacific Islander (AAPI) data inequities in gynecologic oncology.

Asian American and Pacific Islanders (AAPI) are the fastest growing racial group in the United States. Data on AAPI communities, however, are significantly limited. The oversimplification and underreporting of this ethnically and socioeconomically heterogenous population through the use of aggregated data has deleterious effects and worsens disparities in patient treatment, outcomes, and experiences. Gynecologic oncology disparities do not exist in a vacuum, and are rooted in larger cultural gaps in our understanding and delivery of healthcare. In this paper, we aim to demonstrate how AAPI data inequities have negative downstream effects on research and public health policies and initiatives, and also provide a call to action with specific recommendations on how to improve AAPI data equity within these realms.