Data Disaggregation in Action: Filipino Americans Who Do Not Identify As Asian

Journal of Racial and Ethnic Health Disparities https://doi.org/10.1007/s40615-025-02398-6 Data Disaggregation in Action: Filipino Americans Who Do Not Identify As Asian Riti Shimkhada1 · Andrew Juhnke1 · Ninez A. Ponce1,2 Received: 23 December 2024 / Revised: 6 March 2025 / Accepted: 14 March 2025 © The Author(s) 2025 Abstract Background The U.S. Office of Management and Budget (OMB) categorizes Filipino Americans as Asian; however, many may not identify as such, opting instead for “other” or Pacific Islander (PI). This study examines the extent to which Filipino Americans select PI or “other” rather than Asian, using a large population-based survey of Californians. Methods We analyzed data from the 2019, 2020, and 2021 California Health Interview Survey (CHIS), the largest state health survey in the U.S. that includes write-in prompts for detailed race and ethnicity data. The focus was on participants who identified as Pacific Islanders and wrote in 'Filipino,' those who selected 'Asian' and specified 'Filipino,' and respondents who chose 'other' and wrote in 'Filipino.' Results Our analysis included 1,859 Filipino respondents, revealing that 8.8% identified as Pacific Islander, 85.2% as Asian, and 6.1% as "other." Those identifying as PI were more likely to also identify as Latino/Hispanic, be older, and possess U.S. citizenship compared to those identifying as Asian. Discussion Disaggregating Filipino Americans from the broader Asian category in surveys is vital for accurately identifying the community's unique needs. We recommend incorporating open-ended write-in prompts in surveys that ask respondents to first identify their broader race category (e.g. Asian). These prompts help identify and reclassify Filipino respondents who may have identified as PI. Such prompts are also important for other racial/ethnic communities who may be uncertain about how to categorize themselves. Ongoing, dynamic community-driven research is essential for understanding identities and effectively categorizing Filipino Americans and other communities. Keywords Filipino Americans · Race/Ethnicity · Data disaggregation · Asian American · Native Hawaiian and Pacific Islander · Population health surveys Introduction Filipino Americans have long been referred to as the “forgotten Asian Americans” [1] yet they are the third largest group of Asian Americans in the U.S., with a population size of about 4.4 million [2]. Despite this large presence and their distinct community needs, Filipino Americans have received limited, albeit growing, empirical attention in population health research [3, 4]. Disaggregating Filipinos as a distinct * Riti Shimkhada 1 Center for Health Policy Research, University of California, Los Angeles, Los Angeles, CA, USA 2 Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA category in health research is important as the aggregate Asian American category often masks significant disparities within the group [5]. Studies have shown that Filipinos experience higher rates of obesity, hypertension, diabetes, and other chronic conditions compared to non-Hispanic Whites and many other Asian subgroups [3, 6, 7]. Language barriers also impact healthcare access, as nearly 30% of Filipino Americans speak English less than "very well" and may require language assistance, yet they often underutilize interpreter services due to stigma or lack of awareness; further, cultural factors influence patient-provider communication, and professional medical interpreters report challenges in ensuring appropriate care for Filipino patients in the U.S. [8]. Filipinos also face occupational risks, particularly as a large segment of the U.S. healthcare workforce [9]. In 2020 Filipino Americans were thrust to newspaper headlines with reports on the toll of COVID-19 on Filipino Vol.:(0123456789) Journal of Racial and Ethnic Health Disparities American nurses and the larger community. The California Department of Public Health found that at the onset of the pandemic Filipino Americans accounted for at least 35% of the COVID-19 deaths among Asian American. However, they posit this estimate likely did not capture the full picture since “some Filipinos may have self-identified as Pacific Islander rather than Asian” [10]. The inclusion of Filipinos in the PI category, which tends to have small sample sizes in most population surveys, further has the potential to significantly change estimates for the PI group [11, 12]. Filipino Americans are at the perimeter between two race categories: Asian and Pacific Islanders (PI). Under the U.S. Office of Management and Budget’s (OMB) Statistical Policy Directive Number 15 (SPD 15), Filipinos are categorized as Asian [13]. Filipinos have a long history of being part of the Asian American advocacy movement in the U.S. since the 1960s [14]. But, Filipinos also share a similar colonial past with Pacific Islanders who went through similar cultural re-education that required them to speak English, change their indigenous names, and to pledge allegiance to the U.S. [15]. Given shared geography and history, it is not surprising that Filipinos might identify as PI [16]. This has important implications since accurate demographic data is crucial for policy-making, resource allocation, and addressing the needs of specific communities [14, 17, 18]. Most federal and state level surveys and data systems ask individuals to identify their race in a sequential question order wherein they are first asked to identify the aggregate race group before asking individuals to mark their disaggregated detailed race group. If a Filipino person marks PI or “Other” instead of Asian, the only way to identify that they are Filipino is if the person writes in their detailed group in an open-ended prompt. Most surveys do not have the ability to identify the degree to which Filipinos identify as PI instead of Asian because they do not offer this write-in or specify option. Open-ended questions have served as effective follow-ups to closed-ended questions and have been used in the U.S. Census survey questions on race [19]. The California Health Interview Survey (CHIS) uses the write-in option in their surveys thus allowing us to identify Filipino respondents who mark PI as their race. Using 2019–2021 CHIS data, we present here the demographics of these respondents who identify as PI as well as those who identify as Asian, and “Other”. The purpose of this study is to examine the race and ethnicity reporting behavior of Filipinos in CHIS to understand the degree to which they navigate what can be seen as an ambiguous boundary between the Asian and PI racial categories, shedding light on how racial identity is expressed in survey data and its implications for health research and policy. Methods We examined data from adults in the 2019, 2020, and 2021 California Health Interview Survey (CHIS) rounds. CHIS (...truncated)