Call to drop ‘Asian’ label from health stats

A group of Otago academics has called for the designation "Asian" to be removed from health statistics as it fails to present a true impression of people’s wellbeing.

People of Asian descent made up 15% of the New Zealand population in the 2018 census.

However, clumping so many people from such a diverse range of backgrounds masked genuine health issues in several communities and risked creating inequality, an opinion piece published in the New Zealand Medical Journal today said.

"Due to the effect of averaging, this practice grossly masks subgroup differences in health indicators, risk factors and disease prevalence," it said.

"For example, the prevalence of obesity was 16% for Asians in both 2011-13 and 2019-20 ... [but] when ‘Asian’ was subdivided and ethnic-specific body mass index categories were used to define obesity, the prevalence was 57% in South Asians, 25% in Chinese and 33% in the ‘other’ Asian group."

Nutrition surveys, diabetes assessment, cancer rates and examinations of unmet need for primary health care were other examples cited where a catch-all description of "Asian" had failed to truly represent the actual health issues, the authors said.

The statistics also suggested many Asians, a large number of whom were recent migrants, had a poor understanding of how the New Zealand health system worked.

"This is compounded by cultural differences and poor English language proficiency, which in itself is a risk factor for the loss of the healthy migrant status enjoyed by new migrants.

"Hence understanding health issues using high-quality ethnicity data for Asians is imperative."

The article, co-authored by Dunedin School of Medicine senior research fellow Sherly Parackal, medical school Associate Prof Kirsten Coppell, Auckland GP Carlos Lam Yang, Dunedin School of Medicine senior lecturer Trudy Sullivan and Otago Medical School dean Rathan Subramaniam, said it was critical that ethnicity coding was reviewed to better understand Asian health needs and to properly meet them.

The use by some organisations of the designations "Indian, Chinese and other Asian" was of limited use as high rates of obesity and diabetes in at-risk Sri Lankan, Bangladeshi and Pakistani people were obscured by their being labelled "other".

There was strong evidence New Zealand was inadequately addressing Asian health through its "broad-brush" approach, the authors said.

"These high-level categories ignore the subtleties and nuances seen in different Asian cultures, which from a health perspective may under-recognise and under-address certain conditions in some groups, leading to greater harm."

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