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Gee GC, Chien J, Sharif MZ, Penaia C, Tran E. East is east … or is it? Racialization of Asian, Middle Eastern, and Pacific Islander persons. Epidemiol Rev 2023; 45:93-104. [PMID: 37312559 DOI: 10.1093/epirev/mxad007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 04/28/2023] [Accepted: 06/05/2023] [Indexed: 06/15/2023] Open
Abstract
The conventional use of racial categories in health research naturalizes "race" in problematic ways that ignore how racial categories function in service of a White-dominated racial hierarchy. In many respects, racial labels are based on geographic designations. For instance, "Asians" are from Asia. Yet, this is not always a tenable proposition. For example, Afghanistan resides in South Asia, and shares a border with China and Pakistan. Yet, people from Afghanistan are not considered Asian, but Middle Eastern, by the US Census. Furthermore, people on the west side of the Island of New Guinea are considered Asian, whereas those on the eastern side are considered Pacific Islander. In this article, we discuss the complexity of the racial labels related to people originating from Oceania and Asia, and, more specifically, those groups commonly referred to as Pacific Islander, Middle Eastern, and Asian. We begin with considerations of the aggregation fallacy. Just as the ecological fallacy refers to erroneous inferences about individuals from group data, the aggregation fallacy refers to erroneous inferences about subgroups (eg, Hmong) from group data (ie, all Asian Americans), and how these inferences can contribute to stereotypes such as the "model minority." We also examine how group averages can be influenced merely by the composition of the subgroups, and how these, in turn, can be influenced by social policies. We provide a historical overview of some of the issues facing Pacific Islander, Middle Eastern, and Asian communities, and conclude with directions for future research.
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Affiliation(s)
- Gilbert C Gee
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA 90025, United States
| | - Jessie Chien
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA 90025, United States
| | - Mienah Z Sharif
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA 98195, United States
- Center for the Study of Racism, Social Justice and Health, University of California at Los Angeles, Los Angeles, CA 90025, United States
| | - Corina Penaia
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA 90025, United States
| | - Emma Tran
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA 90025, United States
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Hawley NL, Pomer A, Rivara AC, Rosenthal SL, Duckham RL, Carlson JC, Naseri T, Reupena MS, Selu M, Lupematisila V, Unasa F, Vesi L, Fatu T, Unasa S, Faasalele-Savusa K, Wetzel AI, Soti-Ulberg C, Prescott AT, Siufaga G, Penaia C, To SB, LaMonica LC, Lameko V, Choy CC, Crouter SE, Redline S, Deka R, Kershaw EE, Urban Z, Minster RL, Weeks DE, McGarvey ST. Exploring the Paradoxical Relationship of a Creb 3 Regulatory Factor Missense Variant With Body Mass Index and Diabetes Among Samoans: Protocol for the Soifua Manuia (Good Health) Observational Cohort Study. JMIR Res Protoc 2020; 9:e17329. [PMID: 32706746 PMCID: PMC7413272 DOI: 10.2196/17329] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/24/2020] [Accepted: 03/02/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The prevalence of obesity and diabetes in Samoa, like many other Pacific Island nations, has reached epidemic proportions. Although the etiology of these conditions can be largely attributed to the rapidly changing economic and nutritional environment, a recently identified genetic variant, rs373863828 (CREB 3 regulatory factor, CREBRF: c.1370G>A p.[R457Q]) is associated with increased odds of obesity, but paradoxically, decreased odds of diabetes. OBJECTIVE The overarching goal of the Soifua Manuia (Good Health) study was to precisely characterize the association of the CREBRF variant with metabolic (body composition and glucose homeostasis) and behavioral traits (dietary intake, physical activity, sleep, and weight control behaviors) that influence energy homeostasis in 500 adults. METHODS A cohort of adult Samoans who participated in a genome-wide association study of adiposity in Samoa in 2010 was followed up, based on the presence or absence of the CREBRF variant, between August 2017 and March 2019. Over a period of 7-10 days, each participant completed the main study protocol, which consisted of anthropometric measurements (weight, height, circumferences, and skinfolds), body composition assessment (bioelectrical impedance and dual-energy x-ray absorptiometry), point-of-care glycated hemoglobin measurement, a fasting blood draw and oral glucose tolerance test, urine collection, blood pressure measurement, hand grip strength measurement, objective physical activity and sleep apnea monitoring, and questionnaire measures (eg, health interview, cigarette and alcohol use, food frequency questionnaire, socioeconomic position, stress, social support, food and water insecurity, sleep, body image, and dietary preferences). In January 2019, a subsample of the study participants (n=118) completed a buttock fat biopsy procedure to collect subcutaneous adipose tissue samples. RESULTS Enrollment of 519 participants was completed in March 2019. Data analyses are ongoing, with results expected in 2020 and 2021. CONCLUSIONS While the genetic variant rs373863828, in CREBRF, has the largest known effect size of any identified common obesity gene, very little is currently understood about the mechanisms by which it confers increased odds of obesity but paradoxically lowered odds of type 2 diabetes. The results of this study will provide insights into how the gene functions on a whole-body level, which could provide novel targets to prevent or treat obesity, diabetes, and associated metabolic disorders. This study represents the human arm of a comprehensive and integrated approach involving humans as well as preclinical models that will provide novel insights into metabolic disease. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/17329.
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Affiliation(s)
- Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States
| | - Alysa Pomer
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States
| | - Anna C Rivara
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States
| | - Samantha L Rosenthal
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Rachel L Duckham
- Institute of Physical Activity and Nutrition, Deakin University, Geelong, Australia
- Australian Institute for Musculoskeletal Sciences, The University of Melbourne and Western Health, St Albans, Australia
| | - Jenna C Carlson
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | | | | | - Melania Selu
- Obesity, Lifestyle and Genetic Adaptations Study Group, Apia, Samoa
| | | | - Folla Unasa
- Obesity, Lifestyle and Genetic Adaptations Study Group, Apia, Samoa
| | - Lupesina Vesi
- Obesity, Lifestyle and Genetic Adaptations Study Group, Apia, Samoa
| | - Tracy Fatu
- Obesity, Lifestyle and Genetic Adaptations Study Group, Apia, Samoa
| | - Seipepa Unasa
- Obesity, Lifestyle and Genetic Adaptations Study Group, Apia, Samoa
| | | | - Abigail I Wetzel
- International Health Institute, Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States
| | | | - Angela T Prescott
- Department of Plastic and Reconstructive Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Gloria Siufaga
- Obesity, Lifestyle and Genetic Adaptations Study Group, Apia, Samoa
| | - Corina Penaia
- Asian Pacific Islander Forward Movement, Los Angeles, CA, United States
| | - Sophie B To
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Lauren C LaMonica
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States
| | | | - Courtney C Choy
- International Health Institute, Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States
| | - Scott E Crouter
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee Knoxville, Knoxville, TN, United States
| | - Susan Redline
- Departments of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Ranjan Deka
- Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Erin E Kershaw
- Division of Endocrinology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Zsolt Urban
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ryan L Minster
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Daniel E Weeks
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Stephen T McGarvey
- International Health Institute, Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States
- Department of Anthropology, Brown University, Providence, RI, United States
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