To Uncover Disparities, Collect and Disaggregate Self-Identification Data for Middle Eastern and North African Americans

Middle Eastern and North African (MENA) Americans are largely invisible in federal data and surveys, as they usually lack a distinct category for self-identification.1 This data gap obscures whether MENA Americans experience adverse life circumstances more than other groups.2 We argue that researchers should immediately begin designing research instruments that offer a MENA category for self-identification in race/ethnicity questions and should analyze the significant heterogeneity in MENA populations. Because of the lack of self-reported race/ethnicity data, researchers have used creative methods to identify likely MENA Americans and explore possible health disparities.3,4 In this issue of AJPH, Kindratt and Smith (p. 1265) use the ancestry and country of birth measures in the American Community Survey (ACS) to identify MENA adults and compare their odds of cognitive difficulties with those of self-identified White, Black, Hispanic/Latino, Asian, American Indian or Alaska Native, and Native Hawaiian/other Pacific Islander adults aged 45 years and older. Self-identification is the most common measure for studying demographic changes, vital statistics, and disease rates.9 Self-reported race/ ethnicity respects individuals' perceptions of their identity and would enable researchers to compare health indicators of self-identified MENA Americans with those of other ethnoracial groups, resulting in more comparable and standardized estimates. To highlight the substantial heterogeneity among MENA Americans, Figure 1 illustrates differences in health insurance coverage and college degree attainment-critical factors that can influence health outcomes-across various MENA ancestry groups.