May is Asian American and Pacific Islander (AAPI) Heritage Month, when we take time to recognize and celebrate the societal contributions of individuals with Asian and Pacific Islander ancestry. This is also a time for raising awareness of important issues facing AAPI communities, such as their lack of representation in health-related research. For Umesh Venkatesan, PhD, Institute Faculty at Jefferson Moss Rehabilitation Research Institute, and his colleagues in the Traumatic Brain Injury (TBI) Model Systems, representation of AAPIs in TBI research has been a key focus of their recent work.
TBI-related health disparities exist across the entire continuum of care, from acute injury care to long-term recovery.1 Although much of the disparity literature has focused on Black, Hispanic, and Native American populations, the limited research on AAPIs suggests that this group may also experience special challenges to functional and psychosocial recovery after TBI.2,3
In three recent articles, a team of researchers including Dr. Venkatesan examined psychosocial outcomes—including life satisfaction, anxiety, and depression and suicidality—of AAPIs enrolled in the TBI Model Systems. Focusing exclusively on these individuals enabled the researchers to examine the factors that contribute to better or poorer outcome within the AAPI group, information that is often lost when comparing the group to other races/ethnicities. In addition, outcomes were characterized over the 10-year period following injury, allowing researchers to characterize long-term recovery trends among AAPIs.
In an article in the journal, Rehabilitation Psychology,4 the study team reported that life satisfaction among AAPI participants remained stable over time, with higher levels observed in those who were married, more educated, employed at the time of injury, had lower income, and had no prior mental health treatment.
In a subsequent article published in NeuroRehabilitation,5 the researchers noted that anxiety symptoms affected about 11–13% of AAPI participants and followed a stable, low-level trajectory over 10 years. Higher anxiety was linked to lower education and a history of mental health treatment.
The most recent study from this group (appearing in an upcoming issue of the Journal of Head Trauma Rehabilitation) found that depression symptoms among AAPI participants ranged from 10–21% and also remained stable over time. Higher levels of depression were linked to lower education, prior mental health treatment, and violent injury. Suicidal thoughts remained stable as well, with higher levels among unmarried, employed individuals and those with a history of suicide attempts. Overall, higher depression was strongly associated with increased suicidal thoughts both over time and across individuals.
Findings from this series of articles indicate that there is substantial variability in psychosocial functioning among AAPI individuals as a function of sociodemographic and behavioral factors (e.g., education level, mental health treatment history, and marital status). Although the risk factors identified here are similar to those described in other racial/ethnic groups, addressing them in AAPIs may require unique cultural considerations.
The AAPI label encompasses people from more than 50 ethnic groups, spanning East Asia, Southeast Asia, South Asia, and the Pacific Islands. These populations differ widely in language, migration history, socioeconomic status, cultural practices, and health profiles. Yet in many datasets, including the TBI Model Systems, they are combined into a single category. Aggregating data across a diverse group like AAPIs could fail to capture significant psychosocial problems experienced by some subgroups. Additionally, the variability in outcomes observed among AAPIs suggests that interventions may need to be tailored to meet the needs of specific AAPI communities. For example, individuals from distinct AAPI subgroups could experience different barriers to seeking mental treatment.6 Therefore, the research team’s work underscores the importance of interventions that consider each person’s health beliefs, attitudes, practices, and preferences that may vary according to the specific AAPI community to which they belong.
TBI research has made important strides in identifying health disparities, but significant gaps remain, especially for AAPI populations. The recent research from the TBI Model Systems highlights: 1) the importance of ensuring that AAPIs are well-represented in TBI research, and 2) the need to move away from grouping all AAPI individuals together as a homogenous population. Investing in subgroup-specific AAPI research will allow TBI researchers to identify hidden disparities, rehabilitation clinicians to provide culturally responsive care, and policymakers to allocate resources more effectively. As the AAPI population continues to grow in the United States, the urgency of this work will only increase.
References
1. Saadi, Altaf et al. “Racial and Ethnic Disparities Associated with Traumatic Brain Injury Across the Continuum of Care: a Narrative Review and Directions for Future Research.” Journal of racial and ethnic health disparities vol. 9,3 (2022): 786-799. doi:10.1007/s40615-021-01017-4
2. Kuerban, Aliya, and Kristen Dams-O'Connor. “Effect of Race and Nativity on Functional Outcomes Following Traumatic Brain Injury Among Asian, Hispanic, and Non-Hispanic White Survivors in the United States: A NIDILRR TBI Model Systems Study.” The Journal of head trauma rehabilitation vol. 37,5 (2022): E310-E318. doi:10.1097/HTR.0000000000000736
3. Perrin, Paul B et al. “Racial/ethnic disparities in mental health over the first 2 years after traumatic brain injury: a model systems study.” Archives of physical medicine and rehabilitation vol. 95,12 (2014): 2288-95. doi:10.1016/j.apmr.2014.07.409
4. Chapman, Olivia et al. “Life satisfaction trajectories over the 10 years post-TBI among Asian Americans and Pacific Islanders: A model systems study.” Rehabilitation psychology, 10.1037/rep0000653. 2 Mar. 2026, doi:10.1037/rep0000653
5. Malhotra, Bani et al. “Predictors of Anxiety Symptoms Over the 10 Years After TBI in Asian Americans/Pacific Islanders: A Model System Study.” NeuroRehabilitation, 10538135261439933. 9 Apr. 2026, doi:10.1177/10538135261439933
6. Kim, Sophia Bohun, and Yeonjung Jane Lee. “Factors Associated with Mental Health Help-Seeking Among Asian Americans: a Systematic Review.” Journal of racial and ethnic health disparities vol. 9,4 (2022): 1276-1297. doi:10.1007/s40615-021-01068-7