For as long as I could remember, standardized examination days were often fraught with
confusion, but not for the reason one would readily assume. These statewide examinations
certainly posed some difficulties, however, there was one question that flustered me more than
any: “Which of the following ethnic categories best describes you?” My middle school eyes
scanned the options, hoping Middle Eastern or Arab would appear. I ultimately settled for
Asian—after all, I remember my father telling me that our home country of Palestine was on the
continent of Asia. As I continued my journey within the NYC Public School system, I realized
that I had been incorrectly responding to this question time and time again. The U.S. Census
Bureau defines White as a person having origins in any of the original peoples of Europe, the
Middle East, or North Africa. Although I was merely in my teenage years, my lived experiences
up until this point had varied greatly from the traditional view I had of the “White” experience in
Despite having developed a social science outlook throughout my high school and undergraduate
education, I failed to see the health implications of faulty and poorly aggregated ethnic
categories on Arab American and North African populations, until I attended a lecture by Dr.
Nadia Abuelezam. She discussed how health disparities are widened when Arab Americans are
not accurately represented in the health data. In Pennsylvania, for example, there exists a
considerable discrepancy between estimates put forth by the Census Bureau and those from the
Arab American Institute—84,472 and 182,610, respectively. 1 As a result of inaccurate
classifications, funds for initiatives that aim to ameliorate the pressing health needs of an already
marginalized population are poorly allocated. During the COVID-19 pandemic, Arab American
communities that have been struck the hardest failed to receive adequate resources to mitigate
the spread of this virus. Above all, the prevailing health needs and issues that stem from the
unique Arab American experience have not been accurately described.
Under the intersection of post-9/11 xenophobia and lack of social support systems, Arab
Americans are poised to experience significant health barriers in their pursuit of health equity. 2
Additionally, Arab Americans make up a considerable percentage of individuals who have
immigrated to the United States in recent years as a result of political instability in the Middle
East. The COVID-19 pandemic has accentuated many health disparities that plague ethnic
minority groups such as the Hispanic/Latino and African American communities. 3,4 However, its
impact on Arab Americans remains opaque. The risk factors disproportionately experienced by
this community, such as increased rates of living in multigenerational households and
burdensome chronic diseases, lead one to reasonably conclude that the pandemic has had a
notable impact on this demographic. 2,5
As a result of this misclassification, the responsibility of combatting the dearth of knowledge that
exists surrounding Arab American health needs, behaviors, and outcomes has often fallen on
community-based organizations and public health researchers who have taken personal initiative
to enrich our collective understanding. The Advancing Arab American Health Network Alliance
(AAHNA) initiative led by Dr. Abuelezam stands as a quintessential example of the grassroots
structure that is indispensable to engaging the Arab American population in health research.
Through collaborations with patients, providers, and community organizations (e.g., Arab-
American Family Support Center), this project aims to empower Arab Americans with a
platform to lead their own narratives and set the direction for the dynamic and nascent field of
Arab American research. Through interviews with community members, we gain a better
understanding of what underlies vaccine hesitancy. By conducting local community health needs
assessments, public health officials are better equipped to tailor interventions previously used for
marginalized populations to surmount the unique challenges that come with the Arab American
One cannot help but feel a sense of hopelessness when the movement to include Middle Eastern
or North African as a distinct ethnic category faces constant pushback from institutions that
adhere to the U.S. Office of Management’s outdated recommendations. However, small
successes, such as the recent American Medical Association endorsement of a distinct
demographic category, need to be celebrated to ensure that this momentum is sustained and
expanded to all enclaves across the country, including Northeastern Pennsylvania. I have found it
increasingly difficult to connect with the local Arab American community since my move to
Pennsylvania and I attribute this to the fragmentation brought about by current ethnic categories.
I believe that it is our responsibility as future healthcare providers and leaders of Pennsylvania to
identify institutional shortcomings in data collection and demography, understand the
downstream effects of such in our communities, and advocate on a local and national level to
shape a better future.
1. Nasr F. Pennsylvania. Yalla Count Me In! https://yallacountmein.org/states/pennsylvania.
Published April 7, 2020.
2. El-Sayed AM, Galea S. The health of Arab-Americans living in the United States: a
systematic review of the literature. BMC Public Health. 2009;9(1):272. https:// doi. org/
10. 1186/1471- 2458-9- 272.
3. Pew Research Center, July, 2021, “For U.S. Latinos, COVID-19 Has Taken a Personal
and Financial Toll”
4. Vasquez Reyes M. The Disproportional Impact of COVID-19 on African
Americans. Health Hum Rights. 2020;22(2):299-307.
5. United States Census Bureau. Arab households in the United States, 2006‒2010.
www.2.census. gov/library/publications/2013/acs/acsbr 10- 20.pdf. Published May 2013.