Early in KPIX CBS news anchor Ryan Yamamoto's career, an assignment manager told him he would have a great career in broadcast journalism but that he needed to work on his "accent."

"I was thoroughly confused," Yamamoto said. "Maybe I need to enunciate more or maybe I was speaking with some kind of California 'Hey, dude' accent that I needed to drop. So I asked him, 'What do you mean, my accent?' He says, 'Well, you know — your accent. Your accent.'"

Yamamoto didn't have an accent. He and his parents don't speak Japanese. He never learned the language, yet, the implicit racial bias in his colleague's perception was revealing.

"Finally, you know, I just yelled at him and I stormed off," he said during a virtual panel discussion on May 16, titled, "What does it mean to be Asian in America?"

Convened by the Stanford Center for Asian Health Research and Education (CARE) and moderated by Yamamoto, the panel examined the challenges facing Asian Americans, gaps in medical research, the disparities that have worsened during the COVID-19 pandemic and what can be done to remedy the problems.

The panelists included Dr. Malathi Srinivasan, associate director at Stanford Center for Asian Health Research and Education; Dr. Richard Pan, a pediatrician and former California state senator and chair of the California Asian American and Pacific Islander Legislative Caucus; Neil Ruiz, associate director of race and ethnic research with the Pew Research Center; and Russell Jeung, professor of Asian American Studies at San Francisco State University and co-founder of Stop AAPI Hate.

In health and health care, underrepresentation has negatively affected Asian communities, Dr. Srinivasan said. Problems that Asians are facing with diabetes and heart disease, for example, are not recognized because of how data is aggregated and extrapolated.

Looking at individual ethnic groups within the "Asian" category, however, reveals stark and important differences. If one looks at all Asians and coronary artery disease, Asian men have about the same incidence of heart disease as non-Hispanic whites, and women have slightly less. When separating out people who are South Asian and Asian Indian, however, the risk of coronary artery disease is almost twice the risk compared to Filipinos and Vietnamese. People who are of Korean or Japanese ancestry have slightly lower risk. Korean women have very low rates of heart disease overall. The same types of things are true for diabetes.

Genetic factors, such as differences in metabolism between ethnic groups, also affects the dosage of medication for things such as cholesterol to bring down cardiovascular risk.

"If you are Chinese, Japanese or Korean, you need less of the dose to have the same effect, whereas you might need a higher dose for Asian Indians. And when people were giving a medication called Plavix, we were seeing excess bleeding with people for South Asian and more strokes and cardiovascular events like thrombosis with people who were Korean," she said.

However, she noted: "Only about 7% of National Institutes of Health funding goes toward Asian research. And that's partly because the people who make the funding decisions didn't have Asians at the table. And this is happening because of implicit bias. Who's in the room really makes a difference on what gets done," she said.

Dr. Richard Pan, a former lawmaker and practicing pediatrician, said that having data is important for lawmakers who need to show that a problem exists. But oftentimes, there is no data on Asian Americans.

A study of more than 1,000 scientific articles about health found that less than a quarter even identified Asians as a distinct race ethnicity. Of those papers that did, only about 10% reported any outcomes for Asian Americans, he said.

"So now we're talking about 2.5% of all the papers that even have any outcomes for Asian Americans and even a smaller percentage, of course, breakout subgroups (of Asians)," he said. "This is the researchers themselves not collecting the data and not reporting it. … I don't know how many conferences I have gone to and I have paper after paper, abstract after abstract presented and like, where are the Asian Americans? There's no results."

Pan has challenged the presenters who claim the numbers of Asian participants are too small.

"You know, we're actually the third largest racial ethnic group in California, so there's no excuse for anyone who's conducting research in California to not report results for Asian Americans," he said.

Pan said one problem is the underrepresentation of Asians among department chairs, deans and vice deans in academia. People in senior leadership positions often direct research and oversee institutions, he said.

Pan asserted that research that doesn't include data on Asian subjects should be rejected.

"That needs to be the new standard for reporting. Because the problem is that if we're not mentioned, if we have no results, then we cannot make change. We cannot make policy. We do not get our issues addressed. We are erased. And that is a fundamental problem."

Not a monolith

The diversity among Asian Americans was highlighted in a new study by the Pew Research Center, the largest study of Asian Americans' lived experiences that the center has done to date. It involved 264 participants in 66 focus groups, said Ruiz, who was one of the co-researchers.

While pan-ethnic labels such as "Asian" and "Asian American" are commonly used throughout the country, the survey shows that when describing themselves, just 28% use the label "Asian": 12% using it on its own and 16% using the label "Asian American."

More than half of participants — 52% — said they most often use ethnic labels that reflect their heritage, either alone or together with "American," to describe themselves, such as "Chinese" or "Chinese American," "Filipino" or "Filipino American."

About 10% of Asian adults said they use "American" on its own.

Asian adults also see more cultural differences across their group. When asked to choose between two statements — that "Asians in the U.S. share a common culture," or that "Asians in the U.S. have many different cultures" — nearly 90% said U.S. Asians have many different cultures. Just 9% said Asians living in the U.S. share a common culture.

But Asian adults also reported shared experiences. One in 5 said they have hidden a part of their heritage — ethnic food, cultural practices, ethnic clothing or religious practices — from others who are not Asian out of fear of embarrassment or discrimination.

The survey also showed that Asian Americans have identical shared American values as with non-Asian Americans.

"We know there's a myth. There's a myth out there that we're forever foreigners. Well, we have the data to show that we're no different on (shared American) values," Ruiz said.

Russell Jeung said that Asians are a racial group that feels the least sense of belonging in the U.S., even though they are just like other Americans in their beliefs and wanting to belong in America.

"Historically, we have been shaped by this stereotype that Asians are the 'yellow peril.' We're the 'dusky peril' to be avoided. This stereotype is the idea that Asians will come from the East and invade the West, and we threaten the very existence of the West," he said.

The stereotype has continued to this day with hatred and backlashes against South Asians during the war on terrorism, Islamophobia, Muslim bans and mass deportations of South Asians, Arabs and Muslims.

The pandemic only stoked that animosity, he said.

"We knew when COVID-19 was coming that Asians would get blamed for the disease. We get scapegoated and face racism, both interpersonally and in terms of policy, and that's why we created Stop AAPI Hate," he said, referring to the coalition that tracks and responds to incidents of hate, violence, harassment, discrimination, shunning and child bullying against Asian Americans and Pacific Islanders in the United States.

"Even though we're such a diverse community, we're facing similar treatment and we're facing similar discrimination," he said.

Heightened disharmony with China also has him concerned that there will be heightened racial profiling.

"If there's any conflict with China, the backlash against Chinese and those who look Chinese will be severe," he said.

Half of Asians in America feel unsafe today because of their race, Jeung said, citing a study commissioned earlier this year by The Asian American Foundation.

"That's sort of the norm; that we have a sense of fear that's shaping where we go, where we want to live, who we hang out with. And so I think racism is a pretty significant stressor on our communities," he said.