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Peer-reviewed

Research Article

Measures of empathy and compassion: A scoping review

Contributed equally to this work with: Cassandra Vieten, Caryn Kseniya Rubanovich, Lora Khatib, Meredith Sprengel, Chloé Tanega

Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliations Centers for Integrative Health, Department of Family Medicine, University of California, San Diego, San Diego, California, United States of America, Clarke Center for Human Imagination, School of Physical Sciences, University of California, San Diego, San Diego, California, United States of America

Roles Data curation, Formal analysis, Investigation, Methodology, Writing – original draft, Writing – review & editing

Affiliations Department of Psychiatry, University of California, San Diego, San Diego, California, United States of America, San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, San Diego, California, United States of America, T. Denny Sanford Institute for Empathy and Compassion, University of California, San Diego, San Diego, California, United States of America, T. Denny Sanford Center for Empathy and Technology, University of California, San Diego, San Diego, California, United States of America

Roles Conceptualization, Data curation, Formal analysis, Investigation, Visualization, Writing – review & editing

Affiliation Department of Psychiatry, University of California, San Diego, San Diego, California, United States of America

Roles Data curation, Investigation, Methodology, Project administration, Software, Writing – review & editing

Affiliation Human Factors, Netherlands Organisation for Applied Scientific Research (TNO), Soesterberg, The Netherlands

Roles Data curation, Formal analysis, Investigation, Project administration, Validation, Visualization, Writing – review & editing

Affiliation Clarke Center for Human Imagination, School of Physical Sciences, University of California, San Diego, San Diego, California, United States of America

Roles Data curation, Investigation, Validation, Writing – review & editing

¶ ‡ CP, PV, AM, GC, AJL, MTS, LE and CB also contributed equally to this work.

Affiliations U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, Massachusetts, United States of America, Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, United States of America

Affiliation Compassion Clinic, San Diego, California, United States of America

Roles Writing – review & editing

Affiliations Department of Psychiatry, University of California, San Diego, San Diego, California, United States of America, VA San Diego Center of Excellence for Stress and Mental Health, San Diego, California, United States of America

Affiliation VA San Diego Center of Excellence for Stress and Mental Health, San Diego, California, United States of America

Roles Conceptualization, Writing – review & editing

Affiliations Department of Psychiatry, University of California, San Diego, San Diego, California, United States of America, VA San Diego Center of Excellence for Stress and Mental Health, San Diego, California, United States of America, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, California, United States of America

Affiliation Departments of Family Medicine and Medicine (Bioinformatics), School of Medicine, University of California, San Diego, San Diego, California, United States of America

Affiliations Department of Psychiatry, University of California, San Diego, San Diego, California, United States of America, T. Denny Sanford Institute for Empathy and Compassion, University of California, San Diego, San Diego, California, United States of America, T. Denny Sanford Center for Empathy and Compassion Training in Medical Education, University of California, San Diego, San Diego, California, United States of America

Affiliations Department of Psychiatry, University of California, San Diego, San Diego, California, United States of America, T. Denny Sanford Institute for Empathy and Compassion, University of California, San Diego, San Diego, California, United States of America, T. Denny Sanford Center for Empathy and Technology, University of California, San Diego, San Diego, California, United States of America, T. Denny Sanford Center for Empathy and Compassion Training in Medical Education, University of California, San Diego, San Diego, California, United States of America

• Cassandra Vieten, 
• Caryn Kseniya Rubanovich, 
• Lora Khatib, 
• Meredith Sprengel, 
• Chloé Tanega, 
• Craig Polizzi, 
• Pantea Vahidi, 
• Anne Malaktaris, 
• Gage Chu, 

• Published: January 19, 2024
• https://doi.org/10.1371/journal.pone.0297099
• Reader Comments

Evidence to date indicates that compassion and empathy are health-enhancing qualities. Research points to interventions and practices involving compassion and empathy being beneficial, as well as being salient outcomes of contemplative practices such as mindfulness. Advancing the science of compassion and empathy requires that we select measures best suited to evaluating effectiveness of training and answering research questions. The objective of this scoping review was to 1) determine what instruments are currently available for measuring empathy and compassion, 2) assess how and to what extent they have been validated, and 3) provide an online tool to assist researchers and program evaluators in selecting appropriate measures for their settings and populations. A scoping review and broad evidence map were employed to systematically search and present an overview of the large and diverse body of literature pertaining to measuring compassion and empathy. A search string yielded 19,446 articles, and screening resulted in 559 measure development or validation articles reporting on 503 measures focusing on or containing subscales designed to measure empathy and/or compassion. For each measure, we identified the type of measure, construct being measured, in what context or population it was validated, response set, sample items, and how many different types of psychometrics had been assessed for that measure. We provide tables summarizing these data, as well as an open-source online interactive data visualization allowing viewers to search for measures of empathy and compassion, review their basic qualities, and access original citations containing more detail. Finally, we provide a rubric to help readers determine which measure(s) might best fit their context.

Citation: Vieten C, Rubanovich CK, Khatib L, Sprengel M, Tanega C, Polizzi C, et al. (2024) Measures of empathy and compassion: A scoping review. PLoS ONE 19(1): e0297099. https://doi.org/10.1371/journal.pone.0297099

Editor: Ipek Gonullu, Ankara University Faculty of Medicine: Ankara Universitesi Tip Fakultesi, TURKEY

Received: July 5, 2023; Accepted: December 21, 2023; Published: January 19, 2024

Copyright: © 2024 Vieten et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: CV received a grant from the T. Denny Sanford Institute for Empathy and Compassion at https://empathyandcompassion.ucsd.edu/ . Co-authors included faculty members affiliated with the T. Denny Sanford Institute who were involved in study design and reviewing/editing the manuscript. Other than that, the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Historically, psychological assessment has overwhelmingly focused on measuring human struggles, difficulties, and pathologies. However, converging evidence indicates that positive emotions and prosocial qualities are just as important for improving overall well-being as stress, depression, and anxiety are to detracting from health and well-being [ 1 ]. Across fields—from medicine, mental health care, and education to economics, business and organizational development—there is a growing emphasis on investigating prosocial constructs such as compassion and empathy [ 2 ].

Compassion, or the heartfelt wish to reduce the suffering of self and others, promotes social connection and is an important predictor of overall quality of life [ 2 ] and well-being [ 3 ]. Empathy, or understanding and vicariously sharing other people’s positive emotions, is related to prosocial behaviors (e.g., helping, giving, emotional support), positive affect, quality of life, closeness, trust, and relationship satisfaction [ 4 ]. Compassion and empathy improve parenting [ 5 ], classroom environments [ 6 ], and teacher well-being [ 7 ]. Compassionate love toward self and others is associated with disease outcomes as well, such as increased long-term survival rates in patients with HIV [ 8 ]. Self-compassion refers to being gentle, supportive, and understanding toward ourselves in instances of perceived failure, inadequacy, or personal suffering [ 9 ]. Research indicates that self-compassion appears to reduce anxiety, depression, and rumination [ 10 ], and increase psychological well-being and connections with others [ 11 , 12 ]. Both compassion and self-compassion appear to protect against stress [ 13 ] and anxiety [ 10 ].

In healthcare professionals, empathy is associated with patient satisfaction, diagnostic accuracy, adherence to treatment recommendations, clinical outcomes, clinical competence, and physician retention [ 14 – 16 ]. Importantly, it is also linked to reduced burnout, medical errors, and malpractice claims [ 17 ]. However, evidence indicates that empathy declines during medical training and residency [ 18 – 20 ]. This may present an opportunity to improve many aspects of healthcare by identifying ways to maintain or enhance empathy during medical training. It is also important to note that while empathy is beneficial for patients, the effects on healthcare professionals are more complicated. A distinction can be drawn between positive empathy and/or compassion versus over-empathizing , which can lead to what has been termed “compassion fatigue” and/or burnout.

Disentangling these relationships through scientific investigation requires selecting measures and instruments capable of capturing these nuances. In addition, growing evidence that empathy and compassion can be improved through training [ 21 , 22 ] relies on selection or development of measures that can assess the effectiveness of such training. While empathy and compassion training for healthcare professionals has shown positive outcomes, it still requires improvement. For example, in a recent systematic review, only 9 of 23 empathy education studies in undergraduate nursing samples demonstrated practical improvements in empathy [ 23 ]. Another systematic review of 103 compassion interventions in the healthcare context [ 24 ] identified a number of limitations such as focusing on only a single domain of compassion; inadequately defining compassion; assessing the constructs exclusively by self-report; and not evaluating retention, sustainability, and translation to clinical practice over time: all related to how compassion and empathy are conceptualized and measured. The researchers recommend that such interventions should “be grounded in an empirically-based definition of compassion; use a competency-based approach; employ multimodal teaching methods that address the requisite attitudes, skills, behaviors, and knowledge within the multiple domains of compassion; evaluate learning over time; and incorporate patient, preceptor, and peer evaluations” (p. 1057). Improving conceptualization and measurement of compassion and empathy are crucial to advancing effective training.

Conceptualizing compassion and empathy

Compassion and empathy are complex constructs, and therefore challenging to operationalize and measure. Definitions of compassion and empathy vary, and while they are often used interchangeably, they are distinct constructs [ 25 ]. Like many other constructs, both compassion and empathy can be conceptualized at state and/or trait levels: people can have context-dependent experiences of empathy or compassion (i.e., state), or can have a general tendency to be empathic or compassionate (i.e., trait). The constructs of empathy and compassion each have multiple dimensions: affective, cognitive, behavioral, intentional, motivational, spiritual, moral and others. In addition to their multidimensionality, compassion and empathy are crowded by multiple adjacent constructs with which they overlap to varying degrees, such as kindness, caring, concern, sensitivity, respect, and a host of behaviors such as listening, accurately responding, patience, and so on.

Strauss et al. [ 26 ] conducted a systematic review of measures of compassion, and by combining the definitions of compassion among the few existing instruments at the time, proposed five elements of compassion: recognizing suffering, understanding the universality of human suffering, feeling for the person suffering, tolerating uncomfortable feelings, and motivation to act/acting to alleviate suffering. Gilbert [ 27 ] proposed that compassion consists of six attributes: sensitivity, sympathy, empathy, motivation/caring, distress tolerance, and non-judgement.

Likewise, empathy has been conceptualized as having at least four elements (as measured by the Interpersonal Reactivity Index [ 28 ] for example): perspective-taking (i.e., taking the point of view of others), fantasy (i.e., imagining or transposing oneself into the feelings and actions of others), empathic concern (i.e., accessing other-oriented feelings of sympathy or concern) and personal distress (i.e., or unease in intense interpersonal interactions). Early work by Wiseman [ 29 ] used a concept analysis approach identifying four key domains of empathy: seeing the world the way others see it, understanding their feelings, being non-judgmental, and communicating or expressing that understanding. Other conceptualizations of empathy [ 30 ] include subdomains of affective reactivity (i.e., being emotionally affected by others), affective ability (i.e., others tell me I’m good at understanding them), affective drive (i.e., I try to consider the other person’s feelings), cognitive drive (i.e., trying to understand or imagine how someone else feels), cognitive ability (i.e., I’m good at putting myself in another person’s shoes), and social perspective taking. De Waal and Preston [ 31 ] propose a “Russian doll” model of empathy, in which evolutionary advances in empathy layer one on top of the next, resulting in their definition of empathy as “emotional and mental sensitivity to another’s state, from being affected by and sharing in this state to assessing the reasons for it and adopting the other’s point of view” (p. 499).

Compassion is conceptualized as generally positive, and “more is better” in terms of health and well-being. Empathy on the other hand can lead to positive outcomes such as empathic concern, compassion, and prosocial motivations and behaviors, whereas unregulated empathic distress can be aversive, decrease helping behaviors, and lead to burnout [ 32 ]. Compassion and empathy also appear to differ in underlying brain structure [ 33 ] as well as brain function [ 34 ]. Terms such as “compassion fatigue” are more accurately characterized as empathy fatigue, and some evidence indicates that compassion can actually counteract negative aspects of empathy [ 35 ].

When assessing compassion and empathy, it is often important to measure their opposites, or constructs that present barriers to experiencing and expressing compassion or empathy. Personal distress, for example, can be confused for empathy but in fact is a “self-focused, aversive affective reaction” to encountering another person’s suffering, accompanied by the desire to “alleviate one’s own, but not the other’s distress” [ 36 , p.72]. Personal distress is viewed as a barrier to true compassion, and experienced chronically, is associated with burnout (i.e. exhaustion, cynicism, and inefficacy due to feeling frenetic/overloaded, underchallenged/indifferent, or worn-out/neglected [ 37 ]).

Other constructs that have been measured as barriers to compassion include lack of empathy or empathy impairment, apathy, coldness, judgmental attitudes toward specific populations or conditions, and fear of compassion. In sum, compassion and empathy are not so much singular constructs as multi-faceted collections of cognitions, affects, motivations and behaviors. When researchers or program evaluators consider the best ways to assess empathy and compassion, they must often attend to measuring these constructs as well.

Past systematic reviews focused on measurement of empathy and compassion sought to (1) review definitions [ 26 , 38 ]; (2) evaluate measurement methods [ 39 ]; (3) assess psychometric properties [ 40 ]; (4) provide quality ratings [ 26 , 41 , 42 ]; and/or (5) recommend gold standard measures [ 26 , 43 ]. To our knowledge, this review is the first scoping review focused on capturing the wide array of instruments measuring empathy, compassion, and adjacent constructs.

We conducted a scoping review and broad evidence map (as opposed to a systematic review or meta-analysis) for several reasons. Whereas systematic reviews attempt to collate empirical evidence from a relatively smaller number of studies pertaining to a focused research question, scoping reviews are designed to employ a systematic search and article identification method to answer broader questions about a field of study. As such, this scoping review provides a large and diverse map of the available measures across this family of constructs and measurement methodology, with the primary goal of aiding researchers and program evaluators in selecting measures appropriate for their setting.

Another unique feature of this scoping review is a data visualization that we have developed to help readers navigate the findings. This interactive tool is called the Compassion and Empathy Measures Interactive Data Visualization (CEM-IDV) ( https://imagination.ucsd.edu/compassionmeasures/ ).

The aims of this scoping review were achieved, including 1) identifying existing measures of empathy and compassion, 2) providing an overview of the evidence for validity of these measures, and 3) providing an online tool to assist researchers and program evaluators in searching for and selecting the most appropriate instruments to evaluate empathy, compassion, and/or adjacent constructs, based on their specific context, setting, or population.

The objective of this project was to capture all peer-reviewed published research articles that were focused on developing, or assessing the psychometric properties of, instruments measuring compassion and empathy and overlapping constructs, such as self-compassion, theory of mind, perspective taking, vicarious pain, caring, the doctor-patient relationship, emotional cues, sympathy, tenderness and emotional intelligence. We included only articles that were specifically focused on measure development or validation, and therefore did not include articles that may have developed idiosyncratic ways of assessing compassion or empathy in service to conducting experiments. We included self-report assessments, observational ratings or behavioral coding schemes, and tasks. This review was conducted according to the PRISMA statement for scoping reviews [ 44 ]. The population, concept, and context (PCC) for this scoping review were 1) population: adults and children, 2) concepts: compassion and empathy, and 3) context: measures/questionnaires for English-speaking populations (behavioral measures and tasks in all languages).

Eligibility criteria

Articles were included if they focused on development or psychometric validation/evaluation of whole or partial scales, tasks, or activities designed to measure empathy, compassion, or synonymous or adjacent constructs. Conference proceedings and abstracts as well as grey-literature were excluded from this review, as were articles in languages other than English or reporting on self-report scales that were in languages other than English. Behavioral tasks or observational measures that were conducted in languages other than English, but were reported in English and could be utilized in an English-speaking context, were included. Papers were excluded if they were in a language other than English, did not include human participants, or did not focus on reporting on development or psychometric validation of measures of compassion, empathy, or adjacent constructs.

Information sources

To identify the peer-reviewed literature reporting on the psychometric properties of measures of empathy and compassion, the following databases were searched: PubMed, Embase, PsychInfo, CINAHL, and Sociological Abstracts. See Table 1 to review the search terms and strategy applied for each database. All databases were searched in October 2020 and again in May 2023 by a reference librarian trained in systematic and scoping reviews at the University of California, San Diego library.

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https://doi.org/10.1371/journal.pone.0297099.t001

Abstracts of the articles identified through the search were uploaded to Covidence [ 45 , 46 ]. Covidence is a web-based collaboration software platform that streamlines the production of systematic and other literature reviews. Each article was screened by two reviewers and any conflicts reviewed in team meetings until the team reached 90% agreement. Thereafter, one screener included or excluded each abstract.

Full text screening

After articles were screened in, full text for all articles tagged as “Measure Development/Validation” were uploaded to the system. The project coordinator (MS) reviewed all articles that were included to ensure that they were tagged appropriately and that all articles reporting on development or validation of measures or assessments of psychometric properties were included in this review.

Each article was reviewed for its general characteristics and psychometric evaluation/validation data reported. General data extracted from each article included: the article title, full citation, abstract, type of study, the name of the scale/assessment/measure, the author’s definition of the construct(s) being measured (if stated), the specific purpose of the scale (context and population, such as “a scale for measuring nurses’ compassion in patient interactions”), whether the measure was conceptualized as assessing state or trait (or neither or both); whether the scale was self-report, peer-report, or expert observer/coder; the validation population, number, gender proportion, and location; and any reviewer notes.

See Table 2 for the psychometric data extracted from each article. In this scoping review we did not evaluate or record/analyze the results of the psychometric evaluations or validations. We only recorded whether or not they had been completed. Because some members of the team did not have enough experience/training to properly identify psychometric evaluations or assessments, data extraction was completed using two data extraction forms (i.e., one for general data and one for psychometric data) constructed in Survey Planet [ 47 ]. A group of four experienced coders completed both the general and psychometric data extraction forms, and a group of six less experienced coders completed only the general data extraction form with an experienced coder completing the psychometric data extraction form.

https://doi.org/10.1371/journal.pone.0297099.t002

Once the data were extracted, they were reviewed by the research coordinator or principal investigator and combined into a spreadsheet. After combining, the answers were reviewed by a team of four additional reviewers to ensure that the information extracted was correct. These four reviewers received additional training on how to confirm that the appropriate information was extracted from the article as well as how to clean the information in a systematic way.

Systematic literature search

A total of 29,119 articles were identified and 9,673 duplicates were removed, resulting in 19,446 titles/abstracts screened for eligibility ( Fig 1 ). A total of 10,553 full-text articles were assessed for inclusion based on the criteria previously described. A total of 6,023 articles were included in the final sample. Of these articles, 559 reported on the development or validation of a measure of empathy and/or compassion, 1,059 identified biomarkers of empathy and/or compassion, and 3,936 used a measure or qualitative interview of empathy or compassion in the respective study. This scoping review reports on the 559 measure development/validation articles.

https://doi.org/10.1371/journal.pone.0297099.g001

Measure development and validation studies

An overview of the 503 measures of empathy or compassion that were developed, validated, or psychometrically evaluated in the 559 articles can be found in the S1 Table . The majority of the studies ( n = 181) used a student population for development and/or validation. Student populations included undergraduate students, nursing students, and medical students. A total of 136 studies used samples of general, healthy adults (18 and older). Eighty-three (83) studies developed and/or validated a measure using health care workers, mostly comprising physicians and nursing staff. A total of 66 studies reported on a combined sample of populations such as clinicians and patients. There were 63 studies that used a patient population (e.g., cancer patients, surgical patients). A total of 34 studies used samples of individuals in other specific professions (e.g., military personnel), 32 used youth and adolescent samples (5–18 years old), 18 included older adults/aging populations, while 28 used samples in mental health care related professions (e.g., therapists). Nine studies used samples in other specific populations (e.g., spouses of depressed patients).

The number of possible psychometric assessments was 13 (see list below), and the total types of psychometric assessments reported for each measure ranged from 0 to 12. On average, each measure reported four types of psychometric assessments being completed. The measures with the highest number of psychometric assessments reported included the Interpersonal Reactivity Index (IRI) and the Self-Compassion Scale (SCS) with 12 psychometric assessments each. All scales with eight or more psychometric assessments reported in the articles we located can be found in S2 Table .

In regards to the type of psychometric assessments reported, a total of 409 studies assessed internal consistency, 342 used construct validity, 316 used factor analysis or principal component analysis, 299 assessed convergent validity, 218 used confirmatory factor analysis, 187 evaluated content validity, 165 tested for discriminant/divergent validity, 108 assessed test re-test reliability, 71 measured interrater reliability, 69 tested for predictive validity, 68 used structural equation modeling, 38 controlled for or examined correlations with social desirability, and 6 used a biased responding assessment or “lie” scale. Eighty studies performed other advanced statistics.

Measures of empathy and compassion

A total of 503 measures of compassion and empathy were identified in the literature. S3 Table is sorted alphabetically by the name of the measure, and includes a description of each measure, year developed, type of measure, subscales (if applicable), administration time (if provided), number of items, sample items, and response set. The majority of the scales were developed in the past decade (since 2013). Most of the measures identified were self-report scales (412 scales). Fifty-three (53) were peer/corollary report measures (descriptions of target individuals’ thoughts, feelings, motives, or behaviors), and 38 were behavioral/expert coder measures (someone who has been trained to assess target’s thoughts, feelings motives or behaviors). There were 370 measures with subscales and 133 measures without subscales. The number of items of each scale varied widely from 1 item to 567 items. The average number of items was 32 (SD = 45.2) and the median was 21 items. Most authors did not report on the estimated time it would take to complete the measure.

Interactive data visualization

Data visualizations are graphical representations of data designed to communicate key aspects of complex datasets [ 48 ]. Interactive data visualizations allow users to search, filter, and otherwise manipulate views of the data, and are increasingly being used for healthcare decision making [ 49 ]. We used Google Data Studio to create an online open-access interactive data visualization ( Fig 2 ) displaying the results of this scoping review. Access it at: https://imagination.ucsd.edu/compassionmeasures/

https://doi.org/10.1371/journal.pone.0297099.g002

The purpose of this Compassion and Empathy Measures Interactive Data Visualization (CEM-IDV) is to assist health researchers and program evaluators in selecting appropriate measures of empathy and compassion based on a number of parameters, as well as learning more about how these constructs are currently being conceptualized. Visualization parameters include: number of types of psychometric assessments completed (1–12) on the y-axis, number of items on the x-axis (with measures with over 70 items appearing on a separate display, not shown in Fig 2 ), and the bubble size indicating the number of participants in the validation studies. Search filters include Population in which the measure has been validated (e.g. students, healthcare workers, general adults), Construct (e.g. empathy, compassion, caring, self-compassion), and Type of Measure (e.g. self-report, behavioral/expert coder). Users can also search measures by name of the parent measure. For example, there are multiple versions of the Jefferson Scale of Empathy (JSE) (e.g., for physicians, for nurses, for medical students). To retrieve all articles reporting on any version of the JSE, one would search for the parent measure (i.e., “Jefferson Scale of Empathy”). If a measure does not have multiple versions (for example, the Griffith Empathy Measure), this search would yield all articles on that single version.

A robust science of compassion and empathy relies on effective measures. This scoping review examined the broad literature of peer-reviewed published research articles that either developed, or assessed the psychometric properties of, instruments measuring compassion and empathy. The review also includes overlapping and related constructs such as self-compassion, theory of mind, perspective-taking, vicarious pain, caring, the doctor-patient relationship, emotional cues, sympathy, tenderness, and emotional intelligence.

Our review indicates that the field of measuring compassion and empathy is maturing. Strides have been made in recent years in conceptualization, definition, and assessment of compassion and empathy. Since the time of earlier critical reviews of measurement of compassion and empathy, several measures have gained more psychometric support: S2 Table shows that 34 measures have been subjected to 9 or more types of psychometric validation. Multiple measures in this review demonstrate consistent reliability and validity along with many other strengths.

Newer measures align more closely with experimental, theoretical and methodological advances in understanding the various components of compassion and empathy. For example, the newer Empathic Expressions Scale [ 50 ] recognizes that actual empathy behaviors are different from cognitive and affective aspects of empathy. In another example, increasing understanding of the role of warmth and affection as an important component of empathy has led to the development of the Warmth/Affection Coding System (WACS) [ 51 ]. That measure also includes both micro- and macro-social observations, recognizing that implicit and explicit behaviors are important for assessment.

As measurement becomes more precise, assessments have also reflected increasing understanding of the differences between compassion and empathy, and the interaction between the two. For example, the Compassion Scale [ 52 ] subscales include kindness, common humanity, mindfulness and indifference (reverse-scored), whereas the family of the Jefferson Scale(s) of Empathy include compassion as well as “standing in the patient’s shoes” and “understanding the client’s perspective.” Recognizing recent research on how compassion could temper consequences of empathic distress such as burnout, it becomes important for researchers and program evaluators to not only avoid conflating the two, but also measure both separately.

Empathy and compassion in specific circumstances for specific populations have also been developed, such as the Body Compassion Questionnaire [ 53 ] with clear relevance for adolescents and young adults, as well as those with eating and body-dysmorphic disorders, or the modified 5-Item Compassion Measure [ 54 ] created specifically for patients to assess provider compassion during emergency room visits.

In our review, we included self-report assessments, peer/corollary observational measures, and behavioral tasks/expert coder measures, for adults and children in English-speaking populations. A discussion of the utility of each of these types of measures follows, along with a rubric for measure selection that researchers and program evaluators can use with the assistance of the tables and/or CEM-IDV online tool.

Self-report measures

The vast majority of measures of empathy and compassion are self-report measures (surveys, questionnaires, or items asking people to report on their own compassion and empathy). While perhaps the most efficient way to assess large numbers of participants, historically self-assessments of compassion and empathy have been riddled with challenges. Over a decade ago, Gerdes et al. [ 38 ] in their review of the literature noted that:

In addition to a multitude of definitions, different researchers have employed a host of disparate ways to measure empathy (Pederson, 2009). A review of the literature pertaining to empathy reveals that as a result of these inconsistencies, conceptualisations and measurement techniques for empathy vary so widely that it is difficult to engage in meaningful comparisons or make significant conclusions about how we define and measure this key component of human behaviour. (pp. 2327).

While a 2007 systematic review of 36 measures of empathy identified eight instruments demonstrating evidence of reliability, internal consistency, and validity [ 40 ], a systematic review of 12 measures of empathy used in nursing contexts [ 41 ] revealed low-quality scores (scoring 2–8 on a scale of 14), concluding that none of the measures were both psychometrically and conceptually satisfactory.

Our scoping review did not assess psychometric robustness other than the number of psychometric assessments completed, but a 2022 systematic review of measures of compassion [ 26 ] continued to reveal low-quality ratings (ranging from 2 to 7 out of 14) due to poor internal consistency for subscales, insufficient evidence for factor structure and/or failure to examine floor/ceiling effects, test-retest reliability, or discriminant validity. They concluded that “currently no psychometrically robust self- or observer-rated measure of compassion exists, despite widespread interest in measuring and enhancing compassion towards self and others” (pp. 26).

Several issues have been identified as potentially explaining shortcomings of compassion and empathy measures. For example, definitions of compassion and empathy vary widely in scholarly and popular vernacular, which can lead to variability in respondents’ perceptions. In addition to issues of semantics, the vast majority of compassion and empathy measures are face valid, relying on questions such as “I feel for others when they are suffering,” or “When I see someone who is struggling, I want to help.” These questions can increase the risk for social desirability bias (i.e., the tendency to give overly positive self-descriptions either to others or within themselves) and other response biases. Indeed, feeling uncompassionate can be quite difficult to admit, requiring not only a large degree of self-reflection and insight, but also an ability to manage the cognitive dissonance, shame, or embarrassment that could accompany such an admission. This difficulty may be particularly true among healthcare professionals.

Using self-report measures to assess the impact of compassion-focused interventions can also be confounded by mere exposure and demand characteristics, particularly when compared to standard-of-care or wait-list controls. In other words, after spending eight-weeks learning about and practicing compassion, it is not surprising that one might more frequently endorse items with respect to compassion due to increased familiarity with the concept, or implicit desire to satisfy experimenters, as opposed to increased compassionate states or behaviors. On the other hand, interventions could paradoxically result in people more accurately rating themselves lower on these outcomes once they investigate more thoroughly their own levels of, and barriers to, compassion and empathy, potentially masking improvements.

Peer/corollary and behavioral/expert coder measures

With increasing technological, statistical, and conceptual sophistication, we can innovate new measures that can increase validity by triangulating more objective measures with self-perceptions. In fact, multiple measures using observation and ratings by peers, patients, or trained/expert behavioral coders have been developed to do just that. We identified 61 measures utilizing observational measures or peer/corollary reports, some involving a spouse, friend, supervisor, client or patient completing a questionnaire, rating form or checklist regarding their observations of that person. These measures may also include ratings of a live or recorded interaction by someone who has been trained to assess, or is an expert in assessing, compassion or empathy behaviors. Compassion or empathy behaviors include verbalizations and signals such as eye contact, tone of voice, or body language. Similarly, qualitative coding of transcribed narratives, interactions, or responses to interview questions or vignettes can be conducted with human qualitative coders, which is increasingly supported by artificial intelligence.

These methods have the clear benefit of avoiding self-report biases and providing richer data for each individual (for use in admissions or competency exams for instance). However, they can be labor intensive, can introduce potential changes in behavior due to knowing one is being observed, and can introduce another layer of subjectivity on the part of the observer/rater (which can be overcome in part by measures of agreement between two or more raters). They also tend to have fewer psychometric assessments testing their validity or reliability than other measures.

Behavioral tasks

Laboratory-based behavioral tasks have been useful for assessing empathy and compassion under controlled conditions while reducing self-report biases and taking less time than qualitative/observational measures. These lab protocols involve exposure to stimuli designed to induce empathy and compassion or related constructs. For example, respondents might view a video-recorded vignette that reliably results in responses to seeing another person who is suffering [ 55 ] or write a letter to a prison inmate who has committed a violent crime [ 56 ]. Game theory has been used to create tasks focused on giving people options to share with, withhold from, or penalize others with cash, points, or goods. These are used to assess prosocial behaviors and constructs adjacent to empathy and compassion such as altruism and generosity [ 57 ].

The association of these implicit measures of compassion and empathy with real-world settings or with subjective perceptions of empathy and compassion is unknown. A meta-analysis of 85 studies ( N = 14,327) indicates that self-report cognitive empathy scores account for only approximately 1% of the variance in behavioral cognitive empathy assessments [ 58 ]. This finding could demonstrate the superiority of implicit measures and a rather damning verdict for the accuracy of self-perceptions, or could imply that these different types of measures are capturing very different constructs (a problem that exists across many psychosocial versus behavioral measures, see [ 59 ]).

Selecting measures

Our review revealed that there is not one or even a few measures of empathy and compassion that are best across all situations. Rather than providing overarching recommendations, therefore, we emphasize that measurement is context-dependent. As such, we recommend a series of questions researchers and program evaluators might ask themselves when selecting a measure.

We encourage readers to use the online CEM-IDV as a decision-aid tool to identify the best measure for their specific needs. To select the most appropriate instrument(s), we offer the following questions (in a suggested order) to provide guidance:

• Which precise domains of empathy, compassion, or adjacent constructs do you want to measure? For example, is it the participant’s experience of empathy, or a skill or behavior? See the “General Construct” dropdown menu. Because definitions of empathy, compassion and related constructs are often imprecise, investigate whether the sample items, factors, and authors’ definition of the construct matches the outcome or variable you actually want to measure.
• What measurement type is best suited to answering your research/evaluation question, or what is feasible for your setting and sample size? For example, if you have limited time or a large sample size, you may prefer a self-report survey, whereas if you are concerned about self-report bias, you might consider a direct observation or behavioral task/expert coder measure. Use S1 Table to examine measures by type of measure, or use the “Type of Measure” filter in the CEM-IDV.
• What measure length, number of items, or time it takes to complete the assessment is feasible for the study? Refer to the X-axis of the CEM-IDV tool.
• What population (s) are you working with? Use the population filter to explore whether the measures you are considering have been validated in those populations.
• Do you want to differentiate the domain you are measuring from other adjacent constructs , such as sympathy or altruism, or distinguish between empathy and compassion? Select and include measures of each construct in order to make this distinction. Finally, now that you have selected several candidate measures, ask:
• How valid and reliable is the measure? Use S1 Table or the Y-axis of CEM-IDV tool to determine which psychometric assessments have been completed, and click on the measure in the table below to review the full text of the papers to discover the strength of those assessments, as well as familiarizing oneself with the recent literature on the measure. Evidence for the validity, factor structure, or length of measures is often hotly debated, and it can be that a measure has been improved or its interpretation cautioned by recent literature.

For example, imagine you are conducting a study of emergency room outcomes, including number of admissions, time from registration to discharge, and patient satisfaction. You would like to include emergency-room healthcare-provider empathy and/or compassion as a potential predictor or mediator of outcomes. After reviewing the literature on the topic and the definitions, you decide that compassion is the specific domain you are most interested in (Question 1). Because you are aware of the limitations of self-report measures, you decide not to use a self-report measure. You recognize that peer-reports, behavioral tasks, or expert coders are not appropriate for the fast-paced environment and number of interactions, but decide that patient reports of provider compassion would be ideal (Question 2). You recognize that the questionnaire must be brief, given the existing measurement burden and limited time participants have (Question 3). The population is emergency room clinicians and patients (Question 4). In this case, you are not interested in differentiating compassion from other similar constructs because that is not relevant to the question you are trying to answer: whether emergency room physician compassion predicts or mediates patient outcomes (Question 5).

In this case, you might use the CEM-IDV tool to select the population “Patients” and the construct “Compassion.” Your search yields eight potential measures, and upon reviewing each, you find that the 5-item Compassion Scale [ 54 ] has sample items that reflect what you are hoping to measure and was validated with emergency room patients and their clinicians. It demonstrates good reliability and validity and is an excellent choice for your project.

Strengths and limitations

This scoping review has several strengths. First, it covers a wide breadth of literature on ways to assess empathy, compassion, and adjacent constructs using different types of measures (i.e., self-report, peer/corollary report, and behavioral/expert coder). Second, the findings were integrated into an accessible interactive data visualization tool designed to help researchers/program evaluators identify the most suitable measure(s) for their context. Third, the review team included individuals with expertise in conducting reviews, with the project manager having received formal training in best practices for systematic reviews, and an experienced data librarian helping to develop the search string and conduct the literature search. Fourth, the literature search was conducted without a start date limitation, thus capturing all measures published prior to October 2020. Fifth, the review team employed a comprehensive consensus process to establish study inclusion/exclusion criteria and utilized state-of-the-art review software, Covidence, to support the process of screening and data extraction.

There are also several limitations to consider. First, our literature search was limited to five databases (i.e., PubMed, Embase, PsychInfo, CINAHL, and Sociological Abstracts), and excluded grey literature, conference proceedings/abstracts, and measures not written in English. We also included only articles specifically focused on development and/or psychometric validation of measures. Thus, it is possible we missed relevant measures. Second, although we captured how frequently a measure was validated and the types of available psychometric evidence for each measure, we did not review the quality of the evidence. Measures with greater numbers of psychometric assessments may not necessarily be the most appropriate in all contexts or for particular settings, and psychometric studies can lead to conflicting results/interpretations. Importantly, the number of psychometric assessments might be skewed in favor of older measures that have existed in the scientific literature longer, and allegiance biases are possible. Thus, we reiterate that readers would benefit most from using the questions recommended above when selecting measures. Third, this scoping review provides a static snapshot of available measures through October 2020 and does not include measures that may have been published after that time.

Finally, the scoping review does not identify gold-standard measures to use. While systematic reviews typically include quality assessments, scoping reviews do not. Rather, scoping reviews seek to present an overview of a potentially large and diverse body of literature pertaining to a topic. As such, this review did not evaluate the quality of design, appraise the strength of the evidence, or synthesize reliability or validity results for each study. It may therefore include multiple studies that may have weak designs, low power, or evidence inadequate to the conclusions drawn.

Given the multitude of problems facing society (e.g., violence and war, social injustices and inequities, mental health crises), learning how to cultivate compassion and empathy towards self and others is one of the most pressing topics for science to address. Furthermore, studies of compassion, empathy, and adjacent constructs rely on the use of appropriate measures, which are often difficult to select due to inconsistent definitions and susceptibility to biases. Our scoping review identified and reviewed numerous measures of compassion, empathy, and adjacent constructs, extracting the qualities of each measure to create an interactive data visualization tool. This tool is intended to assist researchers and program evaluators in searching for and selecting the most appropriate instruments to evaluate empathy, compassion, and adjacent constructs based on their specific context, setting, or population. It does not replace reviewers’ own critical evaluation of the instruments.

How a construct is measured reflects how it is being defined and conceptualized. Reviewing the subscales/factors and individual items that make up each measure sheds light on how each of these measures conceptualizes empathy and compassion. Ongoing research by our team is using these subscales, factors and items across measures to construct a conceptual map of compassion and empathy, which will be reported in a future paper. In the meantime, a useful feature of the CEM-IDV is that the list of articles yielded by searches includes subscales and sample items from each measure/article. These allow for a snapshot of how each measure or its authors have defined the constructs being assessed.

Future directions for measurement of empathy and compassion should consider incorporating advances in measurement and technology, and strive to bring together two or more assessment methods such as self-report, peer or patient reports, expert observation, implicit tasks, and biomarkers/physiological data to provide a more well-rounded picture of compassion and empathy. Innovations such as voice analysis and automated facial expression recognition may hold promise. Brief measures dispersed across multiple time points such as ecological momentary assessment and daily experience sampling may be useful. In conjunction with mobile technology and wearables, artificial intelligence and machine-learning data processing, could facilitate these formerly labor and time-intensive assessment methods.

Supporting information

S1 table. measure populations and psychometric assessments..

https://doi.org/10.1371/journal.pone.0297099.s001

S2 Table. Measures with 8+ psychometric assessments.

https://doi.org/10.1371/journal.pone.0297099.s002

S3 Table. Measures of compassion and empathy.

https://doi.org/10.1371/journal.pone.0297099.s003

Acknowledgments

Thank you to Omar Shaker for his work to create the online interactive data visualization.

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Empathy as Research Methodology

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While a long-standing concern in psychology and philosophy, empathy is receiving increased attention in the social sciences for its importance in interpersonal relationships and its use in cross-cultural contexts. I begin this chapter with a brief history and overview of the concept of empathy as a means of understanding the perspectives and experiences of others. I then consider the features that distinguish empathy and the modes through which empathy functions. I address empathy’s value across disciplines and extend the application of empathy to the health and social sciences by outlining how practices of empathy might work as a component of research, especially in consideration of different perspectives and social conditions. I apply practices of empathy to research site and participant selection, communication, collaboration, self-reflection, and the recognition of limitations. I advocate the practice of critical empathy, in which researchers acknowledge the biases and shortcomings of empathy while simultaneously looking to establish shared goals and interests. To conclude this chapter, I consider the continued necessity of empathy as a component of research despite empathy’s limitations.

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Application of empathy theory in the study of the effectiveness and timeliness of information dissemination in regional public health events.

• 1 Institute of Education, Nanjing University, Nanjing, Jiangsu, China
• 2 Department of Applied Foreign Language Studies, Nanjing University, Nanjing, Jiangsu, China

Introduction: This study examines the role of empathy theory in enhancing the effectiveness and timeliness of information dissemination during regional public health events, with a focus on the SARS and COVID-19 pandemics as case studies. Utilizing an anthropological interview method, the research delves into the public's transformation from passive recipients to active participants in information dissemination, emphasizing the impact of empathy.

Objective: The study aims to evaluate the application of empathy theory in the context of public health emergencies and to determine its influence on the quality of information dissemination and public engagement.

Methods: The research involved two distinct surveys, each collecting 50 questionnaires from participants in different regions, to capture a diverse range of perspectives. The surveys assessed participants' views on information dissemination, their levels of empathy, and their behaviors in receiving and sharing health-related information.

Results: The findings indicate that empathy plays a crucial role in facilitating the active involvement of the public in information dissemination. There is a notable difference in the public's emotional response and information sharing behaviors between regions with direct experience of the health events and those less affected.

Conclusion: The study concludes that empathy theory, when applied to information dissemination during public health emergencies, can significantly improve the public's engagement and the overall effectiveness of communication strategies. The results underscore the need for empathetic communication to foster a sense of solidarity and collective action in response to public health crises.

1 Introduction

Today, we live in an era of rapid information dissemination, with various forms of information continuously being transmitted or received. In a regional public health emergency, the effectiveness and timeliness of information dissemination are particularly crucial as they directly impact the physical and mental wellbeing, even the safety, of people within the region ( 1 ). Information dissemination is not an event that occurs at a single point in time; rather, it involves a process composed of five elements: the sender, receiver, message, medium, and feedback. It's worth noting that the relationship between the sender and receiver is not fixed during the dissemination process. Therefore, information dissemination always carries a subjective perspective. Thus, from a theoretical standpoint, it is impossible to obtain completely objective information. Our goal is to present information as objectively as possible from others' perspectives, ensuring its effectiveness, objectivity, and timeliness throughout the dissemination process.

Empathy, originating from the field of psychology, refers to an individual's ability to understand and experience the feelings of others. Empathy encompasses both cognitive and affective dimensions. Cognitive empathy involves understanding the thoughts and feelings of others, while affective empathy requires individuals to experience the emotional states of others ( 2 ). In recent years, empathy theory has been widely applied in the fields of communication and interpersonal research. Scholars believe that empathy can enhance interpersonal understanding and improve communication effectiveness ( 3 ). In crisis communication, official accounts that demonstrate empathy are more likely to gain public trust. Empathy has also been applied in doctor-patient communication, helping to improve patient compliance ( 4 ).

Regional public health emergencies are characterized by their suddenness, uncertainty, and complexity, posing potential threats to public health. In this context, the effectiveness and timeliness of information dissemination are crucial for controlling the situation. Any disruptions in information transmission may lead to the escalation of the crisis and delayed rescue efforts. Moreover, transparent information disclosure can enhance public cooperation. Therefore, exploring how empathy theory influences the effectiveness and timeliness of information dissemination in regional public health emergencies will contribute to the formulation of crisis management and communication strategies. Existing research has found that empathy plays a significant role in crisis communication and public emotion regulation. While literature ( 5 ) has investigated the cognitive and emotional responses of the public to epidemic information based on empathy, there remains a notable gap in empirical studies focusing specifically on the application of empathy theory in improving the effectiveness and timeliness of information dissemination during regional public health events. Addressing this gap is essential for gaining a deeper understanding of the mechanisms through which empathy operates in such situations and for informing evidence-based communication strategies. Therefore, this paper aims to expand the application of empathy theory in this emerging field by employing a case study approach. Through the examination of diverse scenarios and contexts, this approach facilitates a nuanced understanding of the complex interplay between empathy, information dissemination, and public response in the face of regional public health crises. In regional public health emergencies, information dissemination often faces various challenges such as information overload, rampant rumors, and public panic, which to some extent trigger a crisis of trust in authoritative information sources ( 6 ). Effective information management is therefore essential, and empathy can serve as a coping mechanism.

The public often shapes collective cognition and emotions in the reporting of regional public health emergencies. News coverage of public health emergencies, especially those affecting specific regions, always plays a critical role in shaping local public emotions. For example, during the COVID-19 outbreak in Wuhan, China in 2020, news coverage of the event united the people of Wuhan in their fight against the epidemic, fostering a shared belief among most residents. Scholars generally believe that individuals with larger social support networks receive more social support and are better equipped to cope with difficulties and challenges. In today's information age, public opinion in the online environment evolves with various media news or reports, affecting public emotions as news evolves. The public in the online environment has transitioned from being merely “passive” to becoming “active” information consumers and generators. Empathy is a subset of emotions and is an innate human ability ( 7 ). Empathy is widely applied in the information dissemination of regional public health emergencies ( 8 , 9 ).

This study aims to explore how empathy theory, initially proposed only in psychology, is applied to the information dissemination of regional public health emergencies from the perspective of empathy, and to investigate how people perceive the widespread application of empathy theory in the information dissemination of regional public health emergencies. Finally, we explore the impact of this theory on the effectiveness and timeliness of information dissemination, particularly in the context of regional public health emergency information dissemination.

2 The connotation and extension of empathy theory

2.1 overview of empathy theory.

The concept of empathy holds a central role in understanding human interaction and communication, particularly within the context of information dissemination during public health emergencies. However, the term itself carries some ambiguity. The popular understanding of “empathy” often refers to stepping outside of one's own perspective and experiences to understand another person's thoughts and feelings. This emotional resonance can lead to actions that benefit the other person, such as “standing in their shoes” to understand their situation.

Academically, the concept of empathy has a deeper history. German philosopher Robert Vischer first introduced the term “Einfühlunge” to describe the act of projecting one's own feelings onto external objects. Later, Edward Titchener proposed “empathy” as a replacement, defining it as “the process of humanizing the object, the process of feeling that we ourselves are inside something else”.

In Chinese translation, the term “empathy” presents a unique challenge. The concept of empathy remains contentious. It has several translations, including “empathy,” “sympathy,” “empathy,” and “empathy.” Chinese scholars have translated empathy as empathy, but they argue that this translation method fails to fully capture the word's complete meaning ( 10 ). The translation of “empathy” emphasizes its sensory aspect, while “Empathy” seems to consider both reason and feeling, with a focus on the rational aspect of human psychology. Translations can be categorized into three main types: the “Love” translation school, the “Sense” school, and the “Rational” translation. Despite the variations in translation, the core essence of empathy remains consistent. This paper defines empathy as the innate ability to directly perceive and comprehend another person's emotional state. It encompasses a multi-dimensional process that can be scrutinized from three primary viewpoints: attributes, essence, and organizational structure. (1) Attributes: this dimension delves into the capacity to directly sense and resonate with another's emotions. It investigates the biological and psychological underpinnings of empathy, exploring how human development shapes the ability to empathize with others. (2) Essence: this perspective interprets empathy as a cognitive manifestation. While valuable, it is constrained by its exclusive focus on the outcome of empathy, overlooking the intricate process involved. (3) Organizational structure: this dimension regards empathy as a multifaceted process characterized by various components. It delineates the stages of empathy, including active listening, perspective-taking, emotional response, and appropriate action.

From the attribute dimension of empathy, empathy is the ability to directly emotionally feel the psychological situation or psychological state of the other, and to understand the emotions of others by feeling this state is universal. At the same time, the origin of empathy is the focus of this dimension of research, and the emotions formed by humans in the process of physiological and psychological development can directly feel what others feel. Starting from the essence of empathy as an entry point to analyze empathy, scholars usually regard empathy as a cognitive result, and this dimension as an entry point for the analysis of empathy has certain limitations, that is, only pay attention to the state and result of empathy but lack of empathy. The process that forms this is less studied. Finally, the research and analysis of empathy is carried out from the dimension of the organizational structure of the hectare as the entry point, and the advantage of this dimension research is that empathy has multiple components in the structure and has the characteristics of specific process, and psychological empathy is a continuous process of layer by layer. People often need to go through five stages: active listening, putting themselves in their shoes, thinking sharply, responding accurately, and leading enlightenment ( Figure 1 ).

Figure 1 . The process of empathy.

The view shared by most scholars in this process is that empathy includes three necessary components of the process and non-emotional outcomes of personal and situational factors that occur in empathizers ( 11 ).

2.2 Extension of empathy theory: empathy communication and the evolution of public opinion

2.2.1 empathy transmission.

Empathy and communication seem to be intrinsically linked. Through the definition of the concept of empathy in the above content, it is not difficult to see that the formation of empathy is inseparable from the mutual communication and emotional sharing between people, so the connection between empathy and communication can be said to be closely related and inseparable. The process of studying empathy is also to a large extent also studying emotional cultural exchange and information dissemination. Today's concept of empathy communication is based on the concept of empathy. Empathy is now widely used in the field of psychology and anthropology, and the definition of empathy transmission is now not limited to individual-to-individual transmission, but also between individuals and groups, in the face of regional health events 2 The typical event of COVID-19 in Wuhan, China in 2020, is an example in which the public actively participates in empathy in the various emotional scenarios constructed in the face of COVID-19. This also breaks through the psychological theory of empathy, where empathy is limited to individual-to-individual connections.

The way of empathy transmission is through the diffusion of information after the dissemination and after sharing, it has an emotional resonance with a certain individual or group within a certain range, and thus produces similar emotions. Communication is often pursued by the communication effect, in communication science the communication effect is divided into cognition, emotion and attitude three levels. The conceptual definition of empathy corresponds to the second and third layers of the effect of communication. Communication activities can have a profound impact on people's views on social issues, and in terms of emotions, they can resonate with similar emotions or emotions, and they can also strengthen people's common will to have ideas or opinions about the same thing. The relationship between the effects of the three levels of the communication effect is complementary, and if the effect of one level changes, the changes at the other two levels will always occur.

2.2.2 Evolution of public opinion

Compared with traditional social public opinion, the corresponding network public opinion shows different characteristics in terms of content generation methods, presentation methods and communication media. The so-called network public opinion refers to the collection of all attitudes, opinions, emotions and behavioral tendencies expressed by the public through the network platform about various matters related to their own interests or interests that arise in a specific time and space and are related to their own interests or interests of specific organizations or individuals. Network public opinion in public health events, including the main body of public opinion and the role of public opinion. Audiences, media, governments, and public opinion are themselves important subjects in dealing with online public opinion ( 12 ). The public is no longer a single communication audience or communication subject, and the public always participates in the process of network public opinion dissemination as a dual identity of communicator and audience ( 13 ). In this process, through the acceptance of information, transmission and transformation of information, its emotional consensus is quickly disseminated to the outside world ( Figure 2 ).

Figure 2 . The transformation of mass identity in internet public opinion.

After the COVID-19 epidemic has been reported by various media, it has quickly transformed into a public opinion issue on the Internet, and in this process, the groups participating in the discussion have their emotions and emotions communicating with each other, because they have the same or similar positions and emotions, so they are more likely to resonate. Just like Twitter users' content and usage attitudes, online public opinion information can be used to assess crisis situations and track and monitor disease conditions. This shows that empathy plays a crucial role in shaping online public opinion ( 14 , 15 ).

3 The application of empathy in the dissemination of information in public health events

3.1 regional public health events and network public opinion.

Public health events are public measures taken by the public sector to prevent disease, increase life expectancy and improve health. These include not only public health events caused by non-pest control, but also public health events caused by epidemics, etc. Throughout human history, the world has faced four major “pandemics”, with the 1918 influenza pandemic being the deadliest, resulting in ~100 million deaths worldwide in just 2 years. At the same time, public health emergencies occur frequently, bringing about various online public opinion events ( 16 ). Due to the complex ecological environment of network information and the intertwining of the number of fake news, the resulting negative network public opinion is generated and spread rapidly, which creates a huge obstacle for public health departments to effectively identify, judge and formulate effective response strategies ( 17 ). Online public opinion events regarding public health emergencies are especially prevalent in the realm of social media. Since 2018, China has made it clear that public health incidents should be managed in the common good and in a model of coordinated governance by multiple entities and regions ( 18 ). Even so, there are many difficulties in responding to sudden regional public health events ( 19 ). For example, the dissemination of information is not timely, on the one hand, the lack of manpower and materials in a single region in responding to a public health event in the region makes it difficult to respond effectively to the event in the first place; On the other hand, due to the lack of timeliness and effectiveness of information dissemination, it is difficult for other regions to make correct judgments in the first place, thus affecting areas that help regional public health events. At the same time, even if the dissemination of information is timely enough, it is difficult to put oneself in the shoes of the incident and consider the problem in the place where the incident occurred, so that it is difficult to provide effective assistance in the case of assistance.

Online public opinion and empathy influence each other and promote each other. On the one hand, the development of online public opinion has a role in promoting the public's display of their own emotions, emotions and the behavior of expressing opinions, on the other hand, the participation of groups that generate empathy in the discussion of public opinion helps to enhance the influence of public opinion. Social networks have become the most important means of communication for sharing awareness, information and innovation. With the realization that even weak social relationships can have an impact, social networks have become a medium for marketing and influence-maximizing technologies ( 20 ).

3.2 Application of empathy theory in information dissemination

3.2.1 application of empathy in the sars incident.

With the frequent occurrence of natural disasters and disease transmission events in China in recent years, the subjective awareness of public participation in public health events is gradually improving, and with the continuous development of network information technology, smart phones are popularized nationwide, and the public is no longer a passive recipient of information dissemination in public health events, but gradually becomes an active participant in the dissemination of this type of event. In the transmission of cross-cultural empathy, the two sides come from different cultural backgrounds, and face differences, estrangements, and even conflicts and confrontations between heterogeneous cultures. It is true that in cross-cultural transmission, ethnocentristic or culturally centristic thinking such as “non-chinese species must be different in their hearts” and “Western-centrism” have always existed, which is the limitation of human beings derived from selfish genes. The spread of cross-cultural empathy guided by human beings is an important way to transcend this limitation ( 21 ). There are also a variety of ways to participate. Taking two of China's more famous public health events as an example, the first public health event that gave the whole of China a deep and heavy memory was the atypical pneumonia that spread rapidly to the whole country at the end of 2002 Event. At that time, this incident, because China lacked experience in dealing with such sudden and large-scale public health events, compared with today, the level of medical care was low and the materials were relatively scarce, and for the memory of that time, the vast majority of Chinese first thought of panic. The high mortality rate has left people in areas where outbreaks are more concentrated, such as Beijing, under the high pressure of the fight against the epidemic; However, for cities that have not been affected by the epidemic, such as Yinchuan in Ningxia, people do not have such a deep memory of SARS. There are many reasons for this phenomenon, one is because there is no local epidemic, people do not have a direct understanding of the things that have not happened around them, so the panic has not spread too much in the local area, and another important reason is because the information dissemination was relatively slow at that time, the channels were relatively small, and the people's reception of relevant information was limited and insufficient. The main reasons for this result are the underdevelopment of communication technology and the relatively low level of science and technology, for example, at that time, smart phones were not popularized throughout China, computers and the Internet were not popularized, and it can be said that China at that time had not yet entered the information age. People have fewer access to information, and can only learn about ephemeral and inadequate information through text messages from friends and family in the outbreak area or by phone. At this time, people participate in the process of disseminating information about public health events and act only as passive participants. Among the people who were involved in this incident, the author randomly selected 50 people as interview subjects in Beijing and Yinchuan, two representative cities, and used the research method of the interview method After collecting information and collating it, it was found that there was a big difference in people's understanding of the public health event of SARS in the two regions. We designed 50 questionnaires to explore the application of empathy theory in the dissemination of information during public health events. The questionnaire includes both quantitative and qualitative questions to collect data on respondents' perspectives on the dissemination of public health event information, their levels of empathy, and how they receive and share information through different channels. When designing the questionnaire, the questions were clear, unambiguous, and able to effectively measure the required data, as shown in Appendix 1 . The composition of the 50 questionnaires in terms of personnel, age groups, and cultural levels is clear. To ensure the representativeness of the questionnaires, we sampled different populations, including various ages, genders, educational backgrounds, and occupations. A stratified random sampling method was used to ensure diversity in the sample's demographic characteristics. For respondents in Beijing and Yinchuan, the sample distribution of both locations was balanced to facilitate effective comparative analysis. The collected questionnaires were analyzed and summarized, with the results shown in Figure 3 .

Figure 3 . Statistics of survey questions. (A) Distribution of information channels. (B) Information preference among different age groups. (C) Evaluation of the importance of information dissemination by respondents. (D) Respondents' perceptions of various aspects of information dissemination.

Figure 3A illustrates the main channels through which respondents acquire information on public health events and their distribution. Television news emerges as the most popular information channel, followed by internet news websites and social media. This reflects respondents' demand for authoritative and timely information. Figure 3B presents the preferred information channels of respondents categorized by age groups. Younger individuals (aged 18–24) tend to favor social media and internet news websites as sources of information, while older individuals (aged 55 and above) rely more on television news and word of mouth. This may be related to varying levels of familiarity and acceptance of technology among different age groups. Older individuals may be more accustomed to traditional information sources, whereas younger individuals are inclined toward digital and social channels. Figure 3C displays the distribution of respondents' evaluations of the importance of information dissemination for public health events. The majority of respondents (75%) consider information dissemination for public health events to be “Very Important”, indicating a widespread belief in the crucial role of timely and effective information dissemination in addressing public health crises. Additionally, 20% of respondents view information dissemination as “Important”, while 5% perceive it as “Neutral”. Notably, no respondents rated information dissemination as “Not Very Important” or “Not Important”, indicating a lack of negative attitudes toward information dissemination. Figure 3D presents respondents' evaluations and average ratings of different aspects of information dissemination for public health events. Respondents gave the highest rating (average rating of 4.5) to the accuracy of information, highlighting their emphasis on truthfulness and reliability. Timeliness and comprehensibility also received relatively high ratings, while emotional impact scored relatively lower. This suggests a need to consider how to evoke emotional resonance among audiences in information dissemination efforts.

Here, the author has selected two representative interview records to interview Mr. W from Yinchuan and Mr. Z from Beijing. The transcript of the interview is shown as Appendix 2 .

As show in Figure 4 , through the above two typical interview records, it can be clearly seen that in the “SARS incident”, the dissemination of information has obvious deficiencies in timeliness and validity. At the same time, people in different regions have greatly different emotional and cognitive views of the same public health event. Even after nearly 20 years, the people who mention the event again can still feel the fear and fear of the heart, but in areas with less information and publicity and far away from the place where the event occurred, people's senses of the event are not so direct, and the impression is not as deep as in Beijing.

Figure 4 . Factors affecting information dissemination of SARS incidents.

3.2.2 Application of empathy in the COVID-19 incident

Taking the public health event of “COVID-19” in the past 2 years as an example, the author once again interviewed people in different regions in the form of interview method research, hoping to understand people's views on the same public health event through interviews. Among them, representative interview content was still selected, hoping to present the interviewee's views on the event as objectively as possible. The interview is shown as Appendix 3 .

A comparison of interviews from these two typical public health events clearly reveals significant differences in how people engage in disseminating information about the event and the extent to which they receive information. Among them, there are many factors that affect the dissemination of information, such as the level of media development, the different levels of scientific and technological development, and the degree of participation of the masses in information dissemination, all of which are related to whether information dissemination is effective and timely. According to the interview content of the two public health events, it is found that the level of science and technology and the degree of participation of the public in information dissemination are important factors affecting the quality of information dissemination. Leaving aside the factor of the level of science and technology, and discussing the degree of mass participation alone, empathy directly affects the degree of participation of the masses in the dissemination of information. Take this interview in Wuhan as an example, this interview obtained an important piece of information, compared to the news report this passive way of receiving information, people are more willing to participate in the dissemination of new media information, whether it is short video or short news, people can be more active according to their own needs to obtain timely and effective information, after obtaining information, a large number of people will make the information spread again through comments, discussions, and sharing. In this process, in view of the authenticity of the information, the masses also participate in the process of information dissemination to carry out individual screening, the multi-source dynamic characteristics of social media information make the user's independent analysis possible, a large number of users respond quickly to the content that does not conform to the facts, so that the false information can be effectively suppressed in the early stage of dissemination ( 22 ). Like the pattern of difference order proposed by Mr. Fei Xiaotong in his book “Native China”, he proposed that China's interpersonal relations have the characteristics of “difference order pattern”, forming a network of relatives and alienations that extend outward with self-centeredness ( 23 ). With a receiver of information as the center of the ripple, the information will continue to spread like a ripple, but the ripple will always return to calm due to the limitations of the limited system of a person's ability. However, if the recipient actively engages in discussing the information upon receipt and shares it with others, it's akin to casting a stone into the outer circle of ripples, thus enhancing the speed and effectiveness of information dissemination ( Figure 5 ).

Figure 5 . Information dissemination mode under the ripple effect.

3.3 Application of empathy theory in information dissemination

The preceding discussion underscores the crucial necessity of applying empathy theory in disseminating information about public health events. However, it is not enough to effectively and reasonably apply empathy theory to the dissemination of information on such events and thus ensure the timely and effective dissemination of information solely by relying on the spontaneous participation of the masses. The author contends that implementing measures to apply empathy theory to the dissemination of information on regional public health events should begin with three main stakeholders. Firstly, there's a need for government support through policies, such as the enactment of relevant laws. Only in this way can we ensure the legitimacy of information dissemination on the one hand and effectively avoid the occurrence of some phenomena that hope to take advantage of the opportunity to spread illegal and false information to make profits for themselves. The second main body is various organizations, including news media platforms, enterprises and self-media teams. If the government plays the role of initiator in this process, then the organizations play the role of executor. The specific measures are to optimize and classify the information received by each platform by optimizing the communication channels, and promote the positive and event-related information, so as to minimize false information and a large number of meaningless confidence dissemination in the process of information dissemination. The third subject is the masses, and the spontaneous participation of the masses in the process of information dissemination can effectively ensure that the dissemination of information can be disseminated on a larger scale.

4 Conclusion

In conclusion, the analysis of 100 survey questionnaires, distributed across two distinct regions, has provided empirical evidence of the pivotal role empathy plays in information dissemination during public health events. The data revealed that in areas where individuals reported higher empathy levels, there was a marked increase in proactive information sharing and a more profound engagement with health communications. This pattern corroborates with the theoretical stance that empathy can be a driving force in communal response to health crises. The findings of this study not only affirm the theoretical propositions but also demonstrate their practical applicability in enhancing public health communication strategies. By integrating these insights, health communicators can craft messages that resonate on a deeper emotional level, thereby improving the overall effectiveness of information dissemination. This study paves the way for future research to delve into the nuanced impacts of cultural differences on empathy and its role in health communication across diverse global contexts.

Author contributions

MZ: Conceptualization, Investigation, Software, Supervision, Writing – review & editing, Writing – original draft. XL: Data curation, Methodology, Writing – original draft, Writing – review & editing.

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by Education Program of the National Social Science Foundation of China (Grant No. BIA230219).

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2024.1388552/full#supplementary-material

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Keywords: public health events, empathy, information dissemination, empathy theory, public health emergencies

Citation: Zhang M and Lu X (2024) Application of empathy theory in the study of the effectiveness and timeliness of information dissemination in regional public health events. Front. Public Health 12:1388552. doi: 10.3389/fpubh.2024.1388552

Received: 20 February 2024; Accepted: 15 April 2024; Published: 30 April 2024.

Reviewed by:

Copyright © 2024 Zhang and Lu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Xiaobing Lu, lxbnju@yeah.net

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Home — Essay Samples — Life — Emotions & Feelings — Empathy

Empathy Essays

Hook examples for empathy essays, anecdotal hook.

"As I witnessed a stranger's act of kindness towards a struggling neighbor, I couldn't help but reflect on the profound impact of empathy—the ability to connect with others on a deeply human level."

Rhetorical Question Hook

"What does it mean to truly understand and share in the feelings of another person? The concept of empathy prompts us to explore the complexities of human connection."

Startling Statistic Hook

"Studies show that empathy plays a crucial role in building strong relationships, fostering teamwork, and reducing conflicts. How does empathy contribute to personal and societal well-being?"

"'Empathy is seeing with the eyes of another, listening with the ears of another, and feeling with the heart of another.' This profound quote encapsulates the essence of empathy and its significance in human interactions."

Historical Hook

"From ancient philosophies to modern psychology, empathy has been a recurring theme in human thought. Exploring the historical roots of empathy provides deeper insights into its importance."

Narrative Hook

"Join me on a journey through personal stories of empathy, where individuals bridge cultural, social, and emotional divides. This narrative captures the essence of empathy in action."

Psychological Impact Hook

"How does empathy impact mental health, emotional well-being, and interpersonal relationships? Analyzing the psychological aspects of empathy adds depth to our understanding."

Social Empathy Hook

"In a world marked by diversity and societal challenges, empathy plays a crucial role in promoting understanding and social cohesion. Delving into the role of empathy in society offers important insights."

Empathy in Literature and Arts Hook

"How has empathy been depicted in literature, art, and media throughout history? Exploring its representation in the creative arts reveals its enduring significance in culture."

Teaching Empathy Hook

"What are effective ways to teach empathy to individuals of all ages? Examining strategies for nurturing empathy offers valuable insights for education and personal growth."

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The Importance of Promoting Empathy in Children

Steps for developing empathy in social situations, the impacts of digital media on empathy, the contributions of technology to the decline of human empathy, get a personalized essay in under 3 hours.

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Importance of empathy for blind people, the most effective method to tune in with empathy in the classroom, thr way acts of kindness can change our lives, the power of compassion and its main aspects, compassion and empathy in teaching, acts of kindness: importance of being kind, the concept of empathy in "do androids dream of electric sheep", the vital values that comprise the definition of hero, critical analysis of kwame anthony appiah’s theory of conversation, development of protagonist in philip k. novel "do androids dream of electric sheep", talking about compassion in 100 words, barbara lazear aschers on compassion, my purpose in life is to help others: helping behavior, adolescence stage experience: perspective taking and empathy, random act of kindness, helping others in need: importance of prioritizing yourself, toni cade bambara the lesson summary, making a positive impact on others: the power of influence, patch adams reflection paper.

Empathy is the capacity to understand or feel what another person is experiencing from within their frame of reference, that is, the capacity to place oneself in another's position.

Types of empathy include cognitive empathy, emotional (or affective) empathy, somatic empathy, and spiritual empathy.

Empathy-based socialization differs from inhibition of egoistic impulses through shaping, modeling, and internalized guilt. Empathetic feelings might enable individuals to develop more satisfactory interpersonal relations, especially in the long-term. Empathy-induced altruism can improve attitudes toward stigmatized groups, and to improve racial attitudes, and actions toward people with AIDS, the homeless, and convicts. It also increases cooperation in competitive situations.

Empathetic people are quick to help others. Painkillers reduce one’s capacity for empathy. Anxiety levels influence empathy. Meditation and reading may heighten empathy.

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Scouts Qualities in to Kill a Mockingbird

This essay about Scout Finch from “To Kill a Mockingbird” analyzes her critical role as the narrator and central character, focusing on her innocence, intelligence, and determination. These traits allow her to offer insightful commentary on racial injustice, ethical growth, and empathy, deeply influencing the reader’s understanding of the novel’s moral themes. Scout’s growth, shaped by her experiences and interactions in Maycomb, highlights her transition from naivety to a nuanced understanding of humanity.

How it works

In Harper Lee’s iconic novel “To Kill a Mockingbird,” Scout Finch serves not only as the central character but also as the story’s narrator, offering a deep and poignant view on complex themes such as racial injustice, ethical development, and empathy. Scout’s narrative is particularly effective due to her distinct characteristics; her innocence, sharp intelligence, and robust determination shape her experiences and deeply influence how readers perceive the moral teachings of the story.

Scout’s innocence is immediately apparent and forms a core theme around which the narrative’s moral lessons are structured.

As a child, she views the world with straightforward curiosity typical of her age. This innocence is vital in a narrative that addresses harsh realities like racism and assault, providing a sharp contrast to the ignorance and prejudice displayed by many adults in the story. Through her interactions with her father, Atticus, and her encounters with deeply ingrained racial prejudices of Maycomb society, Scout’s initial simplicity gradually transforms into a more layered understanding of human complexities. Her evolving relationship with the enigmatic Boo Radley, transitioning from childhood myths to a mature acknowledgment of Boo’s kindness, highlights this development and supports Lee’s commentary on the inherent innocence and decency that can exist alongside human cruelty.

Intelligence is another defining trait of Scout, evident in her precocious reading skills and acute observational abilities. She reads the Mobile Register and interprets complex political cartoons even before attending school, showcasing her advanced intellectual abilities. This intellectual prowess not only sets her apart from her peers but sometimes even isolates her from them. However, it also makes her a perceptive observer of the social and moral dynamics in her community. Scout’s intelligent and reflective narration helps her and the readers question and understand the irrational and unjust behaviors exhibited by the townspeople. This intellectual maturity is crucial as she confronts the racial injustices central to the plot, especially during Tom Robinson’s trial.

Moreover, Scout’s determination is a vital aspect of her character, displayed in how she responds to challenges and confrontations. Whether defending her father’s integrity or confronting peers who insult her family because of Atticus’s role in defending Tom Robinson, Scout’s responses are marked by a fiery spirit and a deep sense of justice and loyalty. Initially, her reactions often involve physical confrontations, but under Atticus’s mentorship, she learns to control her physical impulses and express her strong emotions through more thoughtful avenues. This maturation does not weaken her resolve but rather enhances her ability to deal with the complex moral questions the novel raises.

Throughout the story, Scout’s experiences expose her to the harsh realities of her society, prompting a significant evolution in her understanding of morality. Her interactions with individuals like Calpurnia and Mrs. Dubose help Scout to look beyond initial perceptions and appreciate the inner struggles and strengths of others. This developed capacity for empathy, even towards those who appear different or antagonistic, is a significant growth in her intellectual and emotional journey.

In essence, Scout Finch’s character is a compelling amalgamation of innocence, intelligence, and unwavering determination. These qualities not only define her persona but also propel the narrative and deepen the novel’s exploration of themes like justice, empathy, and the loss of innocence. As readers accompany Scout on her path from naive child to insightful young adult, they are encouraged to contemplate the complexities of human nature and the social structures that influence our moral decisions. Through Scout, Harper Lee not only delivers a gripping tale but also imparts a significant moral education, demonstrating the transformative power of literature.

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Immigration's Effect on US Wages and Employment Redux

In this article we revive, extend and improve the approach used in a series of influential papers written in the 2000s to estimate how changes in the supply of immigrant workers affected natives' wages in the US. We begin by extending the analysis to include the more recent years 2000-2022. Additionally, we introduce three important improvements. First, we introduce an IV that uses a new skill-based shift-share for immigrants and the demographic evolution for natives, which we show passes validity tests and has reasonably strong power. Second, we provide estimates of the impact of immigration on the employment-population ratio of natives to test for crowding out at the national level. Third, we analyze occupational upgrading of natives in response to immigrants. Using these estimates, we calculate that immigration, thanks to native-immigrant complementarity and college skill content of immigrants, had a positive and significant effect between +1.7 to +2.6\% on wages of less educated native workers, over the period 2000-2019 and no significant wage effect on college educated natives. We also calculate a positive employment rate effect for most native workers. Even simulations for the most recent 2019-2022 period suggest small positive effects on wages of non-college natives and no significant crowding out effects on employment.

We are grateful for Rebecca Brough for her research assistance and suggestions. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.

MARC RIS BibTeΧ

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The lived experiences and perspectives of asian americans in their own words.

Asians are the fastest growing racial and ethnic group in the United States. More than 24 million Americans in the U.S. trace their roots to more than 20 countries in East and Southeast Asia and the Indian subcontinent.

The majority of Asian Americans are immigrants, coming to understand what they left behind and building their lives in the United States. At the same time, there is a fast growing, U.S.-born generation of Asian Americans who are navigating their own connections to familial heritage and their own experiences growing up in the U.S.

In a new Pew Research Center analysis based on dozens of focus groups, Asian American participants described the challenges of navigating their own identity in a nation where the label “Asian” brings expectations about their origins, behavior and physical self. Read on to see, in their own words, what it means to be Asian in America.

• Introduction

Table of Contents

This is how i view my identity, this is how others see and treat me, this is what it means to be home in america, about this project, methodological note, acknowledgments.

No single experience defines what it means to be Asian in the United States today. Instead, Asian Americans’ lived experiences are in part shaped by where they were born, how connected they are to their family’s ethnic origins, and how others – both Asians and non-Asians – see and engage with them in their daily lives. Yet despite diverse experiences, backgrounds and origins, shared experiences and common themes emerged when we asked: “What does it mean to be Asian in America?”

In the fall of 2021, Pew Research Center undertook the largest focus group study it had ever conducted – 66 focus groups with 264 total participants – to hear Asian Americans talk about their lived experiences in America. The focus groups were organized into 18 distinct Asian ethnic origin groups, fielded in 18 languages and moderated by members of their own ethnic groups. Because of the pandemic, the focus groups were conducted virtually, allowing us to recruit participants from all parts of the United States. This approach allowed us to hear a diverse set of voices – especially from less populous Asian ethnic groups whose views, attitudes and opinions are seldom presented in traditional polling. The approach also allowed us to explore the reasons behind people’s opinions and choices about what it means to belong in America, beyond the preset response options of a traditional survey.

The terms “Asian,” “Asians living in the United States” and “Asian American” are used interchangeably throughout this essay to refer to U.S. adults who self-identify as Asian, either alone or in combination with other races or Hispanic identity.

“The United States” and “the U.S.” are used interchangeably with “America” for variations in the writing.

Multiracial participants are those who indicate they are of two or more racial backgrounds (one of which is Asian). Multiethnic participants are those who indicate they are of two or more ethnicities, including those identified as Asian with Hispanic background.

U.S. born refers to people born in the 50 U.S. states or the District of Columbia, Puerto Rico, or other U.S. territories.

Immigrant refers to people who were not U.S. citizens at birth – in other words, those born outside the U.S., Puerto Rico or other U.S. territories to parents who were not U.S. citizens. The terms “immigrant,” “first generation” and “foreign born” are used interchangeably in this report.  

Second generation refers to people born in the 50 states or the District of Columbia with at least one first-generation, or immigrant, parent.

The pan-ethnic term “Asian American” describes the population of about 22 million people living in the United States who trace their roots to more than 20 countries in East and Southeast Asia and the Indian subcontinent. The term was popularized by U.S. student activists in the 1960s and was eventually adopted by the U.S. Census Bureau. However, the “Asian” label masks the diverse demographics and wide economic disparities across the largest national origin groups (such as Chinese, Indian, Filipino) and the less populous ones (such as Bhutanese, Hmong and Nepalese) living in America. It also hides the varied circumstances of groups immigrated to the U.S. and how they started their lives there. The population’s diversity often presents challenges . Conventional survey methods typically reflect the voices of larger groups without fully capturing the broad range of views, attitudes, life starting points and perspectives experienced by Asian Americans. They can also limit understanding of the shared experiences across this diverse population.

Across all focus groups, some common findings emerged. Participants highlighted how the pan-ethnic “Asian” label used in the U.S. represented only one part of how they think of themselves. For example, recently arrived Asian immigrant participants told us they are drawn more to their ethnic identity than to the more general, U.S.-created pan-ethnic Asian American identity. Meanwhile, U.S.-born Asian participants shared how they identified, at times, as Asian but also, at other times, by their ethnic origin and as Americans.

Another common finding among focus group participants is the disconnect they noted between how they see themselves and how others view them. Sometimes this led to maltreatment of them or their families, especially at heightened moments in American history such as during Japanese incarceration during World War II, the aftermath of 9/11 and, more recently, the COVID-19 pandemic. Beyond these specific moments, many in the focus groups offered their own experiences that had revealed other people’s assumptions or misconceptions about their identity.

Another shared finding is the multiple ways in which participants take and express pride in their cultural and ethnic backgrounds while also feeling at home in America, celebrating and blending their unique cultural traditions and practices with those of other Americans.

This focus group project is part of a broader research agenda about Asians living in the United States. The findings presented here offer a small glimpse of what participants told us, in their own words, about how they identify themselves, how others see and treat them, and more generally, what it means to be Asian in America.

Illustrations by Jing Li

Publications from the Being Asian in America project

• Read the data essay: What It Means to Be Asian in America
• Watch the documentary: Being Asian in America
• Explore the interactive: In Their Own Words: The Diverse Perspectives of Being Asian in America
• View expanded interviews: Extended Interviews: Being Asian in America
• About this research project: More on the Being Asian in America project
• Q&A: Why and how Pew Research Center conducted 66 focus groups with Asian Americans

One of the topics covered in each focus group was how participants viewed their own racial or ethnic identity. Moderators asked them how they viewed themselves, and what experiences informed their views about their identity. These discussions not only highlighted differences in how participants thought about their own racial or ethnic background, but they also revealed how different settings can influence how they would choose to identify themselves. Across all focus groups, the general theme emerged that being Asian was only one part of how participants viewed themselves.

The pan-ethnic label ‘Asian’ is often used more in formal settings

“I think when I think of the Asian Americans, I think that we’re all unique and different. We come from different cultures and backgrounds. We come from unique stories, not just as a group, but just as individual humans.” Mali , documentary participant

Many participants described a complicated relationship with the pan-ethnic labels “Asian” or “Asian American.” For some, using the term was less of an active choice and more of an imposed one, with participants discussing the disconnect between how they would like to identify themselves and the available choices often found in formal settings. For example, an immigrant Pakistani woman remarked how she typically sees “Asian American” on forms, but not more specific options. Similarly, an immigrant Burmese woman described her experience of applying for jobs and having to identify as “Asian,” as opposed to identifying by her ethnic background, because no other options were available. These experiences highlight the challenges organizations like government agencies and employers have in developing surveys or forms that ask respondents about their identity. A common sentiment is one like this:

“I guess … I feel like I just kind of check off ‘Asian’ [for] an application or the test forms. That’s the only time I would identify as Asian. But Asian is too broad. Asia is a big continent. Yeah, I feel like it’s just too broad. To specify things, you’re Taiwanese American, that’s exactly where you came from.”

–U.S.-born woman of Taiwanese origin in early 20s

Smaller ethnic groups default to ‘Asian’ since their groups are less recognizable

Other participants shared how their experiences in explaining the geographic location and culture of their origin country led them to prefer “Asian” when talking about themselves with others. This theme was especially prominent among those belonging to smaller origin groups such as Bangladeshis and Bhutanese. A Lao participant remarked she would initially say “Asian American” because people might not be familiar with “Lao.”

“​​[When I fill out] forms, I select ‘Asian American,’ and that’s why I consider myself as an Asian American. [It is difficult to identify as] Nepali American [since] there are no such options in forms. That’s why, Asian American is fine to me.”

–Immigrant woman of Nepalese origin in late 20s

“Coming to a big country like [the United States], when people ask where we are from … there are some people who have no idea about Bhutan, so we end up introducing ourselves as being Asian.”

–Immigrant woman of Bhutanese origin in late 40s

But for many, ‘Asian’ as a label or identity just doesn’t fit

Many participants felt that neither “Asian” nor “Asian American” truly captures how they view themselves and their identity. They argue that these labels are too broad or too ambiguous, as there are so many different groups included within these labels. For example, a U.S.-born Pakistani man remarked on how “Asian” lumps many groups together – that the term is not limited to South Asian groups such as Indian and Pakistani, but also includes East Asian groups. Similarly, an immigrant Nepalese man described how “Asian” often means Chinese for many Americans. A Filipino woman summed it up this way:

“Now I consider myself to be both Filipino and Asian American, but growing up in [Southern California] … I didn’t start to identify as Asian American until college because in [the Los Angeles suburb where I lived], it’s a big mix of everything – Black, Latino, Pacific Islander and Asian … when I would go into spaces where there were a lot of other Asians, especially East Asians, I didn’t feel like I belonged. … In media, right, like people still associate Asian with being East Asian.”

–U.S.-born woman of Filipino origin in mid-20s

Participants also noted they have encountered confusion or the tendency for others to view Asian Americans as people from mostly East Asian countries, such as China, Japan and Korea. For some, this confusion even extends to interactions with other Asian American groups. A Pakistani man remarked on how he rarely finds Pakistani or Indian brands when he visits Asian stores. Instead, he recalled mostly finding Vietnamese, Korean and Chinese items.

Among participants of South Asian descent, some identified with the label “South Asian” more than just “Asian.” There were other nuances, too, when it comes to the labels people choose. Some Indian participants, for example, said people sometimes group them with Native Americans who are also referred to as Indians in the United States. This Indian woman shared her experience at school:

“I love South Asian or ‘Desi’ only because up until recently … it’s fairly new to say South Asian. I’ve always said ‘Desi’ because growing up … I’ve had to say I’m the red dot Indian, not the feather Indian. So annoying, you know? … Always a distinction that I’ve had to make.”

–U.S.-born woman of Indian origin in late 20s

Participants with multiethnic or multiracial backgrounds described their own unique experiences with their identity. Rather than choosing one racial or ethnic group over the other, some participants described identifying with both groups, since this more accurately describes how they see themselves. In some cases, this choice reflected the history of the Asian diaspora. For example, an immigrant Cambodian man described being both Khmer/Cambodian and Chinese, since his grandparents came from China. Some other participants recalled going through an “identity crisis” as they navigated between multiple identities. As one woman explained:

“I would say I went through an identity crisis. … It’s because of being multicultural. … There’s also French in the mix within my family, too. Because I don’t identify, speak or understand the language, I really can’t connect to the French roots … I’m in between like Cambodian and Thai, and then Chinese and then French … I finally lumped it up. I’m just an Asian American and proud of all my roots.”

–U.S.-born woman of Cambodian origin in mid-30s

In other cases, the choice reflected U.S. patterns of intermarriage. Asian newlyweds have the highest intermarriage rate of any racial or ethnic group in the country. One Japanese-origin man with Hispanic roots noted:

“So I would like to see myself as a Hispanic Asian American. I want to say Hispanic first because I have more of my mom’s culture in me than my dad’s culture. In fact, I actually have more American culture than my dad’s culture for what I do normally. So I guess, Hispanic American Asian.”

–U.S.-born man of Hispanic and Japanese origin in early 40s

Other identities beyond race or ethnicity are also important

Focus group participants also talked about their identity beyond the racial or ethnic dimension. For example, one Chinese woman noted that the best term to describe her would be “immigrant.” Faith and religious ties were also important to some. One immigrant participant talked about his love of Pakistani values and how religion is intermingled into Pakistani culture. Another woman explained:

“[Japanese language and culture] are very important to me and ingrained in me because they were always part of my life, and I felt them when I was growing up. Even the word itadakimasu reflects Japanese culture or the tradition. Shinto religion is a part of the culture. They are part of my identity, and they are very important to me.”

–Immigrant woman of Japanese origin in mid-30s

For some, gender is another important aspect of identity. One Korean participant emphasized that being a woman is an important part of her identity. For others, sexual orientation is an essential part of their overall identity. One U.S.-born Filipino participant described herself as “queer Asian American.” Another participant put it this way:

“I belong to the [LGBTQ] community … before, what we only know is gay and lesbian. We don’t know about being queer, nonbinary. [Here], my horizon of knowing what genders and gender roles is also expanded … in the Philippines, if you’ll be with same sex, you’re considered gay or lesbian. But here … what’s happening is so broad, on how you identify yourself.”

–Immigrant woman of Filipino origin in early 20s

Immigrant identity is tied to their ethnic heritage

Participants born outside the United States tended to link their identity with their ethnic heritage. Some felt strongly connected with their ethnic ties due to their citizenship status. For others, the lack of permanent residency or citizenship meant they have stronger ties to their ethnicity and birthplace. And in some cases, participants said they held on to their ethnic identity even after they became U.S. citizens. One woman emphasized that she will always be Taiwanese because she was born there, despite now living in the U.S.

For other participants, family origin played a central role in their identity, regardless of their status in the U.S. According to some of them, this attitude was heavily influenced by their memories and experiences in early childhood when they were still living in their countries of origin. These influences are so profound that even after decades of living in the U.S., some still feel the strong connection to their ethnic roots. And those with U.S.-born children talked about sending their kids to special educational programs in the U.S. to learn about their ethnic heritage.

“Yes, as for me, I hold that I am Khmer because our nationality cannot be deleted, our identity is Khmer as I hold that I am Khmer … so I try, even [with] my children today, I try to learn Khmer through Zoom through the so-called Khmer Parent Association.”

–Immigrant man of Cambodian origin in late 50s

Navigating life in America is an adjustment

Many participants pointed to cultural differences they have noticed between their ethnic culture and U.S. culture. One of the most distinct differences is in food. For some participants, their strong attachment to the unique dishes of their families and their countries of origin helps them maintain strong ties to their ethnic identity. One Sri Lankan participant shared that her roots are still in Sri Lanka, since she still follows Sri Lankan traditions in the U.S. such as preparing kiribath (rice with coconut milk) and celebrating Ramadan.

For other participants, interactions in social settings with those outside their own ethnic group circles highlighted cultural differences. One Bangladeshi woman talked about how Bengalis share personal stories and challenges with each other, while others in the U.S. like to have “small talk” about TV series or clothes.

Many immigrants in the focus groups have found it is easier to socialize when they are around others belonging to their ethnicity. When interacting with others who don’t share the same ethnicity, participants noted they must be more self-aware about cultural differences to avoid making mistakes in social interactions. Here, participants described the importance of learning to “fit in,” to avoid feeling left out or excluded. One Korean woman said:

“Every time I go to a party, I feel unwelcome. … In Korea, when I invite guests to my house and one person sits without talking, I come over and talk and treat them as a host. But in the United States, I have to go and mingle. I hate mingling so much. I have to talk and keep going through unimportant stories. In Korea, I am assigned to a dinner or gathering. I have a party with a sense of security. In America, I have nowhere to sit, and I don’t know where to go and who to talk to.”

–Immigrant woman of Korean origin in mid-40s

And a Bhutanese immigrant explained:

“In my case, I am not an American. I consider myself a Bhutanese. … I am a Bhutanese because I do not know American culture to consider myself as an American. It is very difficult to understand the sense of humor in America. So, we are pure Bhutanese in America.”

–Immigrant man of Bhutanese origin in early 40s

Language was also a key aspect of identity for the participants. Many immigrants in the focus groups said they speak a language other than English at home and in their daily lives. One Vietnamese man considered himself Vietnamese since his Vietnamese is better than his English. Others emphasized their English skills. A Bangladeshi participant felt that she was more accepted in the workplace when she does more “American” things and speaks fluent English, rather than sharing things from Bangladeshi culture. She felt that others in her workplace correlate her English fluency with her ability to do her job. For others born in the U.S., the language they speak at home influences their connection to their ethnic roots.

“Now if I go to my work and do show my Bengali culture and Asian culture, they are not going to take anything out of it. So, basically, I have to show something that they are interested in. I have to show that I am American, [that] I can speak English fluently. I can do whatever you give me as a responsibility. So, in those cases I can’t show anything about my culture.”

–Immigrant woman of Bangladeshi origin in late 20s

“Being bi-ethnic and tri-cultural creates so many unique dynamics, and … one of the dynamics has to do with … what it is to be Americanized. … One of the things that played a role into how I associate the identity is language. Now, my father never spoke Spanish to me … because he wanted me to develop a fluency in English, because for him, he struggled with English. What happened was three out of the four people that raised me were Khmer … they spoke to me in Khmer. We’d eat breakfast, lunch and dinner speaking Khmer. We’d go to the temple in Khmer with the language and we’d also watch videos and movies in Khmer. … Looking into why I strongly identify with the heritage, one of the reasons is [that] speaking that language connects to the home I used to have [as my families have passed away].”

–U.S.-born man of Cambodian origin in early 30s

Balancing between individualistic and collective thinking

For some immigrant participants, the main differences between themselves and others who are seen as “truly American” were less about cultural differences, or how people behave, and more about differences in “mindset,” or how people think . Those who identified strongly with their ethnicity discussed how their way of thinking is different from a “typical American.” To some, the “American mentality” is more individualistic, with less judgment on what one should do or how they should act . One immigrant Japanese man, for example, talked about how other Japanese-origin co-workers in the U.S. would work without taking breaks because it’s culturally inconsiderate to take a break while others continued working. However, he would speak up for himself and other workers when they are not taking any work breaks. He attributed this to his “American” way of thinking, which encourages people to stand up for themselves.

Some U.S.-born participants who grew up in an immigrant family described the cultural clashes that happened between themselves and their immigrant parents. Participants talked about how the second generation (children of immigrant parents) struggles to pursue their own dreams while still living up to the traditional expectations of their immigrant parents.

“I feel like one of the biggest things I’ve seen, just like [my] Asian American friends overall, is the kind of family-individualistic clash … like wanting to do your own thing is like, is kind of instilled in you as an American, like go and … follow your dream. But then you just grow up with such a sense of like also wanting to be there for your family and to live up to those expectations, and I feel like that’s something that’s very pronounced in Asian cultures.”

–U.S.-born man of Indian origin in mid-20s

Discussions also highlighted differences about gender roles between growing up in America compared with elsewhere.

“As a woman or being a girl, because of your gender, you have to keep your mouth shut [and] wait so that they call on you for you to speak up. … I do respect our elders and I do respect hearing their guidance but I also want them to learn to hear from the younger person … because we have things to share that they might not know and that [are] important … so I like to challenge gender roles or traditional roles because it is something that [because] I was born and raised here [in America], I learn that we all have the equal rights to be able to speak and share our thoughts and ideas.”

U.S. born have mixed ties to their family’s heritage

“I think being Hmong is somewhat of being free, but being free of others’ perceptions of you or of others’ attempts to assimilate you or attempts to put pressure on you. I feel like being Hmong is to resist, really.” Pa Houa , documentary participant

How U.S.-born participants identify themselves depends on their familiarity with their own heritage, whom they are talking with, where they are when asked about their identity and what the answer is used for. Some mentioned that they have stronger ethnic ties because they are very familiar with their family’s ethnic heritage. Others talked about how their eating habits and preferred dishes made them feel closer to their ethnic identity. For example, one Korean participant shared his journey of getting closer to his Korean heritage because of Korean food and customs. When some participants shared their reasons for feeling closer to their ethnic identity, they also expressed a strong sense of pride with their unique cultural and ethnic heritage.

“I definitely consider myself Japanese American. I mean I’m Japanese and American. Really, ever since I’ve grown up, I’ve really admired Japanese culture. I grew up watching a lot of anime and Japanese black and white films. Just learning about [it], I would hear about Japanese stuff from my grandparents … myself, and my family having blended Japanese culture and American culture together.”

–U.S.-born man of Japanese origin in late 20s

Meanwhile, participants who were not familiar with their family’s heritage showed less connection with their ethnic ties. One U.S.-born woman said she has a hard time calling herself Cambodian, as she is “not close to the Cambodian community.” Participants with stronger ethnic ties talked about relating to their specific ethnic group more than the broader Asian group. Another woman noted that being Vietnamese is “more specific and unique than just being Asian” and said that she didn’t feel she belonged with other Asians. Some participants also disliked being seen as or called “Asian,” in part because they want to distinguish themselves from other Asian groups. For example, one Taiwanese woman introduces herself as Taiwanese when she can, because she had frequently been seen as Chinese.

Some in the focus groups described how their views of their own identities shifted as they grew older. For example, some U.S.-born and immigrant participants who came to the U.S. at younger ages described how their experiences in high school and the need to “fit in” were important in shaping their own identities. A Chinese woman put it this way:

“So basically, all I know is that I was born in the United States. Again, when I came back, I didn’t feel any barrier with my other friends who are White or Black. … Then I got a little confused in high school when I had trouble self-identifying if I am Asian, Chinese American, like who am I. … Should I completely immerse myself in the American culture? Should I also keep my Chinese identity and stuff like that? So yeah, that was like the middle of that mist. Now, I’m pretty clear about myself. I think I am Chinese American, Asian American, whatever people want.”

–U.S.-born woman of Chinese origin in early 20s

Identity is influenced by birthplace

“I identified myself first and foremost as American. Even on the forms that you fill out that says, you know, ‘Asian’ or ‘Chinese’ or ‘other,’ I would check the ‘other’ box, and I would put ‘American Chinese’ instead of ‘Chinese American.’” Brent , documentary participant

When talking about what it means to be “American,” participants offered their own definitions. For some, “American” is associated with acquiring a distinct identity alongside their ethnic or racial backgrounds, rather than replacing them. One Indian participant put it this way:

“I would also say [that I am] Indian American just because I find myself always bouncing between the two … it’s not even like dual identity, it just is one whole identity for me, like there’s not this separation. … I’m doing [both] Indian things [and] American things. … They use that term like ABCD … ‘American Born Confused Desi’ … I don’t feel that way anymore, although there are those moments … but I would say [that I am] Indian American for sure.”

–U.S.-born woman of Indian origin in early 30s

Meanwhile, some U.S.-born participants view being American as central to their identity while also valuing the culture of their family’s heritage.

Many immigrant participants associated the term “American” with immigration status or citizenship. One Taiwanese woman said she can’t call herself American since she doesn’t have a U.S. passport. Notably, U.S. citizenship is an important milestone for many immigrant participants, giving them a stronger sense of belonging and ultimately calling themselves American. A Bangladeshi participant shared that she hasn’t received U.S. citizenship yet, and she would call herself American after she receives her U.S. passport.

Other participants gave an even narrower definition, saying only those born and raised in the United States are truly American. One Taiwanese woman mentioned that her son would be American since he was born, raised and educated in the U.S. She added that while she has U.S. citizenship, she didn’t consider herself American since she didn’t grow up in the U.S. This narrower definition has implications for belonging. Some immigrants in the groups said they could never become truly American since the way they express themselves is so different from those who were born and raised in the U.S. A Japanese woman pointed out that Japanese people “are still very intimidated by authorities,” while those born and raised in America give their opinions without hesitation.

“As soon as I arrived, I called myself a Burmese immigrant. I had a green card, but I still wasn’t an American citizen. … Now I have become a U.S. citizen, so now I am a Burmese American.”

–Immigrant man of Burmese origin in mid-30s

“Since I was born … and raised here, I kind of always view myself as American first who just happened to be Asian or Chinese. So I actually don’t like the term Chinese American or Asian American. I’m American Asian or American Chinese. I view myself as American first.”

–U.S.-born man of Chinese origin in early 60s

“[I used to think of myself as] Filipino, but recently I started saying ‘Filipino American’ because I got [U.S.] citizenship. And it just sounds weird to say Filipino American, but I’m trying to … I want to accept it. I feel like it’s now marry-able to my identity.”

–Immigrant woman of Filipino origin in early 30s

For others, American identity is about the process of ‘becoming’ culturally American

Immigrant participants also emphasized how their experiences and time living in America inform their views of being an “American.” As a result, some started to see themselves as Americans after spending more than a decade in the U.S. One Taiwanese man considered himself an American since he knows more about the U.S. than Taiwan after living in the U.S. for over 52 years.

But for other immigrant participants, the process of “becoming” American is not about how long they have lived in the U.S., but rather how familiar they are with American culture and their ability to speak English with little to no accent. This is especially true for those whose first language is not English, as learning and speaking it without an accent can be a big challenge for some. One Bangladeshi participant shared that his pronunciation of “hot water” was very different from American English, resulting in confusions in communication. By contrast, those who were more confident in their English skills felt they can better understand American culture and values as a result, leading them to a stronger connection with an American identity.

“[My friends and family tease me for being Americanized when I go back to Japan.] I think I seem a little different to people who live in Japan. I don’t think they mean anything bad, and they [were] just joking, because I already know that I seem a little different to people who live in Japan.”

–Immigrant man of Japanese origin in mid-40s

“I value my Hmong culture, and language, and ethnicity, but I also do acknowledge, again, that I was born here in America and I’m grateful that I was born here, and I was given opportunities that my parents weren’t given opportunities for.”

–U.S.-born woman of Hmong origin in early 30s

During the focus group discussions about identity, a recurring theme emerged about the difference between how participants saw themselves and how others see them. When asked to elaborate on their experiences and their points of view, some participants shared experiences they had with people misidentifying their race or ethnicity. Others talked about their frustration with being labeled the “model minority.” In all these discussions, participants shed light on the negative impacts that mistaken assumptions and labels had on their lives.

All people see is ‘Asian’

For many, interactions with others (non-Asians and Asians alike) often required explaining their backgrounds, reacting to stereotypes, and for those from smaller origin groups in particular, correcting the misconception that being “Asian” means you come from one of the larger Asian ethnic groups. Several participants remarked that in their own experiences, when others think about Asians, they tend to think of someone who is Chinese. As one immigrant Filipino woman put it, “Interacting with [non-Asians in the U.S.], it’s hard. … Well, first, I look Spanish. I mean, I don’t look Asian, so would you guess – it’s like they have a vision of what an Asian [should] look like.” Similarly, an immigrant Indonesian man remarked how Americans tended to see Asians primarily through their physical features, which not all Asian groups share.

Several participants also described how the tendency to view Asians as a monolithic group can be even more common in the wake of the COVID-19 pandemic.

“The first [thing people think of me as] is just Chinese. ‘You guys are just Chinese.’ I’m not the only one who felt [this] after the COVID-19 outbreak. ‘Whether you’re Japanese, Korean, or Southeast Asian, you’re just Chinese [to Americans]. I should avoid you.’ I’ve felt this way before, but I think I’ve felt it a bit more after the COVID-19 outbreak.”

–Immigrant woman of Korean origin in early 30s

At the same time, other participants described their own experiences trying to convince others that they are Asian or Asian American. This was a common experience among Southeast Asian participants.

“I have to convince people I’m Asian, not Middle Eastern. … If you type in Asian or you say Asian, most people associate it with Chinese food, Japanese food, karate, and like all these things but then they don’t associate it with you.”

–U.S.-born man of Pakistani origin in early 30s

The model minority myth and its impact

“I’ve never really done the best academically, compared to all my other Asian peers too. I never really excelled. I wasn’t in honors. … Those stereotypes, I think really [have] taken a toll on my self-esteem.” Diane , documentary participant

Across focus groups, immigrant and U.S.-born participants described the challenges of the seemingly positive stereotypes of Asians as intelligent, gifted in technical roles and hardworking. Participants often referred to this as the “model minority myth.”

The label “model minority” was coined in the 1960s and has been used to characterize Asian Americans as financially and educationally successful and hardworking when compared with other groups. However, for many Asians living in the United States, these characterizations do not align with their lived experiences or reflect their socioeconomic backgrounds. Indeed, among Asian origin groups in the U.S., there are wide differences in economic and social experiences. 

Academic research on the model minority myth has pointed to its impact beyond Asian Americans and towards other racial and ethnic groups, especially Black Americans, in the U.S. Some argue that the model minority myth has been used to justify policies that overlook the historical circumstances and impacts of colonialism, slavery, discrimination and segregation on other non-White racial and ethnic groups.

Many participants noted ways in which the model minority myth has been harmful. For some, expectations based on the myth didn’t match their own experiences of coming from impoverished communities. Some also recalled experiences at school when they struggled to meet their teachers’ expectations in math and science.

“As an Asian person, I feel like there’s that stereotype that Asian students are high achievers academically. They’re good at math and science. … I was a pretty mediocre student, and math and science were actually my weakest subjects, so I feel like it’s either way you lose. Teachers expect you to fit a certain stereotype and if you’re not, then you’re a disappointment, but at the same time, even if you are good at math and science, that just means that you’re fitting a stereotype. It’s [actually] your own achievement, but your teachers might think, ‘Oh, it’s because they’re Asian,’ and that diminishes your achievement.”

–U.S.-born woman of Korean origin in late 20s

Some participants felt that even when being Asian worked in their favor in the job market, they encountered stereotypes that “Asians can do quality work with less compensation” or that “Asians would not complain about anything at work.”

“There is a joke from foreigners and even Asian Americans that says, ‘No matter what you do, Asians always do the best.’ You need to get A, not just B-plus. Otherwise, you’ll be a disgrace to the family. … Even Silicon Valley hires Asian because [an] Asian’s wage is cheaper but [they] can work better. When [work] visa overflow happens, they hire Asians like Chinese and Indian to work in IT fields because we are good at this and do not complain about anything.”

–Immigrant man of Thai origin in early 40s

Others expressed frustration that people were placing them in the model minority box. One Indian woman put it this way:

“Indian people and Asian people, like … our parents or grandparents are the ones who immigrated here … against all odds. … A lot of Indian and Asian people have succeeded and have done really well for themselves because they’ve worked themselves to the bone. So now the expectations [of] the newer generations who were born here are incredibly unrealistic and high. And you get that not only from your family and the Indian community, but you’re also getting it from all of the American people around you, expecting you to be … insanely good at math, play an instrument, you know how to do this, you know how to do that, but it’s not true. And it’s just living with those expectations, it’s difficult.”

–U.S.-born woman of Indian origin in early 20s

Whether U.S. born or immigrants, Asians are often seen by others as foreigners

“Being only not quite 10 years old, it was kind of exciting to ride on a bus to go someplace. But when we went to Pomona, the assembly center, we were stuck in one of the stalls they used for the animals.” Tokiko , documentary participant

Across all focus groups, participants highlighted a common question they are asked in America when meeting people for the first time: “Where are you really from?” For participants, this question implied that people think they are “foreigners,” even though they may be longtime residents or citizens of the United States or were born in the country. One man of Vietnamese origin shared his experience with strangers who assumed that he and his friends are North Korean. Perhaps even more hurtful, participants mentioned that this meant people had a preconceived notion of what an “American” is supposed to look like, sound like or act like. One Chinese woman said that White Americans treated people like herself as outsiders based on her skin color and appearance, even though she was raised in the U.S.

Many focus group participants also acknowledged the common stereotype of treating Asians as “forever foreigners.” Some immigrant participants said they felt exhausted from constantly being asked this question by people even when they speak perfect English with no accent. During the discussion, a Korean immigrant man recalled that someone had said to him, “You speak English well, but where are you from?” One Filipino participant shared her experience during the first six months in the U.S.:

“You know, I spoke English fine. But there were certain things that, you know, people constantly questioning you like, oh, where are you from? When did you come here? You know, just asking about your experience to the point where … you become fed up with it after a while.”

–Immigrant woman of Filipino origin in mid-30s

U.S.-born participants also talked about experiences when others asked where they are from. Many shared that they would not talk about their ethnic origin right away when answering such a question because it often led to misunderstandings and assumptions that they are immigrants.

“I always get that question of, you know, ‘Where are you from?’ and I’m like, ‘I’m from America.’ And then they’re like, ‘No. Where are you from-from ?’ and I’m like, ‘Yeah, my family is from Pakistan,’ so it’s like I always had like that dual identity even though it’s never attached to me because I am like, of Pakistani descent.”

–U.S.-born man of Pakistani origin in early 20s

One Korean woman born in the U.S. said that once people know she is Korean, they ask even more offensive questions such as “Are you from North or South Korea?” or “Do you still eat dogs?”

In a similar situation, this U.S.-born Indian woman shared her responses:

“I find that there’s a, ‘So but where are you from?’ Like even in professional settings when they feel comfortable enough to ask you. ‘So – so where are you from?’ ‘Oh, I was born in [names city], Colorado. Like at [the hospital], down the street.’ ‘No, but like where are you from?’ ‘My mother’s womb?’”

–U.S.-born woman of Indian origin in early 40s

Ignorance and misinformation about Asian identity can lead to contentious encounters

“I have dealt with kids who just gave up on their Sikh identity, cut their hair and groomed their beard and everything. They just wanted to fit in and not have to deal with it, especially [those] who are victim or bullied in any incident.” Surinder , documentary participant

In some cases, ignorance and misinformation about Asians in the U.S. lead to inappropriate comments or questions and uncomfortable or dangerous situations. Participants shared their frustration when others asked about their country of origin, and they then had to explain their identity or correct misunderstandings or stereotypes about their background. At other times, some participants faced ignorant comments about their ethnicity, which sometimes led to more contentious encounters. For example, some Indian or Pakistani participants talked about the attacks or verbal abuse they experienced from others blaming them for the 9/11 terrorist attacks. Others discussed the racial slurs directed toward them since the COVID-19 pandemic in 2020. Some Japanese participants recalled their families losing everything and being incarcerated during World War II and the long-term effect it had on their lives.

“I think like right now with the coronavirus, I think we’re just Chinese, Chinese American, well, just Asian American or Asians in general, you’re just going through the same struggles right now. Like everyone is just blaming whoever looks Asian about the virus. You don’t feel safe.”

–U.S.-born man of Chinese origin in early 30s

“At the beginning of the pandemic, a friend and I went to celebrate her birthday at a club and like these guys just kept calling us COVID.”

–U.S.-born woman of Korean origin in early 20s

“There [were] a lot of instances after 9/11. One day, somebody put a poster about 9/11 [in front of] my business. He was wearing a gun. … On the poster, it was written ‘you Arabs, go back to your country.’ And then someone came inside. He pointed his gun at me and said ‘Go back to your country.’”

–Immigrant man of Pakistani origin in mid-60s

“[My parents went through the] internment camps during World War II. And my dad, he was in high school, so he was – they were building the camps and then he was put into the Santa Anita horse track place, the stables there. And then they were sent – all the Japanese Americans were sent to different camps, right, during World War II and – in California. Yeah, and they lost everything, yeah.”

–U.S.-born woman of Japanese origin in mid-60s

As focus group participants contemplated their identity during the discussions, many talked about their sense of belonging in America. Although some felt frustrated with people misunderstanding their ethnic heritage, they didn’t take a negative view of life in America. Instead, many participants – both immigrant and U.S. born – took pride in their unique cultural and ethnic backgrounds. In these discussions, people gave their own definitions of America as a place with a diverse set of cultures, with their ethnic heritage being a part of it.

Taking pride in their unique cultures

“Being a Pakistani American, I’m proud. … Because I work hard, and I make true my dreams from here.” Shahid , documentary participant

Despite the challenges of adapting to life in America for immigrant participants or of navigating their dual cultural identity for U.S.-born ones, focus group participants called America their home. And while participants talked about their identities in different ways – ethnic identity, racial (Asian) identity, and being American – they take pride in their unique cultures. Many also expressed a strong sense of responsibility to give back or support their community, sharing their cultural heritage with others on their own terms.

“Right now it has been a little difficult. I think it has been for all Asians because of the COVID issue … but I’m glad that we’re all here [in America]. I think we should be proud to be here. I’m glad that our families have traveled here, and we can help make life better for communities, our families and ourselves. I think that’s really a wonderful thing. We can be those role models for a lot of the future, the younger folks. I hope that something I did in the last years will have impacted either my family, friends or students that I taught in other community things that I’ve done. So you hope that it helps someplace along the line.”

“I am very proud of my culture. … There is not a single Bengali at my workplace, but people know the name of my country. Maybe many years [later] – educated people know all about the country. So, I don’t have to explain that there is a small country next to India and Nepal. It’s beyond saying. People after all know Bangladesh. And there are so many Bengali present here as well. So, I am very proud to be a Bangladeshi.”

Where home is

When asked about the definition of home, some immigrant participants said home is where their families are located. Immigrants in the focus groups came to the United States by various paths, whether through work opportunities, reuniting with family or seeking a safe haven as refugees. Along their journey, some received support from family members, their local community or other individuals, while others overcame challenges by themselves. Either way, they take pride in establishing their home in America and can feel hurt when someone tells them to “go back to your country.” In response, one Laotian woman in her mid-40s said, “This is my home. My country. Go away.”

“If you ask me personally, I view my home as my house … then I would say my house is with my family because wherever I go, I cannot marry if I do not have my family so that is how I would answer.”

–Immigrant man of Hmong origin in late 30s

“[If somebody yelled at me ‘go back to your country’] I’d feel angry because this is my country! I live here. America is my country. I grew up here and worked here … I’d say, ‘This is my country! You go back to your country! … I will not go anywhere. This is my home. I will live here.’ That’s what I’d say.”

–Immigrant woman of Laotian origin in early 50s

‘American’ means to blend their unique cultural and ethnic heritage with that in the U.S.

“I want to teach my children two traditions – one American and one Vietnamese – so they can compare and choose for themselves the best route in life.” Helen , documentary participant (translated from Vietnamese)

Both U.S.-born and immigrant participants in the focus groups shared their experiences of navigating a dual cultural environment between their ethnic heritage and American culture. A common thread that emerged was that being Asian in America is a process of blending two or more identities as one.

“Yeah, I want to say that’s how I feel – because like thinking about it, I would call my dad Lao but I would call myself Laotian American because I think I’m a little more integrated in the American society and I’ve also been a little more Americanized, compared to my dad. So that’s how I would see it.”

–U.S.-born man of Laotian origin in late 20s

“I mean, Bangladeshi Americans who are here, we are carrying Bangladeshi culture, religion, food. I am also trying to be Americanized like the Americans. Regarding language, eating habits.”

–Immigrant man of Bangladeshi origin in mid-50s

“Just like there is Chinese American, Mexican American, Japanese American, Italian American, so there is Indian American. I don’t want to give up Indianness. I am American by nationality, but I am Indian by birth. So whenever I talk, I try to show both the flags as well, both Indian and American flags. Just because you make new relatives but don’t forget the old relatives.”

–Immigrant man of Indian origin in late 40s

Pew Research Center designed these focus groups to better understand how members of an ethnically diverse Asian population think about their place in America and life here. By including participants of different languages, immigration or refugee experiences, educational backgrounds, and income levels, this focus group study aimed to capture in people’s own words what it means to be Asian in America. The discussions in these groups may or may not resonate with all Asians living in the United States. Browse excerpts from our focus groups with the interactive quote sorter below, view a video documentary focused on the topics discussed in the focus groups, or tell us your story of belonging in America via social media. The focus group project is part of a broader research project studying the diverse experiences of Asians living in the U.S.

Read sortable quotes from our focus groups

Browse excerpts in the interactive quote sorter from focus group participants in response to the question “What does it mean to be [Vietnamese, Thai, Sri Lankan, Hmong, etc.] like yourself in America?” This interactive allows you to sort quotes from focus group participants by ethnic origin, nativity (U.S. born or born in another country), gender and age.

Video documentary

Videos throughout the data essay illustrate what focus group participants discussed. Those recorded in these videos did not participate in the focus groups but were sampled to have similar demographic characteristics and thematically relevant stories.

Watch the full video documentary and watch additional shorter video clips related to the themes of this data essay.

Share the story of your family and your identity

Did the voices in this data essay resonate? Share your story of what it means to be Asian in America with @pewresearch. Tell us your story by using the hashtag #BeingAsianInAmerica and @pewidentity on Twitter, as well as #BeingAsianInAmerica and @pewresearch on Instagram.

This cross-ethnic, comparative qualitative research project explores the identity, economic mobility, representation, and experiences of immigration and discrimination among the Asian population in the United States. The analysis is based on 66 focus groups we conducted virtually in the fall of 2021 and included 264 participants from across the U.S. More information about the groups and analysis can be found in this appendix .

Pew Research Center is a subsidiary of The Pew Charitable Trusts, its primary funder. This data essay was funded by The Pew Charitable Trusts, with generous support from the Chan Zuckerberg Initiative DAF, an advised fund of the Silicon Valley Community Foundation; the Robert Wood Johnson Foundation; the Henry Luce Foundation; The Wallace H. Coulter Foundation; The Dirk and Charlene Kabcenell Foundation; The Long Family Foundation; Lu-Hebert Fund; Gee Family Foundation; Joseph Cotchett; the Julian Abdey and Sabrina Moyle Charitable Fund; and Nanci Nishimura.

The accompanying video clips and video documentary were made possible by The Pew Charitable Trusts, with generous support from The Sobrato Family Foundation and The Long Family Foundation.

We would also like to thank the Leaders Forum for its thought leadership and valuable assistance in helping make this study possible. This is a collaborative effort based on the input and analysis of a number of individuals and experts at Pew Research Center and outside experts.

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