Easing the burden of COVID-19 on U.S. Pacific Islanders

Today’s guest bloggers are APHA members Iyanrick John, JD, MPH, senior policy strategist for the Asian & Pacific Islander American Health Forum, and Priya Raman, program assistant for the Statewide Pacific Islander Asian American Resource and Coordinating Center. John serves as policy director and Raman is caucus collaborative director for APHA’s Asian & Pacific Islander Caucus for Public Health.

Over the past few months, we’ve witnessed the disproportionate impact of COVID-19 on many communities of color and vulnerable populations in the U.S., including Pacific Islanders. 

Data from states such as Arkansas, California, Oregon, Utah and Washington show that Native Hawaiians and Pacific Islanders are experiencing disproportionate COVID-19 rates. For example, in Hawaii, Pacific Islanders make up just 4% of the state’s population, but as of June 26, 23% of COVID-19 cases.

While disparities in COVID-19 incidence and mortality for Pacific Islanders are cause for concern, they are not surprising given existing disparities and conditions: 

• Pacific Islanders already have higher rates of many chronic diseases, including diabetes — they are two-and-a-half times more likely to have diabetes than white peers — and heart disease — Native Hawaiians and Pacific Islanders are 10% more likely to be diagnosed with coronary heart disease than white people. Both underlying conditions increase the risk of death with COVID-19 infection.

• Many Pacific Islander groups still experience high rates of uninsurance, despite coverage gains resulting from the Affordable Care Act. For example, Micronesians still have an uninsured rate around 11%, compared to 6% for white residents. In addition, some Pacific Islanders are excluded from participation in Medicaid due to immigration status, leaving many people unable to afford costs associated with treatment and care for COVID-19.

• About a quarter of Pacific Islanders serve in essential frontline positions, including military, security and service-related industries, increasing their exposure to COVID-19. According to a recent survey, 82% of the Pacific Islanders in Arkansas live in a household with at least one essential worker.

All of these factors together combine to place a heavy burden on Pacific Islanders living in the U.S. COVID-19 has only helped expose and highlight underlying structural and social inequalities that have contributed to health inequities experienced by Pacific Islanders and other communities of color for decades.

And although Pacific Islanders are experiencing alarmingly disproportionate impacts from COVID-19, public health officials and agencies in many states are still unaware of the problem’s urgency, as data on Pacific Islanders is not always collected or reported. In many states, Pacific Islander data is lumped together under an “Asian American/Native Hawaiian/Pacific Islander” or “Other” category.

To respond and raise awareness in the national dialogue, the Pacific Islander Center of Primary Care Excellence launched a new nationwide effort — the Pacific Islander COVID-19 Response Team. The team of researchers, health experts, community leaders and advocates convened to plan and implement an infrastructure for informing and supporting families and communities about COVID-19.

The group is tapping into the existing Pacific Islander community in the U.S., working with churches, community organizations and leaders. Some of its recommendations so far include: 

• Advocating for all state and local health departments to collect and report disaggregated race and ethnicity data for Asian Americans, Native Hawaiians and Pacific Islanders to improve effectiveness of testing and future treatment strategies. Hawaii provides a good example as the first state in the nation to report disaggregated data for Pacific Islanders, Native Hawaiians and Asian American subgroups. 

• Community educational resources, culturally appropriate health messaging and translated materials are also needed so Pacific Islander communities can stay informed on social distancing practices and important public health recommendations.

For more information on efforts to address the impact of COVID-19 on Pacific Islanders, visit the Pacific Islander COVID-19 Response Team.