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Impacts of COVID-19 Among Native Hawaiians

By Dr. Landon Opunui, ND

The United Nations has warned indigenous populations that they may be at a disproportionately high risk of being impacted by COVID-19 because of preexisting health inequalities.

Across the nation, there is strong evidence showing Native Hawaiian and Pacific Islanders (NHPI), defined as people having origins in any of the original peoples of Hawaii, Tahiti, Samoa, Guam or other Pacific Islands, are at greater risk of being infected and of having severe symptoms compared to other United States racial populations including African American, Asian, Latino and Caucasian.

This should raise alarms for the island of Molokai as it has the highest number of Native Hawaiians per capita of all the Hawaiian Islands, excluding Niʻihau. According to the 2010 U.S. Census, the majority of people on Molokai identified as NHPI. The Ka Huakaʻi 2014 Native Hawaiian Educational Assessment further reports that 4,527 Native Hawaiians reside on Molokai, which is 62 percent of the island’s total population.

As of April 30, 14 percent of Hawaiiʻs COVID-19 cases are NHPI, while this racial group only consists of 10 percent of the stateʻs population. Because many Native Hawaiians may be reported in multiracial or unknown ethnic categories, these rates are likely higher.

Several other U.S. states with high percentages of NHPI communities such as California, Oregon, Utah and Washington are showing the highest case rates per 100,000 people of all racial groups, with some an order of magnitude greater.

We donʻt have this type of detailed data in a number of other places NHPIs may reside because these racial groups are commonly combined with Asian or Pacific Islanders (API), a group that includes Japanese, Chinese, Korean, Filipino, and Vietnamese, among many other ethnic backgrounds that originate throughout Asia with different genetic susceptibilities and health disparities. Through the Health Equity and Accountability Act there is hope that we as a country will work toward disaggregated health data to addresses long-standing health disparities within the API racial grouping.

There is even further discussion within the Native Hawaiian community to further disaggregate NHPI data. The indigenous people of this place are not even being counted independently from other Pacific Islanders within their own birthrights, which has implications on representation and funding. But, teasing apart this data is easier said than done.

Almost 25 percent of Hawaii residents identify with multiple races or ethnicities compared to a three percent national average, which makes Hawaii a truly unique melting pot. Native Hawaiians are three times as likely to identify as multiracial, making it clear that Native Hawaiians are being misrepresented in our stateʻs racial data.

Although the immediate health impacts and concerns of COVID-19 appear to be waining, there is the very real concern of worsening health disparities among Native Hawaiians, especially on Molokai, because of the parallel economic impacts this pandemic has left in its wake. As a result, health disparity gaps are likely going to continue widening. The short- and long-term impacts will be challenging to fully illuminate because of ongoing racial data limitations both locally and nationally, which need to be addressed.

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