The impacts of colonization have complicated efforts to vaccinate Native Hawaiian and Pacific Islander communities against COVID-19.
They range from the degradation of natural resources to broken promises from federal and state governments.
Public researcher Keʻalohilani Worthington says that one of the recurring themes in vaccine hesitancy is that it isn't just one factor that causes these discrepancies.
"It’s a multitude of things. Everybody has a multitude of factors influencing what’s going on at home," Worthington says.
Worthington is one of the authors of a report examining the COVID-19 vaccination effort in NHPI communities.
Researchers who interviewed frontline workers found generational trauma in the NHPI community that can manifest itself through structural racism and inadequate or inappropriate health care — which undermined trust enjoyed by other communities.
But Worthington says community-led testing and vaccination efforts have worked in both rebuilding trust and prioritizing cultural values and traditions.
"We created safe spaces, culturally-relevant safe spaces that provided services that didn’t just address like COVID itself, but addressed other needs that are going on."
She says that the state health department also collaborated on the work, a follow-up to DOH’s 2021 report describing how long-standing systemic inequalities were laid bare during the COVID-19 pandemic.
State Epidemiologist Dr. Sarah Kemble says the findings in this report may be unique to Hawaiʻi's population, but can provide insight to public health efforts in marginalized and underserved communities around the world.
"We know a lot of these themes — people in DOH, our community members — are familiar with these themes," Kemble says.
"There’s a lot of lessons learned captured here that I’m not sure other states in the U.S. and other states in the world are aware of and so I think sharing those experiences of what we’ve learned about the approaches to equity during an emergency is really important to share and get out there."
