Native Hawaiians, Pacific Islanders Face Higher Rates of COVID-19

Apr 27, 2020

Credit Alissa Eckert, MS; Dan Higgins, MAMS

Anyone can be infected with the coronavirus, but data coming out of several states – including Hawaiʻi – show Native Hawaiians and Pacific Islanders have higher rates of contracting COVID-19. This reflects nationwide findings showing the virus is hitting different populations unequally, and many are wondering why.

Native Hawaiians and Pacific Islanders are seeing higher rates of COVID-19 cases when compared to other ethnic groups in at least four states – Hawaiʻi, Washington, California, and Oregon. Public health scholar Keaweʻaimoku Kaholokula says heʻs concerned but he isnʻt surprised. 

“Native Hawaiians and Pacific Islanders have among the highest rates of chronic diseases. You know they have the shortest life expectancy. They get disease earlier,” says Kaholokula, “Times like this where thereʻs this pandemic, they are going to be hit the hardest.”

Kaholokula heads the Native Hawaiian Health Department at the University of Hawaii medical school. Heʻs been tracking and analyzing the data and says a lot of it has to do with underlying chronic health conditions. 

“Diabetes, obesity, hypertension, heart disease – these are things that if you know someone does get the virus, it could really hurt them really hard,” says Kaholokula. “And unfortunately, more of our people have diabetes, obesity, heart disease.”

But other factors also play a role. Native Hawaiians and Pacific Islanders are more likely to work in service-related industries that carry a higher risk for exposure. These include grocery stores, food service, and health care.

“And when they go home, they are going home most likely to a larger household because we do know our Native Hawaiians and Pacific Islander communities have multi-generational households,” says Kaholokula. “There's just a higher likelihood of them being exposed and bringing the virus back home.” 

According to state Health Director Bruce Anderson, this cominbation of essential workers living in multifamily housing is likely the cause of community spread of the virus in Kailua-Kona on Hawaiʻi Island. A cluster of 36 confirmed cases of COVID-19 is being tied to a Marshallese worker at the local McDonaldʻs restaurants who subsequently passed the illness to family members. 

“This Marshallese community in the Kona area basically were in living situations where they couldnʻt effectively isolate themselves,” said Anderson to state legislators at a briefing last week.

While some of the risk factors cannot be controlled by policies, Kahalokula says they can be influenced — with attention to structural inequities from health care to job opportunities. 

“These disparities didnʻt just show up with COVID. They just got exacerbated,” says Kaholokula. “For a long time, theyʻve neglected these disparities. You know what we need to do is really look at these inequities and begin to account for this in our recovery plan.” 

COVID-19 DATA ON NATIVE HAWAIIANS AND PACIFIC ISLANDERS

The Pacific Islander Center of Primary Care Excellence released COVID-19 data last week showing Native Hawaiians and Pacific Islanders have an infection rate two to three times the average in at least four states - California, Oregon, Utah, and Washington. 

In California, as of last week, the statewide average number of confirmed COVID-19 cases per 100,000 population was 62. The rate for Pacific Islanders living in California was 217 – over a three-fold higher. 

In Oregon, the Oregon Health Authority reported Pacific Islanders had nearly triple the stateʻs average rate of coronavirus infections. 

In Salt Lake County, Utah, Pacific Islander infection rates were double the state average for 100,000 people.

In King County, Washington, the rate of confirmed cases of COVID-19 is highest among Native Hawaiian or Pacific Islanders and Hispanics or Latinos. 

Many states donʻt separate data on Native Hawaiians and Pacific Islanders. But in states where statistics are available, they show that the highest rates of infection are in these communities as well.  

A Los Angeles Times analysis of state health department data from California shows Native Hawaiians/Pacific Islanders are dying from the coronavirus at the most disproportionate rates – four times their share of the stateʻs population.