Some are looking for more boxes to check out the “other” Pacific Islanders

HONOLULU (AP) – A few months after the start of the pandemic, data showed Pacific Islanders were suffering the highest infection rates in Hawaii.

But what early figures haven’t shown publicly is which Pacific Islanders in the diverse identification category – which includes people with ethnic roots in Samoa, Micronesia and other islands but excluding Native Hawaiians – were the most affected.

In August 2020, when Hawaii recorded its highest number of cases, people who identify as Pacific Islanders accounted for 24% of all COVID-19 cases but made up just 4% of the state’s population, according to a state health department report with academic and community groups.

The Health Equity Report, released in March this year, showed that the two largest groups represented among Pacific Islander COVID-19 cases were the Samoans at 29% and the Chuukeses at 24%.

Before detailed data was readily and widely available, Kauai’s Dr Kapono Chong-Hanssen printed lists of people who checked the Pacific Islander box and looked at surnames in an attempt to understand specific racial origins.

The exploit was possible on a small island, he recalled, but it would have been faster and easier to target communities with educational outreach in the languages ​​they speak with more specific state data, which provide information on Native Hawaiians but bring together all other Pacific Rim countries. Islanders.

In the 1990s, motivated by concerns that Native Hawaiian students were seen as overrepresented in colleges when counted as Asian, Esther Kia’āina worked at the federal level to separate native Hawaiian data from Asian data. Since then, however, all other Pacific Islanders have remained in one category.

Now a member of Honolulu City Council, Kia’āina introduced a resolution passed last month urging Hawaii government agencies to go beyond minimum federal standards and be more specific when collecting racial data in the one of the most racially diverse states in the country.

Of Hawaii’s 1.5 million people, 38% are Asian – mostly Japanese and Filipino – 26% are white, 2% are black, and many people are of multiple ethnicities, according to U.S. Census figures. Native Hawaiians make up about 20% of the population.

“We are geographically unique and we are culturally, racially, ethnically very unique compared to the rest of the United States,” said Chong-Hanssen, medical director of the Kauai Community Health Center and a member of the board of directors of the Association of Native Hawaiian. Doctors. “So federal standards don’t really serve our public health… and other services. “

Disaggregated data – data broken down into smaller groups – is also helpful now in the effort to get people to get vaccinated, he said.

The resolution proposes separate categories for Samoans, Micronesians, Tongans, Chamorros and “other Pacific Islanders”. Categories also include whites, blacks, Native Americans or Alaska natives, Filipinos, Japanese, Chinese, Koreans, Vietnamese, and “other Asians”.

Even though the resolution is not binding, Kia’āina said the agencies she has contacted so far are supportive. She said she plans to send the resolution to city and state agencies, asking them to voluntarily comply with it.

“We do this not only to get the data to determine funding priorities, but also to enact policies to address the underlying disparities for whatever reason,” she said, “it s ‘deal with housing, education, health. ”

On the Big Island, Dr Wilfred Alik, a Marshallese-speaking native of the Republic of the Marshall Islands, said he made a point of collecting specific ethnic data himself when speaking with a patient about the Pacific Islands that tested positive.

While groups organized collectively as Asians and Pacific Islanders can bolster the number of smaller communities, obtaining specific data is useful for contact tracing, especially regarding language skills and sensitivity. cultural, said Alik, who works for Kaiser Permanente.

At the start of the pandemic, We Are Oceania, a group that advocates for Hawaii’s Micronesian communities, called on state health officials to provide specific data to Pacific islanders, group CEO Josie said. Howard.

While they believed the data would be key to understanding how people were affected by the virus, they also feared the data would further stigmatize Micronesians, who are often targets of racism in Hawaii, Howard said.

Stigma and privacy were also concerns for state health officials, who are already collecting detailed and disaggregated data beyond what is recommended by the city council resolution, said Joshua Quint, epidemiologist at the city council. Ministry of Health. There are limits on how to publish data responsibly, including privacy concerns, especially when it comes to small populations, he said.

This is one of the reasons they don’t break down Pacific Islanders into what’s available on the department’s COVID-19 website, he said.

It’s also difficult to spot disparities when there aren’t good population estimates for smaller groups, such as the Chuukais, Quint said.

In Hawaii, there are around 15,000 to 20,000 Micronesians, who began to migrate here in greater numbers in the 1990s in search of economic and educational opportunities, according to We are Oceania. The figures for people from Chuuk, one of the four states of the Federated States of Micronesia, are more difficult to determine.

When the virus cases were first diagnosed in Hawaii, health officials asked questions of people who tested positive, focusing on their travel history, Quint said. But when the community spread of the virus was established, social disparities between racial and ethnic groups began to emerge.

Advocates say expanding options in the ethnic category is an issue that goes beyond the pandemic.

“When we come together… when it comes to services, we are on the back burner,” said Elisapeta Alaimaleata, executive director of Le Fetuao Samoan Language Center.

Without specific data, it becomes more difficult to advocate for Samoan language education services in public schools in Hawaii, she said as an example.

The ability to mark a box that is not just “other” may have personal identity advantages, said Chong-Hanssen, who is half white, a Chinese quarter and a Hawaiian native quarter, and grew up in Iowa.

“It helps the wider population, at least in Hawaii, if not in the great United States, understand that we exist,” he said. “These different kinds of Pacific Islanders are real people.”