Pacific Islanders in US hospitalized with Covid-19 at up to 10 times the rate of other groups

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WASHINGTON (The Guardian/Pacnews) — Pacific islanders living in the U.S are being hospitalized with Covid-19 at up to 10 times the rate of some other racial groups.

The U.S is the most infected country on earth, with more than 4 million confirmed cases of Covid-19 and nearly 150,000 deaths, and the 1.5 million Pacific islanders living there are massively overrepresented in infection and hospitalization rates.

In Washington state, rates of confirmed cases for Native Hawaiian or other Pacific islander people are nine times higher than those of white people, while hospitalization rates are 10 times that of white people, according to department of health figures.

The numbers are most dramatic in that state’s Spokane county. People from the Marshall Islands make up less than 1% of the county’s population but represent around 30% of confirmed Covid-19 cases.

Across the country, states with significant islander populations are showing similar trends.

In Oregon, Pacific islanders are just 0.4% of the population, but represent nearly 3% of all Covid-19 infections. Islanders there are three times more likely than any other racial group to be infected by the novel coronavirus.

In Arkansas, Pacific islanders are 0.3% of the population, yet account for 8% of the Covid-19 cases. In Hawaii, Pacific islanders are 4% of the state’s population, but 25% of Covid-19 cases.

Health authorities argue that there are a number of factors driving up Pacific islander infection and hospitalization rates. These factors include that islanders tend to live in large family groups and close-knit communities and have higher rates of chronic diseases, such as diabetes, which can complicate Covid-19.

Experts say islanders are also more likely than others to be un- or under-insured, or excluded from Medicaid because of their immigration status, and are more likely to perform frontline essential work, such as serving in the military or working in the security and service industries, which increases their risk of exposure to Covid-19.

Dr. Nia Aitaoto, from the Pacific Islands Center of Primary Care Excellence, said cultural practices also contributed.

“We live in large families, if one family gets infected they can pass to another. And we celebrate and gather, that’s just our nature and that does not help,” Aitaoto, a member of the center’s Pacific islander Covid-19 response team, said.

“When you are positive, you need to be in isolation, this is hard to do for Pacific islanders. It’s hard to isolate anyone in that environment, in most cases with two bedrooms and eight to 10 people per household.”

Aitaoto said pre-existing medical conditions, perceptions around healthcare provision, insecure work, and stigma also contributed to the disproportionate Covid-19 impact on Pacific islanders.

“Some have disregarded rules and snuck into funeral homes to farewell their family members who died from Covid-19. Others don’t admit they have it for fear of losing their jobs.”

Jiji Jally, a community organizer with the Marshallese Women’s Association, said she was concerned to see rising numbers of infection in her community.

“There are so many barriers like unemployment, access to medical care or insurance … that stop our people from treatment or testing.”

While people from freely associated states the Marshall Islands, Palau and the Federated States of Micronesia can travel to and work in the U.S., they do not receive the full benefits of a citizen, Jally said.

“We only qualify for medical in Washington and Oregon, so we are seeing a lot of them move from Arkansas to these states to get coverage.”

However, Jally said even when her community members were eligible for medical assistance to treat Covid-19, the language barrier and the complexity of access to care discourages many.

“People who may have qualified for unemployment during Covid-19 never pursued it because it was too hard. Those who can get medical assistance when they are affected find it too hard,” she said.

The Office of Insular Affairs at the U.S. Department of the Interior told the Guardian that governments and organizations were working to provide Pacific island language support.

“Part of the problem is that we do not have a designation as Pacific islanders at the federal level,” said Joseph Seia, executive director of the Pacific Islander Community Association.

He said that bureaucratic invisibility meant that funding for Covid-19 could not be specifically targeted for Pacific islander interventions in the U.S.

“Our plight is similar to Native Americans and black people. Because of the systematic racism that litters the U.S., Pacific islanders, along with native and black and brown communities, do not have universal healthcare.”

Seia’s organization, responding to the growing number of cases, initiated a partnership with public health services to conduct more than 1000 Covid-19 tests specifically for Pacific islanders in Washington state at church parking lots and places that the islander community was familiar with.

“We now realize the system is so broken that the only hope that our people have, is if we organize the interventions ourselves and tell the government health agencies...what they need to do,” he said.

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