HomePasifikaCommentary: Native Hawaiians and Pacific Islanders at-risk of being unseen

Commentary: Native Hawaiians and Pacific Islanders at-risk of being unseen

Native Hawaiians performing a dance with a musician playing a Ipu Heke at Hawai'i Volcanoes National Park.
Native Hawaiians performing a dance with a musician playing a Ipu Heke at Hawai’i Volcanoes National Park.

By Jake Ryann C Sumibcay, MPH

Moving forward in a new year and decade, we are not just two months away from the upcoming Census on April 1, 2020. Mandated by the Constitution, the U.S. Census Bureau is required to do a complete count of the population in all 50 states, the District of Columbia, and five U.S. territories (Puerto Rico, American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, and the U.S. Virgin Islands).

Asian and Pacific Islanders (API) have historically been undercounted, diminishing the cultural richness and numerous contributions that Asian and Pacific Islander Americans have made to American society. APIs had been grouped together under a single governmental classification until 1997 when the Office of Management and Budget (OMB) established separate categories, namely, “Asian” and “Native Hawaiian and other Pacific Islander (NHPI)” thereby “improving” the collection of accurate federal statistics and reporting as well as preserving the unique identities of both groups. 

Prior to this change, the paucity and lack of disaggregated data generally masked the identity and needs of both Asian and Pacific Islander groups and severely hindered progress on vital issues regarding immigration, health access, public health outcomes, funding for social services, and related policies.  Unfortunately, disaggregated health data for NHPIs are still limited and highlight a population at high risk for health disparities.

NHPIs refer to indigenous peoples of Polynesia, Micronesia and Melanesia and compared to most other ethnic groups, they have disproportionately high rates of smoking, alcohol consumption, and obesity, according to the Department of Health and Human Services Office of Minority Health.

HHS reported that the leading causes of death among NHPIs include heart disease, cancer, stroke, diabetes, and accidental injuries. Moreover, a 2015 Income and Poverty report by the U.S. Census found that almost 20 percent of NHPIs live at or below the poverty threshold and over 16 percent lack health coverage.

From 2000 to 2010, the NHPI population grew by 40 percent to 1.2 million or 0.4 percent of the U.S. population. With a new count approaching, the NHPI population is expected to follow growth trends. An accurate count is vital to NHPIs as they have traditionally been undercounted, leading to data underrepresentation and  federal funding to serve community needs.

NHPIs have endured adverse experiences due to Western and U.S. influences. The death rates of Native Hawaiians accelerated after their first encounter with the Europeans in the late 1770s due to imported diseases such as smallpox, measles, and other epidemics. In 1983, the U.S. overthrew the Hawaiian Kingdom which marginalized the Native Hawaiians in their homelands and forcibly denounced Hawaiian language, customs and cultural practices. In the Marshall Islands, the U.S. military conducted nuclear tests from 1946 to 1958 which caused devastating and lingering health issues in the Marshallese people and nuclear contamination to the environment. The U.S. still maintains a strong military presence across the Pacific such as in Guam and American Samoa, two U.S. Territories.

The historical impacts are one of the many factors to why many NHPIs today experience poor health outcomes. To truly understand the underlying causes and consequence of health disparities faced by NHPIs, we need to improve the collection of data. NHPIs remain to be a largely understudied and underserved population. Often times, NHPI health data are still grouped with Asian Americans, who tend to be healthier masking the true differences in health status, behaviors and health disparities. Without high-quality and representative data, NHPIs are omitted from research agendas and further worsens the disparities.

As a budding public health researcher working with NHPI communities, it is frustrating and concerning that relatively little is known about these populations. We rely on accurate data to inform policy decisions and resource allocation. It is critical to increase attention and bring visibility to NHPI populations. Genuine efforts with considerations to cultural and policy barriers are needed to accurately count them in the upcoming 2020 Census and advocate for accurate and increased health data at the state and federal levels. We should strive to provide Native Hawaiians and Pacific Islanders the representation they deserve and make them count.


RELATED INFORMATION: 2020 Census – Webpage

2020 Census PSA – YouTube

2020 Census PSA: Native Hawaiian and Pacific Islander

Asian Americans working to ensure everyone is counted in 2020 census

Census bureau cuts back Asian language outreach for 2020 census

(About the author: Jake Ryann Sumibcay is a doctoral student in Public Health at Claremont Graduate University in Southern California. His training and concentration focus on driving effective health engagement through ethnographic strategies among the Asian American, Native Hawaiian, and Pacific Islander (AANHPI) adolescent and young adult population.  He is also a Robert Wood Johnson Foundation Health Policy Research Scholar, where he applies his research to promote health equity by empowering people of color to find value in personalized health and health within communities)

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