An accurate representation of Native Hawaiian and Pacific Islander (NHPI) is critically needed in the healthcare system, especially as the long-term effects of the COVID pandemic continue to occur, according to Native Hawaiian oncologist Kekoa Taparra, MD, Ph.D.

Paka Ola Lokahi, a non-profit organization dedicated to improving the health of Native Hawaiians, recently hosted a webinar where Taparra spoke about the historical context that has led to current health inequalities in Pacific Islander communities, and how to address inequalities in the future.

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Prior to contact with Western societies, there were many different health practices in Pacific Islander communities, including an emphasis on connection with nature and the foundations of holistic medicine. Possible contact with Western society brought diseases such as gonorrhea, syphilis and tuberculosis that decimated the population. By 1900, Taparra said that over 95% of the native Hawaiian population had been wiped out, leading to a genetic bottleneck that continues to influence modern health problems.

According to Taparra, the colonization and war in the Pacific not only led to racial discrimination and the loss of land and culture for Pacific Islanders, but also had a direct impact on their health.

“The physical effects of radioactive iodine fallout from nuclear bomb tests are associated with an increased risk of certain types of cancer,” he said. “It also leads to generations of people who are extremely unfavorable to radiation. [treatment] … due to the perception of radiation as the only thing that can be harmful. As a doctor, it can be very difficult for me to talk people out of this.”

In addition to an increased risk of certain types of cancer, Taparra noted that Pacific Islanders also have higher rates of obesity, infant mortality and shorter life expectancy.

These differences are also noticeable with respect to COVID. With reference to March 2021 study according to the UCLA Center for Health Policy Research, 18 of the 20 reporting states identified Native Hawaiians and Pacific Islanders as the ethnic group with the highest per capita mortality rate.

However, Taparra said little attention has been paid to the issue due to the trend towards merging NHPI data with Asians, which could mask the inconsistency.

“When we don’t have representatives in clinical trials, the question really becomes whether the data is applicable to the patients we’re trying to treat,” he said.

In terms of what health care leaders can do to address these disparities, Taparra recommends more culturally sensitive research that disaggregates NHPI data as a distinct, unique group. He has also advocated for greater NHPI representation in the health workforce, in particular through increased federal funding or scholarships. programs for those who want to work.

Taparra also noted the ongoing displacement of the native Hawaiian diaspora to the US. He said the 2020 census showed for the first time that more native Hawaiians indicated they lived on the mainland than in Hawaii due to growth the cost of living and dead-end wages. To support those living on the mainland, Taparra encouraged local support groups to think about how they can reallocate their resources to better reach those living on the mainland.

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