New Platform Provides Much-Needed Data on COVID-19 Impacts Among Native Hawaiians and Pacific Islanders

by Joyce Lee-Ibarra, JLI Consulting LLC

Last month, the UCLA Center for Health Policy Research unveiled its Native Hawaiian and Pacific Islander COVID-19 Data Policy Lab and corresponding NHPI COVID-19 Data Policy Lab Dashboard in an effort to address the dearth of information regarding the disease’s impact on these groups. Why is the launch of the Lab significant for NHPI researchers, and what can decision- and policy makers learn from the data the Lab makes available? Here are a few answers:

Why is the launch of the NHPI COVID-19 Data Policy Lab important?

Native Hawaiians and Pacific Islanders (NHPIs) have historically been institutionally underserved and over-represented among groups with persistent health disparities. As we have noted previously, NHPIs are often grouped with Asian Americans in social science or health data analyses, resulting in their specific outcomes being masked. To this end, the NHPI COVID-19 Data Policy Lab is zeroing in on data specifically concerning these populations, providing a more focused lens to understand the effects of the pandemic among NHPIs.

By more accurately accounting for confirmed cases, deaths, and burden of disease among NHPIs, efforts to address social determinants of health—such as housing, income, and employment status—can be better taken into consideration. Recognizing, for instance, that nearly a quarter of NHPIs work in essential sectors such as military, security, health, and service industries can help governments and employers anticipate that these groups may experience outsize impacts from the disease. Similarly, knowing that NHPIs are among the most affected by COVID-19 can point the way toward developing culturally appropriate education materials. For example, messaging for social distancing guidelines, mask use, and other precautions can be tailored and translated to the appropriate languages once states and counties identify which populations are being most affected by COVID-19, and what information is failing to resonate in those communities.

What data can be found on the Lab’s dashboard?

The landing page of the Lab’s dashboard provides a national snapshot of which states are tracking NHPI COVID-19 data, as well as a relative sense of which states are faring better or worse in their rates of NHPI COVID-19 cases. Site visitors can also see a quick overview of a selected state’s NHPI case rate, NHPI case rate ranking, and comparative trend lines for racial/ethnic groups, as demonstrated below:

Visitors can view more detailed data by clicking on the State NHPI COVID-19 Data tab, which shows trend lines for death as well as case rates for selected states, in addition to state rankings for NHPI case and death rates. Longitudinal data for COVID-19 cases and deaths among NHPIs are compared graphically with (where available) Whites, Blacks, Hispanics, American Indians/Alaska Natives, and Asians:

What decisions might the NHPI COVID-19 Data Policy Lab’s findings inform?

Here in Hawaii, the Lab’s data can help researchers place local NHPI COVID-19 case and death rates in a larger context, and demonstrate that the disparate burden of the disease carried by NHPI communities is not a phenomenon particular to Hawaii. On a per capita basis (in states where relevant data is available), NHPIs across the country are among the racial/ethnic groups most impacted by COVID-19. By mapping where this issue is acute, the Lab’s findings point to other states where researchers may be motivated allies in addressing NHPI health inequities.

Local health equity advocates might also find the Lab’s data supports a more general assertion that NHPIs are underserved by existing health systems, and that their needs require more targeted interventions as well as proportional allocation of resources. By centralizing and making publicly available NHPI COVID-19 data from multiple states, the Data Policy Lab can help policy- and decision makers better understand that NHPIs experience systemic health disparities that cross geographic and state boundaries, and that subsequently require institution-level—and not just individual—interventions.

Finally, the data presented by the Lab underscores the need for state agencies to carefully and consistently collect and report race/ethnicity data to uncover these patterns and better address NHPI health needs. Locally, the Lab dashboard can provide a level of accountability for state and local officials’ response to the disease by publicly tracking NHPI case and death rates against those of other states. As described previously, Hawaii’s state agencies lack a uniform policy for tracking race/ethnicity for a range of outcomes; the Lab underscores the need to collect and report that information in order to track local NHPI health outcomes, and to contribute to a greater national understanding regarding NHPI health needs.

What are the limitations of the NHPI COVID-19 Data Policy Lab’s Dashboard?

One of the most notable limitations of the Lab’s dashboard is not a fault of its own making, but rather an inherent issue of the states’ information upon which it relies: missing or unavailable data. The COVID-19 Dashboard generated by the Hawaii Department of Health’s Disease Outbreak Control Division is a case in point; as of September 18, footnotes to the Race tab indicate the COVID-19 cases in Hawaii that lack race information (n=5,493) nearly equal those where race is indicated (n=5,565), leaving researchers to extrapolate per capita figures based on incomplete data. An explanation of methods and limitations would aid visitors to the Data Policy Lab’s Dashboard, and further highlight the need for all states to capture more complete, detailed information on race/ethnicity.

Furthermore, here in Hawaii, recognizing and addressing granular group differences in health outcomes, even within the NHPI population, is of critical importance. This point was emphasized in one of our recent blog posts, which notes that Pacific Islanders in our state have far outstripped other racial/ethnic groups—including Native Hawaiians—in their over-representation among confirmed COVID-19 cases. Having more specific racial/ethnic information among NHPIs and their experience with the disease would be helpful in our state’s context; unfortunately, the Data Policy Lab doesn’t currently report this more nuanced level of data.

These limitations notwithstanding, the NHPI COVID-19 Data Policy Lab is a tool that helps us see the national pattern of NHPIs being disproportionately overrepresented among both COVID-19 cases and deaths. Furthermore, it underscores what we have long observed in our state: that Native Hawaiians and Pacific Islanders continue to shoulder the weight of significant health disparities. By working to provide concise, visualized data in a user-friendly platform, the Policy Lab is making it possible to begin addressing NHPI health inequities in more targeted and data-driven ways.

Joyce Lee-Ibarra is principal of JLI Consulting LLC and a consultant to the Hawaii Data Collaborative.