Pacific Islanders in Hawaii, excluding Native Hawaiians, make up just 4% of the state’s population.

But they compose 13% of coronavirus cases in the state.

That’s according to new data from the Hawaii Department of Health released Friday that provides the most detailed breakdown yet about how COVID-19 is affecting diverse communities in Hawaii. The latest analysis eliminates the “mixed race” group and calculates population sizes slightly differently from typical census categories.

The state’s second-worst COVID-19 disparity is affecting the Filipino community. Filipinos make up 16% percent of Hawaii’s population but make up 21% of the state’s coronavirus cases.

Hawaii’s white community is also experiencing a smaller disparity — they make up 28% of cases but just 25% of the population.

Josie Howard, who moved to Hawaii from Chuuk decades ago and is co-leading a statewide Pacific Islander COVID-19 response team, said she has been increasingly concerned about coronavirus among Pacific Islanders, especially as the state slowly re-opens and people return to work and socializing.

“I was worried that once (the virus) hits our community, it was going to be hard, and I think we’re there,” she said. She’s glad that Native Hawaiian leaders are working with her and other members of the Pacific Islander community to coordinate statewide responses and push for better data and testing.

“We don’t want to be left out or left behind just because we don’t matter,” she said. Pacific Islanders face high rates of COVID-19 in several states ranging from Alaska to Arkanasas.

Amy Agbayani, a longtime advocate for Hawaii’s Filipino community, says both Pacific Islanders and Filipinos are essential workers and many live in multi-generational housing. Many are also immigrants or migrants with limited English proficiency and less access to health insurance and social safety nets.

“COVID actually exposes a lot of inequities in our system and clearly these foreign born workers and their families are impacted a lot,” she said. “They’re left out of federal CARES program and other benefits and even if they are eligible they have a hard time accessing them.”

No Disparity For Hawaiians

One surprising aspect of the newly disaggregated data is that Native Hawaiians aren’t currently experiencing disproportionate rates of COVID-19 — in fact, the opposite is true. Previously, state data combined Native Hawaiians and other Pacific Islanders into a single category which made it appear as though Hawaiians did experience disproportionate rates.

But once people who identify as Native Hawaiian or part-Native Hawaiian are disaggregated, the data shows they make up 21% of the population but just 13% of cases.

It’s important to note that the data is constantly changing as the pandemic continues.  Hawaii announced nine newly confirmed cases of coronavirus Friday, bringing the state’s official total up to 664.

Sterling Wong, spokesman for the Office of Hawaiian Affairs, said he is happy that the agency broke down the data. Knowing that Native Hawaiians aren’t currently experiencing high rates of COVID-19 is “really going to help us focus more of our energy in trying to get more of the socio-economic data,” he said.

“We’re not completely out of the woods yet,” he added. “Who knows if there is going to be a second wave?” Still, “Having this data updated regularly from this disaggregated perspective is going to be important in tracking this disease moving forward.”

Hawaii’s Japanese community is also less likely to get COVID-19 compared with their share of the population. And unlike many states on the mainland, Hawaii’s relatively small black community isn’t experiencing high rates of coronavirus here either.

The state’s analysis excludes 63 non-residents and 33 cases in which no race data is available. People were placed into the “white” category if they listed no other race, and into the “Native Hawaiian” category if they listed that at all. But for every other category, the state categorized people “based on first non-white race listed.” State officials said this is based on how race and ethnic data is compiled for the Hawaii Health Data Warehouse, which maintains statewide health statistics.

Sarah Park, the state’s epidemiologist, said the state chose to disaggregate racial groups largely depending on their share of the population. She thanked OHA and the nonprofit Papa Ola Lokahi for their help.

“We’re blessed in Hawaii where we’ve not had a huge pandemic wave,” she said. But the small numbers make it difficult to provide further specificity, she said. “As you start to break down further into various subgroups it’s increasingly challenging to draw more meaning from the data.”

Esther Kia’aina, executive director of the Pacific Basin Development Council, has been an outspoken critic about how long it’s taken for the state to provide more precise data.

But she said Friday that she’s ecstatic and grateful about the new publicly available data. She is hopeful that the state will eventually be able to break out data on Samoan, Vietnamese and Micronesian communities. The state hasn’t yet published any data about the Hispanic or Latino community.

Communities Mobilize Responses

Amelia Casamina Cabatu runs a daycare center for elderly people on Oahu. She’s also a columnist for the Fil-Am Courier, a local Filipino newspaper, and runs a radio show about Filipino community issues.

Cabatu says the new data is saddening but she’s hopeful it will spur action.

“I truly, truly believe that we need to increase the testing among the Filipino community because many of us are caregivers,” she said.

Bryant de Venecia, spokesman for Unite Here Local 5, a local union for hospitality and health care workers, says most of its members are Filipino and Pacific Islander. He wasn’t surprised to hear about the COVID-19 disparities Friday.

“It all go backs to the socioeconomic conditions that our members live in,” he said. “A lot them live in housing with two, three other families.” Service workers also have a hard time avoiding respiratory diseases.

“People who are working in the food service industry and other hospitality industries are in very tight spaces like kitchens,” he noted.

Dr. Wilfred Alik, a Marshallese physician in Hilo, says the Marshallese community has been taking extra care to stay healthy because so many don’t have health insurance. The 1996 Welfare Reform Act eliminated their eligibility for federal Medicaid and Hawaii slashed many migrants’ eligibility for Med-QUEST during the last recession.

“Something needs to be done systematically policy-wise in terms of making sure that there’s more access to health care,” he said.

In the meantime, communities have been mobilizing their own responses. There’s a national Pacific Islander COVID-19 task force, a local Native Hawaiian and Pacific Islander response team, and individual response groups for the Marshall Islands, the Federated States of Micronesia and migrants from both those countries plus Palau.

Howard hopes that people understand that Pacific Islanders already face health disparities stemming from colonization, nuclear testing and exclusion from public health insurance. Pacific Islanders have some of the highest poverty rates compared with other ethnic groups in Hawaii, but Howard emphasizes they aren’t poor in terms of culture and family.

“I do want people to understand that this is not by choice,” she said, adding the community recognizes the need “for us to organize ourselves in order for us to assess the needs of our people, take care of the needs of our people and be ready for the second wave.”