A new report authored by Hawaii researchers highlights the value of separating public health data in order to identify and address racial disparities.
According to the state Department of Health, data from Native Hawaiian, Pacific Islander and Asian populations often are combined into one group in studies, which can hide important differences between these communities.
“Native Hawaiian and Pacific Islander populations have been disproportionately affected by COVID-19,” stated the report, which was authored by researchers from the DOH, the University of Hawaii and the Office of Hawaiian Affairs. “Native Hawaiian, Pacific Island and Asian populations vary in language; cultural practices; and social, economic, and environmental experiences, which can affect health outcomes. However, data from these populations are often aggregated in analyses.
“Although data aggregation is often used as an approach to increase sample size and statistical power when analyzing data from smaller population groups, it can limit the understanding of disparities among diverse Native Hawaiian, Pacific Islander, and Asian populations.”
To assess such disparities in COVID-19 outcomes, an analysis was performed using race data from 21,005 COVID-19 cases and 449 COVID-related deaths reported to the DOH between March 1, 2020, and Feb. 28, 2021.
During that time, the number of infections reported, or incidences, was 1,477 per 100,000 people.
Looking at the aggregated data, Native Hawaiian and Pacific Islander individuals experienced the highest rate of infection, 2,501 per 100,000 people, across five minimum race categories, the report states.
But breaking down the data showed that Pacific Islanders, who account for 5% of Hawaii’s population, represented 22% of COVID-19 cases and deaths, and had the highest incidence rate of 7,070 cases per 100,000, according to the report.
Further analysis found that among all Pacific Islander subcategories, the highest incidence of cases, 10,580 per 100,000 people, occurred among Marshallese individuals.
Incidence among the Native Hawaiian population was 1,181 per 100,000.
Filipino and Vietnamese individuals had the highest incidence of cases among Asian populations, at 1,247 and 1,200 cases per 100,000 people, respectively.
“These findings demonstrate the importance of collecting and disaggregating data to more effectively address health disparities,” Joshua Quint, a DOH epidemiologist and the report’s primary author, said in a news release. “We are thankful for our community partners who have worked hand-in-hand with DOH in our health equity efforts and we are committed to continuing to make data available to improve health outcomes.”
According to the DOH, race and ethnicity can serve as markers for underlying systemic and structural inequities that drive health disparities.
The data allowed the department to improve its community response to the COVID-19 pandemic, which included the creation of the Pacific Islander Priority Investigations and Outreach Team and the COVID-19 Outreach and Public Health Education project to provide translated prevention information, improved access to resources, and support community outreach.
These efforts complemented grassroots initiatives within Native Hawaiian, Pacific Islander and Filipino communities, the DOH said.
The study was published in the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, a national weekly journal highlighting public health information and recommendations.
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