Native Hawaiian, Pacific Islander Communities Faced Significant Disparities in Mental, Physical Health During Pandemic


Native Hawaiians and Pacific Islanders are suggested to have had some of the highest levels of mortality, depression, alcohol use, and anxiety disorders during the COVID-19 pandemic.

The Native Hawaiian (NH) and Pacific Islander (PI) communities were severely impacted by the COVID-19 pandemic, according to 2 studies published in Public Health Reports and Drug and Alcohol Review. During the pandemic, 1 in 5 NH/PI participants lost a family member; they also had a mortality rate of 1 per 400 individuals by the end of 2021. Further, the NH/PI communities’ rates of alcohol use disorder were 2.6 times greater than the national rates.

"NH/PIs may carry the highest rates of COVID-19 infections and deaths of any US racial/ethnic minority group during the pandemic," said Andrew Subica, PhD, associate professor in the School of Medicine's Department of Social Medicine, Population, and Public Health, at the University of California, Riverside, in a press release.

In an earlier study, Subica noted that the data demonstrated the NH/PI population had the most deaths per capita in 90% of all states. To investigate this further, Subica and a team of researchers surveyed more than 300 NH/PIs in states with the highest NH/PI populations—including Washington, Utah, Oregon, California, and Arkansas—between April 2021 and November 2021.

More than 50% of NH/PI participants had a family member who was diagnosed with COVID-19, and 30% were diagnosed themselves. The results of the first study identified factors that increased NH/PI COVID-19 exposure risk—these include a job on the frontline, living in a densely populated house or neighborhood, or participation in large-scale group social events.

The second study observed that the NH/PI communities consumed high levels of alcohol, tobacco, and other drugs during the pandemic. Among NH participants, 47% used alcohol or cigarettes, and in PIs the rate was 22%. Additionally, 35% of all NH/PIs used illegal substances. Among NH/PIs, 1 in 4 screened positive for alcohol use disorder.

Based on the data, smoking has been shown to be a comorbidity of severe COVID-19 outcomes, making the high rate of smoking among NH/PIs an increased risk factor during the pandemic, explained Subic. The author added that the NH/PI communities have other high-risk comorbidities as well, such as obesity, cancer, and heart disease, which can further increase the severity of COVID-19 outcomes in NH/PIs.

This population also had high levels of depression, anxiety, and unmet treatment needs. During the pandemic, the researchers found that 27% of patients had major depressive disorder, 20% had generalized anxiety disorder, and 50% of non-binary NH/PI participants screen positive for probable alcohol use disorder.

"Our findings call for greater attention and funding of NH/PI research to prevent and reduce NH/PIs' glaring health disparities associated with COVID-19," Subica said in the press release. "This illuminates the need for further research exploring the behavioral health needs of these at-risk individuals. We need to develop and implement culturally responsive prevention, intervention, and recovery programs to reduce NH/PI substance use and mental health disparities during and after the COVID-19 pandemic."


University of California- Riverside. COVID-19 took serious toll on Native Hawaiian/Pacific Islander mental and physical health. Science Daily. September 19, 2022. Accessed on September 20, 2022.

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