This piece was published in the 31st print volume of the Asian American Policy Review.
Our current work tells us what we have always known — that we have never been in national policy discussions — and we are no longer waiting to ask to be included anymore.
Empowering Pacific Islander Communities is a pro-Black, pro-Indigenous, anti-racist national organization based on Tongva land that advances social justice by engaging Native Hawaiians and Pacific Islanders in culture-centered advocacy, leadership development, and research. We know that our cultural-centered approach for advocacy will help us thrive as a community and lead us to freedom, not just for us, but for all. As Lilla Watson said, “If you have come here to help me you are wasting your time, but if you have come because your liberation is bound up with mine, then let us work together.”[1] We look to our kāinga, or community, for insight, wisdom, and guidance to ensure we participate and engage in spaces that we are typically left out of, especially in national policy discussions. When I see my mom and her sisters gather together to put in the time, labor, and lessons to preparing yards of handmade ngatu, fuatanga, fala kie, and a kato teu (cultural mats and baskets) together, to offer as ceremonial gifts for Pacific Islander events, it doesn’t make sense to me why we are deemed the most vulnerable, most underserved, and most underrepresented communities in data and policy. Such protocols and ceremonies require us to give our absolute best, which always takes a collective effort. Yet, in the context of policy, we are not given the best opportunities to weigh in about decisions that shape our realities.
Our cultural practice of tauhi vā has been a tool of advocacy for a world which we have been creating long before this pandemic took place, and especially now. A world that includes our stories and experiences beyond statistics and numbers. A world where it doesn’t take a pandemic to see the inequities that exist. Tauhi means to care for or to take care of, and vā is the social or relational space connecting people. Through our moments of grief and resilience, tauhi vā has been a way for us to communicate virtually with each other from holding space to making decisions collectively to advocating to policymakers about the impact COVID-19 has on our communities.
EPIC has answered the call to be in community and tauhi vā through the National Pacific Islander COVID-19 Response Team (NPICRT),[2] which mobilized in April 2020 immediately upon the reports of data identifying the disproportionately high incidence of COVID-19 cases and mortality among Native Hawaiians and Pacific Islanders (NHPI). It consists of a supporting network of over 30 Native Hawaiian and Pacific Islander advocacy organizations and academic institutions spanning the continental US and Hawai‘i.
The COVID-19 pandemic has shed light on the inequities across many areas in our society including health care, research, policy, and essential community services. Although data that separates Pacific Islander numbers from the general population is limited, the states and counties that are reporting data show Pacific Islanders are disproportionately affected by COVID-19—with some regions seeing rates of infection up to five times that of white people.[3] As of November 30, 2020, the NHPI community surpassed 30,000 COVID-19 cases. This represents an increase of nearly 8,000 NHPI COVID-19 cases and 42 NHPI COVID-19 deaths in the past month. This means that, on average, at least one member of the NHPI community died from COVID-19 every day in November.
Pre-existing health disparities and inequities in the social determinants of health are driving the COVID-19 risk among NHPIs.[4] They make up a large number of the essential workforce, such as in the tourism and food industries.[5] In the military, NHPI representation is six times higher than in the general US population.[6] NHPIs are more likely to live in large multi-generational households and denser communities, which further increases their exposure risk.[7] The high rates of asthma, obesity, diabetes, heart disease, smoking, and vaping among NHPI increase the risk for severe COVID-19 symptoms.[8] COVID-19 containment and mitigation measures have led to an increase in economic hardships, behavioral health issues, and difficulties in managing chronic disease for many NHPIs.[9]
As a result, here are some examples of our collective advocacy:
- In early December 2020, NPICRT sent letters along with the National Council of Asian Pacific Americans to President-elect Joe Biden, providing recommendations to appoint two Native Hawaiian and Pacific Islander medical professionals to his newly formed COVID-19 Equity Task Force, in addition to outlining the impact the pandemic has had on NHPI communities.
- On 11 November 2020, NPICRT sent a letter to the Centers for Disease Control (CDC) and to the National Institute of Health (NIH) requesting to allot funding for the secondary analyses of public health databases to increase the yield of information regarding COVID-19 in NHPI communities to optimize interventions via the identification of factors that increase the susceptibility of NHPIs to infection and adverse outcomes.
- On 4 September 2020, NPICRT submitted a comment letter to the National Academies’ Committee on Equitable Allocation of Vaccine for the Novel Coronavirus to address the lack of inclusion of Native Hawaiian and Pacific Islanders in their 114-page draft discussion document of a preliminary framework for equitable allocation of COVID-19 vaccine and offered to work together moving forward.
- On 27 May 2020, the US House Committee on Ways and Means held a hearing titled “The Disproportionate Impact of COVID-19 on Communities of Color,” where Dr. Raynald Samoa served as a witness and provided testimony. [10]
- Development of the NHPI Health Data Policy Lab housed at the UCLA Center of Public Health and Policy that provides weekly updates on the status of COVID-19 in NHPI communities around the country.
- Implementation of community-led COVID-19 testing in NHPI communities in Arkansas, Northern California, Southern California, Hawaii, Oregon, Utah, and Washington state.
- Broadcasting weekly topics regarding COVID-19 and NHPI communities such as information regarding participating in clinical trials and the latest information regarding the different COVID-19 vaccines to a viewership of 10,000+.
For many of our partners in NPICRT, this advocacy work is done in addition to their current work, and others do this outside of their regular jobs while balancing family responsibilities. We have even lost some of our leaders to COVID-19, like Margarita Satini who dedicated her life to ensure Native Hawaiians and Pacific Islanders were civically engaged.
Similar to knowing what it takes to give our best when practicing our cultural ceremonies, we also know that this is what it takes to work together to influence upstream measures through research, data collection, and policy. Our current work tells us what we have always known—that we have never been in national policy discussions—and we are no longer waiting to ask to be included anymore. The call for data disaggregation will inform better research and resources needed to address and improve the health disparities that exist. Tauhi vā has been a source for us to navigate this horrific storm of a pandemic, and we will continue to practice it with each other and with our allies until we have the representation we need because we deserve the absolute best and nothing less.
References
[1] “About,” Lilla, 28 January 2010, https://lillanetwork.wordpress.com/about/.
[2] “Pacific Islander COVID-19 Response Team – Pacific Islander Center Of Primary Care Excellence (PI-Copce),” Pacific Islander Center of Primary Care Excellence (PI-CoPCE), 2020, https://pi-copce.org/covid19response/.
[3] Ibid
[4] J. K. Kaholokula et al., “COVID-19 Special Column: COVID-19 Hits Native Hawaiian and Pacific Islander Communities the Hardest,” Hawai’i Journal of Health & Social Welfare, no. 79(5) (2020): 144–146. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226312/
[5] Brittany Morey et al., “Structural Racism and Its Effects on Native Hawaiians and Pacific Islanders in the United States: Issues of Health Equity, Census Undercounting, and Voter Disenfranchisement,” AAPI Nexus Policy Practice and Community no. 17 (2020). https://www.researchgate.net/publication/345821132_Structural_Racism_and_Its_Effects_on_Native_Hawaiians_and_Pacific_Islanders_in_the_United_States_Issues_of_Health_Equity_Census_Undercounting_and_Voter_Disenfranchisement
[6] 2018 Demographics: Profile of the Military Community, Department of Defense, 2018) [PDF file], https://download.militaryonesource.mil/12038/MOS/Reports/2018-demographics-report.pdf.
[7] Joseph Keawe‘aimoku Kaholokula, “Amplifying the Voice Of Native Hawaiian and Pacific Islander Communities Amid the Covid-19 Crisis Nimhd,” National Institute of Minority Health and Health Disparities, 30 November 2020, https://nimhd.blogs.govdelivery.com/2020/11/30/amplifying-the-voice-of-native-hawaiian-and-pacific-islander-communities-amid-the-covid-19-crisis/
[8] Raynald Samoa et al.,“COVID-19 and the State of Health of Pacific Islanders in the U.S.,” AAPI Nexus Policy Practice and Community 17, (2020), https://www.researchgate.net/publication/344592475_COVID-19_and_the_State_of_Health_of_Pacific_Islanders_in_the_US
[9] Joseph Kaholokula, “Amplifying the Voice Of Native Hawaiian.”
[10] Statement of Raynald Albert Samoa M.D., (Pacific Islander Response Team, 27 May 2020) [PDF file], https://waysandmeans.house.gov/sites/democrats.waysandmeans.house.gov/files/documents/Samoa_Testimony.pdf