Chapter 10. Reconnecting Our Roots

Introduction Pacific Islanders living in Hawai‘i with ancestral ties to islands in the western Pacific region of Micronesia are common targets of uninhibited forms of prejudice in multiple sectors, including healthcare. Whether the explicit societal-level attitudes toward this group are reflected in implicit attitudes among healthcare providers is unknown; therefore, we designed a pilot study to investigate this question. Our study measures implicit racial bias toward Pacific Islanders from Micronesia among Obstetrician-Gynecologists (OB-GYNs) in Hawai‘i. Methods We developed 4 new implicit association tests (IATs) to measure implicit attitudes and associations (i.e., stereotypes) toward Pacific Islanders from Micronesia in 2 conditions: (1) Micronesians vs. Whites and (2) Micronesians vs. Japanese Americans. Participants were practicing OB-GYNs in Hawai‘i. The study was conducted online and included survey questions on demographic and physician practice characteristics in addition to IATs. The primary outcome was the mean IAT D score. Associations between IAT D scores and demographic and practice characteristics were also analyzed. Results Of the 49 OB-GYNs, 38 (77.6%) were female, mean age was 40 years, 29.5% were Japanese, 22.7% were White, and none were from a Micronesian ethnic group. The mean IAT D score in the Micronesian vs. White condition (N = 29) was 0.181, (SD: 0.465, p < 0.05) for the Attitude IAT and 0.197 (SD: 0.427; p < 0.05) for the Stereotype IAT. Conclusion The findings from this pilot suggest a slight degree of implicit bias favoring Whites over Micronesians within this sample of OB-GYNs and warrant a larger investigation into implicit biases toward this unique and understudied Pacific Islander population.

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Implicit Racial Attitudes and Associations Among Obstetricians in Hawaiʻi: a Pilot Study

Delafield

Hermosura

Ahn

et al. 2022

J. Racial and Ethnic Health Disparities

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“You Have to Prove that You’re Homeless”: Vulnerability and Gatekeeping in Public Housing Prioritization Policies

2022

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Building on theories of symbolic boundaries, this article explores the role of the state as gatekeeper to social programs, such as public housing. Using interviews with 75 randomly sampled households living in public housing in Honolulu County, we link contemporary research on gatekeeping with decades of work on how housing policy drives residential outcomes for marginalized groups. In particular, we consider the largely unexamined case of “local preferences,” which fast-track certain individuals into social programs based on locally established criteria. Our data suggest that these prioritization categories have evolved over time and are now largely focused on providing housing to those experiencing homelessness and victims of domestic violence. Ultimately, this apparently mundane bureaucratic process mediates relationships between social service agencies, individual needs, and overwhelming housing demand, all collaborating to construct symbolic boundaries across which deservingness is defined and adjudicated. We find that waitlist prioritization criteria cannot be reduced to a basic assessment of need as it necessarily instigates issues of definition (e.g., what is homelessness?) and legibility (e.g., how does one prove homelessness?). These collateral issues amplify the importance of institutional social capital and, in some cases, generate conflict between and within eligible communities.

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Chapter 10. Reconnecting Our Roots

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Implicit Racial Attitudes and Associations Among Obstetricians in Hawaiʻi: a Pilot Study

Implicit Racial Attitudes and Associations Among Obstetricians in Hawaiʻi: a Pilot Study

“You Have to Prove that You’re Homeless”: Vulnerability and Gatekeeping in Public Housing Prioritization Policies

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