Navigating Native Hawaiian and Pacific Islander Cancer Disparities From a Cultural and Historical Perspective

Abstract

The coronavirus disease 2019 (COVID-19) disparities disproportionately affecting communities of color have summoned a call to examine the racist nature, scope, and root of health inequities in our society. Native Hawaiians and other Pacific Islanders (NHPIs) represent a geographically isolated and often ignored minority population. Herein, we navigate the cancer disparities of these people.Author affiliations and support information (if applicable) appear at the end of this article.

Pacific Islanders Searching for Inclusion in Medicine

“…It is critical to understand that NHPIs are distinct from Asian Americans, and these 2 groups were legally disaggregated during the Clinton administration. 2 NHPI nations contain no Asian countries and do not share any unifying history with Asian nations. Thus, using the antiquated term "Asian Americans and Pacific Islanders" (or "AAPI") obscures the health disparities and oppression specific to the NHPI experience.…”

“…When disaggregated, Native Hawaiians have shorter life spans and higher incidence of diabetes, asthma, substance abuse, and obesity compared with all major Asian American ethnic groups. 2,5,6 The largest NHPI subgroup in the US, Native Hawaiians, are descendants of navigators who populated the Hawaiian Islands between 200 and 900 CE. Unfortunately, popular culture has often romanticized Hawaii, whitewashing the reality that these Native people nearly faced extinction.…”

“…5,7 While other ethnic minorities certainly face similar disparities, a search of the medical literature in January 2021 for "COVID-19" with Black, Latinx, American Indian/Alaska These steps will promote health equity given that NHPI patients report improved health care satisfaction and clinical outcomes with ethnically concordant NHPI physicians. 2,8 The onus is not solely on the medical community. NHPIs must find it within ourselves to identify disparities and heal our Oceanic people.…”

Mitigating Implicit Bias in Radiation Oncology

“…This is also true for other URM individuals such as Hispanic and Native Americans. [27][28][29] Black students are more likely to attend institutions that do not have a radiation oncology department, therefore, less likely to have exposure to research and fewer networking opportunities provided by the home program faculty. 9 Moreover, implicit linguistic bias may exist in letters of recommendation for radiation oncology residency candidates as well as with other postgraduate training programs [30][31][32][33] URM individuals have been found to have lower USMLE test scores as compared to White individuals.…”

“…This is also true for other URM individuals such as Hispanic individuals and Native Americans. 27 , 28 , 29 …”