Discrimination Experiences during COVID-19 among a National, Multi-Lingual, Community-Based Sample of Asian Americans and Pacific Islanders: COMPASS Findings

Reports of escalated discrimination among Asian Americans and Pacific Islanders (AAPIs) due to COVID-19 are alarming, making this a public health priority. However, there are limited empirical studies on the scope and impact of COVID-19-related discrimination among AAPIs. Using the COVID-19 Effects on the Mental and Physical Health of AAPI Survey Study (COMPASS) data (N = 4971; survey period: October 2020–February 2021), which is a U.S.-wide multi-lingual survey, we examined the prevalence of, and factors associated with discrimination experiences attributable to being an AAPI during the COVID-19 pandemic. Overall, 60.7% reported experiencing discrimination; the group prevalence ranged from 80.0% (Hmong) to 40.5% (Native Hawaiians and Pacific Islanders). Multivariable logistic regression models revealed that COVID-19-related factors were associated with many discrimination experiences: having a shelter-in-place order of ≥1 month, living in areas with perceived similar/higher COVID-19 severity, and negative impact in family income/employment due to COVID-19. Additionally, being Asian American (versus Native Hawaiians and Pacific Islanders), females, non-heterosexuals, younger, more severe effect on family income, living in the non-West, and poorer health were significantly correlated with discrimination experiences. Findings may assist in formulating anti-AAPI-discrimination policies and programs at the local, state, and federal levels. Culturally appropriate programs and policies to combat this are urgently needed.

Native Voices Exhibition: Stories of health, wellness, and illness from American Indians, Alaska Natives, and Native Hawaiians

The U.S. National Library of Medicine (NLM) exhibition known as Native Voices reflected Donald A.B. Lindberg M.D.’s keen and long-held desire to help improve public understanding of Native American health challenges and honor the culture, tradition, and healing ways of Native Peoples. A centerpiece of the exhibition was a large set of video interviews that Dr. Lindberg conducted with Native health and community leaders. Dr. Lindberg and his team engaged Native advisors in the exhibition development; sought Native input through Listening Circles, Tribal Consultations; and site visits, and made the video interviews accessible via interactive kiosks and iPads. For its time, this was state-of-the-art exhibition technology. The exhibition also included Native artifacts and art works to complement the videos, including a scale model of the iconic Hokule’a Native Hawaiian voyaging canoe, and a full-size Lummi Indian healing totem pole. The totem journeyed across the U.S. prior to its installation next to the NLM herbal garden in Bethesda, MD. A traveling version of the exhibition visited more than 130 venues in 40 States across the U.S. The interview clips and other content are accessible on the exhibition website, and the full-length interviews are retained in the NLM permanent video collection.

Reflections on Dr. Donald A.B. Lindberg and Native Voices

Personal reflections on Donald A.B. Lindberg M.D. are offered by four Native American leaders who were instrumental in the successful development of the National Library of Medicine’s (NLM) Native Voices Exhibition: Stories of Health and Wellness from American Indians, Alaska Natives and Native Hawaiians. A uniquely collaborative effort, the exhibition features nearly 100 videographed interviews conducted by Dr. Lindberg with Native elders, healers, leaders, and people. He is credited with the incorporation of indigenous peoples’ healing knowledge in a personal and relational way, making for a wonderful journey together that was a very large chapter in his life and that of the authors.

Diabetes Prevalence Among Underserved Older Adults in the US: The Case of Native Hawaiians and Pacific Islanders

The effects of chronic diabetes among older adults in the United States represent ongoing challenges in diagnosis, treatment, comorbidities, amputations, and the increased risk of death. These challenges are made more complicated among underserved populations due to limited access to healthcare, medication costs, and later diagnosis of the condition. These issues are particularly true for the NHPI population, which has high rates of lifetime diabetes, greater levels of poverty, and inadequate health insurance. Useful statistics about diabetes among the NHPI have been difficult to obtain due to their small population size and lack of inclusion in federal health surveys. While early work by Panapasa examined prevalence among NHPI males in California, no reliable measures of diabetes among older NHPI’s existed at the national level. Released in 2017, the 2014 Native Hawaiian Pacific Islander National Health Interview Survey represents the first representative survey of the health and socio-economic correlates for this population, allowing the examination of health conditions such as diabetes at the national level. This presentation will examine the prevalence of diabetes among NHPI’s aged 60 and older and the impacts of this disease on overall health and quality of life. The paper will use the NHPI-NHIS to examine the use and access to diabetic medications and overall access to affordable health care. The paper will examine differences by age group, gender, immigration status, and ethnicity. While we know the overall prevalence of diabetes is high, this paper will offer new information on differentials within the older NHPI population.

Prostate Cancer Disparities in Risk Group at Presentation and Access to Treatment for Asian Americans, Native Hawaiians, and Pacific Islanders: A Study With Disaggregated Ethnic Groups

PURPOSE We identified (1) differences in localized prostate cancer (PCa) risk group at presentation and (2) disparities in access to initial treatment for Asian American, Native Hawaiian, and Pacific Islander (AANHPI) men with PCa after controlling for sociodemographic factors. METHODS We assessed all patients in the National Cancer Database with localized PCa with low-, intermediate-, and high-risk disease who identified as Thai, White, Asian Indian, Chinese, Vietnamese, Korean, Japanese, Filipino, Hawaiian, Pacific Islander, Laotian, Pakistani, Kampuchean, and Hmong. Multivariable logistic regression defined adjusted odds ratios (AORs) with 95% CI of (1) presenting at progressively higher risk group and (2) receiving treatment or active surveillance with intermediate- or high-risk disease, adjusting for sociodemographic and clinical factors. RESULTS Among 980,889 men (median age 66 years), all AANHPI subgroups with the exception of Thai (AOR = 0.84 [95% CI, 0.58 to 1.21], P > .05), Asian Indian (AOR = 1.12 [95% CI, 1.00 to 1.25], P > .05), and Pakistani (AOR = 1.34 [95% CI, 0.98 to 1.83], P > .05) men had greater odds of presenting at a progressively higher PCa risk group compared with White patients (Chinese AOR = 1.18 [95% CI, 1.11 to 1.25], P < .001; Japanese AOR = 1.36 [95% CI, 1.26 to 1.47], P < .001; Filipino AOR = 1.37 [95% CI, 1.29 to 1.46], P < .001; Korean AOR = 1.32 [95% CI, 1.18 to 1.48], P < .001; Vietnamese AOR = 1.20 [95% CI, 1.07 to 1.35], P = .002; Laotian AOR = 1.60 [95% CI, 1.08 to 2.36], P = .018; Hmong AOR = 4.07 [95% CI, 1.54 to 10.81], P = .005; Kampuchean AOR = 1.55 [95% CI, 1.03 to 2.34], P = .036; Asian Indian or Pakistani AOR = 1.15 [95% CI, 1.07 to 1.24], P < .001; Native Hawaiians AOR = 1.58 [95% CI, 1.38 to 1.80], P < .001; and Pacific Islanders AOR = 1.58 [95% CI, 1.37 to 1.82], P < .001). Additionally, Japanese Americans (AOR = 1.46 [95% CI, 1.09 to 1.97], P = .013) were more likely to receive treatment compared with White patients. CONCLUSION Our findings suggest that there are differences in PCa risk group at presentation by race or ethnicity among Asian American, Native Hawaiian, and Pacific Islander subgroups and that there exist disparities in treatment patterns. Although AANHPI are often studied as a homogenous group, heterogeneity upon subgroup disaggregation underscores the importance of further study to assess and address barriers to PCa care.

The Silent Forest: Impact of Bird Hunting by Prehistoric Polynesians on the Decline and Disappearance of Native Avifauna in Hawai’i

This research focuses on the historical demise of Hawaiian avifauna due to hunting by ancient Polynesians. Numerous documents, published since the early 1800s, were scrutinized and evaluated; these provided information on bird hunting and traditional Hawaiian practices. Hawaiians used birds as sources of feathers and food. Feathers were important symbols of power for Polynesians; in Hawai’i, feathers were more highly prized than other types of property. Feathers used for crafts were obtained from at least 24 bird species, however, the golden feathers of ‘ō‘ō and mamo birds made them primary targets for birdhunters; both birds became extinct by the late 1800s. Feathers were utilized for many items, including ‘ahu‘ula [cloaks], mahiole [war helmets], and kāhili [standards]. Most garments utilized a considerable number of feathers; a cloak for Kamehameha consumed the golden feathers of 80,000 mamo birds. Bird meat was an important food item for native Hawaiians. It is believed that most birds were killed after being plucked; historical sources mention ~30 bird species were consumed. The ‘ua‘u (Pterodroma sandwichensis), a currently endangered seabird, was ruthlessly hunted and avidly eaten. Its current geographical range is just a minute fraction of its former one; now, ‘ua‘us are largely restricted to inaccessible cliffs at Haleakalā Crater (Maui).