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It has been widely reported that COVID-19 disproportionately impacts several communities in Hawaiʻi, including Pacific Islanders and Filipinos. But less attention has been given to the role of chronic disease. High underlying rates of illnesses such as heart disease and diabetes have put these groups at elevated risk of contracting and dying from COVID-19.

cartherine pirkle
Catherine Pirkle

In Hawaiʻi, it is impossible to separate the challenges of COVID-19, chronic diseases and health inequities. This is the focus of a new special issue of the Hawaiʻi Journal of Health & Social Welfare, which examines and offers solutions addressing the root causes of these three interrelated issues. Across 11 articles, a diverse group of researchers and practitioners, many affiliated with the University of Hawaiʻi System, detail the impacts of COVID-19 and chronic diseases in Hawaiʻi, describe community-led public health efforts to respond to the pandemic, and offer approaches to advance health equity.

“The idea behind this issue is that we know both COVID-19 and many chronic diseases are tied to the same determinants of health. These factors that put people at higher risk are often the same,” explained lead guest editor Catherine Pirkle, an associate professor at UH Mānoa’s Office of Public Health Studies in the Thompson School of Social Work & Public Health. “We need to go beyond the clinical setting and realize that how we allocate resources and power shape people’s health and lead to negative outcomes in communities that are marginalized by our political, economic and health systems.”

Issue highlights include:

  • An examination of challenges and impacts of COVID-19 on critical health issues in Hawaiʻi’s communities, including mental health, food security, access to care and breastfeeding.
  • Community-led responses to address the many impacts of the pandemic in Hawaiʻi, with a specific focus on Native Hawaiians and Micronesians.
  • Perspectives on advancing health equity and building capacity to respond to future threats, incorporating cultural frameworks and efforts to improve health literacy, as well as offering specific policy recommendations.

Role of chronic disease during COVID-19

Several authors in this special issue highlight how chronic diseases and COVID-19 are fueled by racism, economic discrimination and other barriers to accessing healthcare and living well.

According to co-editor Jessica Yamauchi, chief executive officer of Hawaiʻi Pacific Health Institute, “The conditions placing certain people at higher risk of infection and poor outcomes once infected were already present before the pandemic. People who earn low wages, live in crowded conditions, lack sufficient health insurance, do not have paid sick leave at work, or have low English skills are more likely to contract COVID-19 and/or be hospitalized or die from it. Overall, they also experience more chronic conditions, less access to healthcare and receive poorer quality of care when they do seek services.”

Learning from public health leaders

Behind the headlines, community leaders have mobilized to fill gaps in the current public health system conducting outreach to support testing and vaccine access; collecting data to understand the health, economic and social impacts of the pandemic; and contributing to culturally responsive and multisectoral strategies.

“It is important to look broadly at the unsung heroes doing so much to help people through the pandemic and to learn from their work, so we can be more resilient in the future. This special issue describes efforts by many groups that we do not hear much about,” said co-editor Lola Irvin, administrator for the chronic disease and health promotion division in the Hawaiʻi State Department of Health.

Read the special issue PDF of Hawaiʻi Journal of Health & Social Welfare.

This research is an example of UH Mānoa’s goal of Excellence in Research: Advancing the Research and Creative Work Enterprise PDF, one of four goals identified in the 2015–25 Strategic Plan PDF, updated in December 2020.

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