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. 2021 Sep;80(9 Suppl 1):88-101.

A Historical and Contemporary Review of the Contextualization and Social Determinants of Health of Micronesian Migrants in the United States

Davis Rehuher  1 , Earl S Hishinuma  1 , Deborah A Goebert  1 , Neal A Palafox  2
Affiliations

A Historical and Contemporary Review of the Contextualization and Social Determinants of Health of Micronesian Migrants in the United States

Davis Rehuher et al. Hawaii J Health Soc Welf. 2021 Sep.

Abstract

Hawai'i's Pacific Islander (PI) population has suffered a higher burden of coronavirus disease 2019 (COVID-19) infections, hospitalizations, and deaths compared to other groups in the state. The Hawai'i Emergency Management Agency Community Care Outreach Unit conducted an assessment across the state to gain an understanding of the impact of the COVID-19 pandemic on the health and social welfare of households. Survey data was collected from individuals across the state during a period of 3 weeks (August 12-September 5, 2020). The following are resulting recommendations from the Pacific Island community to mitigate the impact and disparities of the pandemic as immediate and medium-term structural requests: (1) ensure that Pacific Island communities are proactively represented in state and county committees that develop health interventions to ensure that relevant language and culturally tailored communications and strategies are included, (2) provide consistent funding and community centered support to ensure consistent COVID-19 impact services for the Pacific Island families, (3) enhance the capacity of PI health care navigators and interpreters through increased funding and program support, and (4) engage state policy makers immediately to understand and address the systemic structural barriers to health care and social services for Pacific Islanders in Hawai'i. These recommendations were developed to address the generational inequities and disparities that exist for Pacific islanders in Hawai'i which were exacerbated by the COVID-19 pandemic.

Keywords: Micronesian history; Micronesians; health; migration; review; social determinants of health.

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Figures

Figure 1.
Figure 1.
Regions in the Pacific: Micronesia, Melanesia, Polynesia CartoGIS Services, College of Asia and the Pacific, The Australian National University (https://creativecommons.org/licenses/by-sa/4.0/)
Figure 2.
Figure 2.
Countries and Territories of the Micronesia Region Reprinted with permission.
Figure 3.
Figure 3.
United States Affiliated Pacific Islands Per Capita Health Expenditures Abbreviations: AS = American Samoa, CNMI = Commonwealth of the Northern Mariana Islands, FSM = Federated States of Micronesia, GU = Guam, PPP = Purchasing Power Parity, PW = Palau, RMI = Republic of the Marshall Islands, USD = US Dollar, WHO = World Health Organization, WPRO = Western Pacific Regional Office Pacific Cancer Programs.
Figure 4.
Figure 4.
World Health Organization Social Determinants of Health Framework Solar & Irwin, 2010.
See this image and copyright information in PMC

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