Hawaii community leaders discuss ensuring health equity beyond the pandemic

Hawaii community leaders met last week at a virtual Civil Beat panel to discuss health equity and lessons learned from the COVID-19 pandemic. The panelists include We Are Oceania CEO Josie Howard, Sheri Daniels, MD, Executive Director of Papa Ola Lokahi and Chantelle “Tellie” Matagi, Contact Tracing Lead Investigator Team 6B for the State Department of Health’s Pacific Islanders Outreach Team. They discussed the state’s progress over the last year and a half and their long term health equity goals. 

 

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Dr. Daniels first recounted the creation of a COVID response team that would specifically serve the state’s Native Hawaiian and Pacific Islander communities. These communities were disproportionately affected by the pandemic, accounting for 24 percent of state’s diagnosed COVID cases in January, despite only making four percent of the state’s population. By connecting with partners from those communities, her team at Papa Ola Lokahi was able to create a task force that focused on three R’s: response, recovery and resilience. 

“Through [the response team] we were able to create opportunities and spaces to talk about testing, contact tracing, isolation, vaccines, social support and recovery, policy, data and research.”

Matagi, whose team under the DOH was first created in October 2020, emphasized the importance of providing adequate resources to support communities affected by COVID, such as providing safety nets for essential workers. 

“These are essential workers that are living paycheck to paycheck. And if you call them up and you say to them, ‘You are a positive case, I need to put you into isolation or quarantine and you can’t go to work,’ what are you offering them to support [staying in isolation]? Are they breaking isolation and quarantine because they don’t want to participate or is it because they have to provide for their family?”

Approaching vulnerable communities must be done in a way that allows those members to fully collaborate and advocate for themselves, Matagi continued. 

“Anyone who has worked with any minority population knows you can’t just walk through the door and assume that you can tell everybody in that room what to do…you have to knock, you have to be invited in, and you need to create a partnership where you’re hearing them and they’re hearing you.” 

One way to create space for Hawaii’s vulnerable populations to advocate for themselves is through language resources, Howard pointed out. 

“To me, without language access, honestly, there is no equity.” 

Other ways to address disparities include increasing funding for organizations that serve vulnerable communities and ensuring there is enough data about communities most affected by COVID. According to a health equity report from Papa Ola Lokahi released in mid-March, the vaccination rate of Native Hawaiians and Pacific Islanders was only around seven percent. That number is now closer to 30 percent of the population, according to Dr. Daniels. 

“We have a lot of ways to go, but what it allowed was a pulse check…it also showcases to the departments, to the state government, ‘Okay, we need to have a conversation again.’ And it’s not just about conversation but it’s about action. And [data] allows us to push back and have those hard conversations.”

Looking forward, Matagi says organizations need to take on a new framework that recognizes and supports marginalized communities’ language and culture.

“COVID-19 is a good starting point for us to readjust what we think of our community members and how we interact with them. We need to give them value.”

Dr. Daniels added that even though the DOH has been pressured to take on this new framework due to its role in addressing the pandemic, all state departments need to follow suit. 

“When we hold [only] one department to task, then what happens is we make those changes, but it doesn’t retain because the other 10, 12, 20, departments aren’t following the same playbook, and the work starts again. That’s something we really have to put on the table.”