OPINION | Addressing Disparities in Health Care Careers Affecting Native Hawaiians and Pacific Islanders

by Minal Gowda and Belen Sime

In light of Minority Health Month in April, it is important to reflect on some of the major challenges for underrepresented communities in the health care field. Not only is there a lack of proper support for minority groups to access health care, but there is also a lack of representation for BIPOC (Black, Indigenous, and other People of Color) among providers and leaders in health care careers. The discrimination that causes this doesn't just start with the health care employment process; it begins well before. Disparities in the education system limit opportunities for minority groups, such as Native Hawaiians and Pacific Islanders (NH/PI), to succeed in the health care field.

The Association of American Medical Colleges (AAMC) reports that only 941 physicians identified as Native Hawaiian/Pacific Islanders out of the 918,547 registered in the U.S. in 2018. To put that into perspective, if you had a jar filled with 1,000 jelly beans, a single one would account for the 0.1% of NH/PI who make up America's physician population. In Washington specifically, only 0.4% of practicing physicians identify as NH/PI. This marginalization is important to call out because representation influences future generations of NH/PIs aspiring to be in positions of power and leadership in the medical field. It sets the societal standard for what those people can or can't do.

Other implications also come with these disparities. Not having enough representation for communities such as Native Hawaiians/Pacific Islanders can lead to poor care for patients of the same descent. In an interview, Stanford medical student Kekoa Taparra, of Native Hawaiian ancestry, explains that "racially and ethnically concordant physicians can improve patient health outcomes by building strong doctor-physician relationships in marginalized communities that may otherwise have distrust for the medical system."

Addressing the root cause of problems that eventually lead to the disempowerment of Native Hawaiians/Pacific Islanders joining the health care career field starts with education. We've all heard how hard it is to get into medical school, but what is often less well-known is that it is significantly harder for NH/PIs to achieve. The AAMC's public data shows that in the 2023—2024 academic year, Native Hawaiians/Pacific Islanders had the lowest percentage rates of acceptance to medical schools, coming in at 36% in comparison to most other racial/ethnic groups in the mid to high 40% range. In fact, the U.S. Department of Health and Human Services says only 7.4% of NH/PIs have obtained professional/graduate degrees, whereas the rate among whites is nearly double that percentage. This further proves that educational disparities remain prevalent for minority groups like NH/PIs, which is a major cause of the disparities in health care representation.

It is crucial that we implement strategies for fighting back against these educational disparities. As a community, we must challenge the societal standards that limit how much success is possible for certain groups. Some of the initiatives that have been put into action so far include establishments of community health centers and programs at medical schools devoted to working for a single cause. For instance, AAPCHO (the Association of Asian Pacific Community Health Organizations) is an organization that promotes "advocacy, collaboration, and leadership to improve the health of Asian Americans, Native Hawaiians, and Pacific Islanders." The organization has been active for five years, implementing community-based initiatives to improve the health of NH/PI communities and providing opportunities for them to gain medical knowledge.

Additionally, medical schools are working to support students from underserved backgrounds; UW Medicine works closely with WWAMI AHEC (Washington, Wyoming, Alaska, Montana, and Idaho Area Health Education Center), to enhance the education of health care professionals and to distribute more of them to underserved communities. Similarly, Seattle Public Schools has organizations dedicated to supporting youth, individuals, and families within NH/PI communities. Its Youth Healing Project is a youth-led organization that supports young leaders within the Native Hawaiin and Pacific Islander community. Through initiatives like these, we can empower students from minority groups to follow their passion and worry less about their race being held against them.

It's no surprise that we need to continue addressing these disparities. Professor Kehaulani Vaughn, assistant director of the Asian American Resource Center at Pomona College, emphasizes the need for API (Asian/Pacific Islander) studies, connecting with students and youth to show them that higher education is for everyone: "We need to make these connections for our students, for our youth, that says higher education is a place for you." Since youth are our future leaders, we must begin by empowering younger students, especially those from underrepresented groups, so we can show them that they can achieve great things. Representation for Native Hawaiian/Pacific Islanders in the health care field will only get better once we start advocating for the problem and continue taking initiative. There's still much more to do, and we must aim for change.

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Minal Gowda is a student at Lincoln High School in Seattle. She is a participant in the Explorers Virtual Internship with the Fred Hutchinson Cancer Center.

Belen Sime is a student at University Prep in Seattle. She is a participant in the Explorers Virtual Internship with the Fred Hutchinson Cancer center.

Featured image via TimeImage Production/Shutterstock.com.