Advancing Health Equity in Research

Background: Local studies show that Native Hawaiians and Pacific Islanders (NHPI) have significantly poorer health-related outcomes than other racial/ethnic groups. These findings are understated or hidden in national studies because NHPI data are aggregated with Asian Americans (AAs) due to small sample sizes, by convention, or assumptions of homogeneity.

Objective: We conducted a national study of HRSA-funded Health Center (HC) patients to demonstrate health differences between NHPIs and AAs.

Methods: Two HRSA data sources were analyzed: 1) 2009 Patient Survey – a national sample of HC patients, and 2) 2010 Uniform Data System – a reporting requirement for all HRSA grantees. Key outcomes included: 1) Health indicators: overweight/obese, hypertension, diabetes, controlled hypertension (BP < 140/90), controlled diabetes (HbA1c < 7), and low birth weight (LBW) babies; 2) Access to healthcare: delayed or no receipt of needed medical care in past year.

Results: Nearly 70% of NHPI patients reported hypertension, 20% diabetes, and 81% overweight/obese. In contrast, 30% of AAs reported hypertension, 15% diabetes, and 30% overweight/obese. 50% of hypertensive NHPIs had BP < 140/90 and 23% of diabetic NHPIs had HbA1c <7 at their last clinic visit. In contrast, 62% of AAs had BP <140/90 and 45% had HbA1c <7. Discussion: NHPI patients generally had poorer health indicators than AAs, particularly for overweight/obese and hypertensive. Findings suggest primary prevention activities may improve the health, quality of life (QOL), and birth outcomes for NHPI patients. Targeted interventions in primary care can impact health and QOL later in life.