BACKGROUNDIn the month of August, when the state recorded its greatest number of cases, Pacific Islanders represented approximately 24% of all cases, despite accounting for just 4% of the state?s population. Filipinos make up 16% of the state?s population but represent 20% of COVID-19 cases since the inception of the pandemic in Hawaii. These disparities, which mirror disparities in chronic disease incidence in historically underserved racial and ethnic populations in Hawaii, were detailed in a report titled: ?COVID-19 in Hawai?i: Addressing Health Equity in Diverse Populations,? released on March 16, 2021. The report was a result of a collaborative effort between the Hawai?i State Department of Health (HDOH) and a diverse group of academic and community partners, and was undertaken in recognition of the need to elevate issues facing racial and ethnic communities in Hawai?i experiencing disproportionate burden of disease from COVID-19. This funding opportunity provides the opportunity to accelerate and adequately resource implementation of the recommendations detailed in Hawai?i?s Health Equity Report. APPROACHReducing the burden of COVID-19 disease in disproportionately impacted communities will require extensive collaboration across state agencies and with community partners. HDOH will establish a cross-cutting Office of Health Equity (OHE) that will expand upon the work of several programs to address the recommendations from the health equity report and provide enhanced support for community initiatives and stakeholder collaboration. Key outcome the OHE will seek to attain include:?Increase accessible and culturally attuned testing opportunities for racial and ethnic communities disproportionately impacted by COVID-19 including on neighbor islands and in rural communities?Through culturally rooted and language-accessible messaging and outreach, improve vaccination coverage among populations that express ongoing uncertainty about vaccination?
Activate and develop community health workers trained through academic partnerships as critical community resources and leaders?Establish collaborative initiatives between academic institutions, health care professionals and community stakeholders to develop a public health workforce reflective of the populations served by HDOH, and to improve data quality and enable meaningful analysis of data to evaluate and address health disparitiesSuccess will require collaboration between HDOH programs (Chronic Disease Prevention and Health Promotion Division, which will house the Office of Health Equity, the Disease Outbreak Control Division, State Laboratories Division, the Office of Primary Care and Rural Health, and the Office of Planning, Policy, and Program Development), other state agencies (the State Libraries and the University of Hawaii), and external partners (Federally Qualified Health centers, community based and faith based organizations). Target populations include Filipinos and Pacific islanders, who have had high COVID-19 infection rates, high rates of chronic disease, and linguistic and cultural barriers to accessing care. Native Hawaiian populations also have high rates of underlying chronic disease and experience continued challenges in overcoming historic disempowerment and mistrust of government. Racial and ethnic disparities are compounded in rural areas where access to education and healthcare has been limited. The OHE will consolidate efforts to engage these communities and will make additional resources available to community partners to scale up efforts to increase participation in testing and provide culturally sensitive education on COVID-19 vaccines. Infrastructure developments for neighbor island health centers and hospitals in rural communities will support expanded testing and vaccine clinics, and will complement programs to develop and expand a network of community health workers performing outreach in these communities.
