Pacific Islander and Native Hawaiian Mental Health Spotlight
Unpacking the Alphabet Soup of “Asian American Pacific Islander” Terms
Have you ever gotten slightly confused over terms like AAPI, API, AANHPI, APA, APIDA?
Don’t worry, we have too. It’s a lot to remember!
At its core, these are terms to describe the diversity of the Asian community, particularly the immigrant diaspora and also Asian Americans in the United States.
Asian Americans are not a monolith yet, in the absence of data disaggregation, they may often be grouped together. This also includes terms like AAPI which includes Pacific Islanders.
You may have heard terms like AAPI or Asian American broadly, but now there are many new terms like:
APIDA: Asian Pacific Islander Desi American
APA: Asian Pacific American
AANHPI: Asian American Native Hawaiian and Pacific Islander
API: Asian-Pacific Islander
But what are the differences?
This article begins to shed some light on some distinctions.
Who is covered under the term “Native Hawaiian and Pacific Islander?”
The story of Pacific Islanders in America is a rich tapestry of unique cultures, histories, and experiences. While often grouped with Asian Americans in demographic statistics, Pacific Islanders have distinct identities and challenges that set them apart.
Pacific Islanders, or Native Hawaiians and Other Pacific Islanders (NHOPI), encompass people from Hawaii, Guam, Samoa, Fiji, and other islands in the Pacific Ocean. According to the U.S. Census Bureau, the NHOPI population in the United States was approximately 1.6 million in 2020. This group is incredibly diverse, with each island nation boasting its own language, traditions, and social structures.
What are distinctions in the “NHPI” part of “AANHPI”
One major difference between Pacific Islanders and other Asian Americans is their historical relationship with the United States. For instance, Hawaii was an independent kingdom before it was annexed by the U.S. in 1898, and Native Hawaiians have a history of colonization that deeply impacts their community today. Similarly, people from Guam are U.S. citizens, but their island is an unincorporated territory, meaning they have limited representation in the U.S. government. These historical contexts contribute to unique political and social challenges for Pacific Islanders.
Economically, Pacific Islanders often face significant disparities. A 2014 report from the Asian & Pacific Islander American Health Forum revealed that Pacific Islanders have higher poverty rates compared to the general U.S. population. For example, the poverty rate for Samoans in the U.S. is around 19%, compared to the national average of about 12%. This economic hardship is compounded by lower educational attainment levels. According to the National Center for Education Statistics, only about 16% of Pacific Islanders aged 25 and older have a bachelor’s degree, compared to 54% of Asian Americans.
Health disparities also significantly impact Pacific Islander communities. The Centers for Disease Control and Prevention (CDC) reports that Pacific Islanders have higher rates of obesity, diabetes, and cardiovascular disease compared to other racial groups in the U.S. For example, the obesity rate among Native Hawaiians and Pacific Islanders is around 42%, significantly higher than the national average of 32%. These health issues are often linked to socioeconomic factors, including access to healthcare and nutritious food.
Culturally, Pacific Islanders place a strong emphasis on family and community. The concept of “ohana” in Hawaiian culture, which means family in an extended sense, including blood-related, adoptive, and intentional family, highlights the importance of communal support. This contrasts with the more individualistic culture that can be seen in some Asian American communities. Furthermore, Pacific Islanders often maintain a deep connection to their land and traditions, which can sometimes clash with the pressures of assimilation in the mainland United States.
Intersection of Mental Health with Native Hawaiian and Pacific Islander Identities
Here are a few stats-at-a-glance when examining the relation between one’s cultural context, ethnic identity, and mental health. According to Mental Health America:
16.1% of Native Hawaiian and Pacific Islander adults experienced a mental health condition within the past year.
3.5% of Native Hawaiian and Pacific Islander adults experienced a serious mental illness within the past year.
9.4% of Native Hawaiian and Pacific Islander adults experienced a co-occurring substance use disorder alongside a mental health condition.
4.3% of Native Hawaiian and Pacific Islander adults experienced a major depressive episode (MDE) within the past year.
6.8% of Native Hawaiian and Pacific Islander adults have had serious thoughts of suicide within the past year.
0.1% of Native Hawaiian and Pacific Islander adults made plans for suicide within the past year.
These outcomes are often influenced by individuals’ perception of childhood upbringing, as well as beliefs that individuals could overcome these conditions on their own. In short, stigma is a huge factor in Native Hawaiian and Pacific Islanders’ aversion to seeking support.
73% (depression) and 86% (schizophrenia) of NHPIs attributed disorders to bad character/way raised, compared to 54% and 51% of the U.S. public.
Greater percentage of NHPIs perceived depression and schizophrenia as not serious and likely to improve on their own.
34% of NHPIs believed schizophrenia would improve on its own (vs. 11% of the U.S. public).
82% of NHPIs believed schizophrenia would improve with treatment (vs. 98% of the U.S. public).
Value Systems and Important Topics for Allies to Consider
Pacific Islander communities deeply value environmental stewardship, seeing land and ocean not merely as resources but as integral parts of their identity, heritage, and spiritual beliefs. Issues like sustainability and conservation are especially important as these islands face direct threats from climate change and rising sea levels. Allies should recognize that Pacific Islanders are at the forefront of environmental activism, often advocating for policies that protect their land and water from exploitation and pollution. Supporting these values means respecting and amplifying Pacific Islander voices in environmental conversations and understanding that environmental degradation can profoundly impact mental health, as it threatens their way of life and cultural continuity.
Another critical topic for allies to consider is the impact of foreign military bases and testing on Pacific Islands, as well as the strain caused by an influx of remote workers, especially since COVID-19. Military presence has historically led to environmental contamination and disrupted communities, which in turn affects residents’ physical and mental well-being. Take for instance the nuclear testing the U.S carried out on the Marshall Islands. Between 1946 and 1958, the United States conducted 67 nuclear tests in the region, exposing Marshallese communities to massive radiation levels. The most infamous of these tests, the "Castle Bravo" detonation in 1954, was over a thousand times more powerful than the atomic bomb dropped on Hiroshima. The immediate fallout from this test contaminated nearby islands, leading to severe health issues and environmental destruction.
The effects on the Marshallese people were profound. Many were forcibly relocated from their ancestral lands, disrupting their cultural ties and way of life. Those exposed to the fallout suffered high rates of cancer, birth defects, thyroid disease, and other radiation-related illnesses that persist across generations. Beyond the physical health impacts, the trauma of displacement and loss of land has had significant impacts on mental health, with many Marshallese experiencing feelings of loss, anger, and disempowerment due to the enduring legacy of these tests. Additionally, the surge of remote workers in island regions has strained local housing and resources, often driving up costs and making essential resources less accessible to locals. Allies should be sensitive to these pressures and advocate for policies that prioritize Pacific Islanders' access to affordable resources and that respect the autonomy and environmental integrity of these communities.
Media Representation of Pacific Islanders
Pacific Islanders are significantly underrepresented in mainstream media and pop culture. A study conducted by the USC Annenberg Inclusion Initiative found that out of 51,159 speaking characters in movies, only 5.9% were under the umbrella of API, and an even smaller percentage of that 5.9% being Pacific Islander. This narrow representation can lead to feelings of invisibility and reinforce harmful stereotypes, affecting self-perception and limiting young Pacific Islanders' aspirations by presenting few relatable role models.
Actress Sheila Ivy Traister seconds this, stating that “When we don't see ourselves, when we don't see a true reflection of the American scene and the human condition represented in our stories, it's too easy for others to objectify us”. Traister went on to explain how she and other actors of Pacific Islander descent felt “invisible” in the media industry. They say that their stories go untold, the lack of representation in front of and behind the camera erases the community from Hollywood's portrayal of America. Positive, nuanced media portrayals can help combat these issues, offering representation that validates and reflects the diverse identities within Pacific Islander communities, fostering cultural pride and well-being.
Conclusion
Despite these challenges, Pacific Islanders have made significant contributions to American society. They are prominent in fields such as sports, entertainment, and the military. Notable figures include Dwayne "The Rock" Johnson, who is of Samoan descent, and Tulsi Gabbard, the first Hindu member of Congress with Samoan heritage. Their achievements highlight the resilience and talent within the Pacific Islander community.
In conclusion, while Pacific Islanders share some similarities with other Asian Americans, their distinct historical experiences, socioeconomic challenges, and cultural values set them apart. Understanding these differences is crucial for creating policies and programs that adequately address the unique needs of Pacific Islander communities in America. By recognizing and celebrating their distinct identities, we can foster a more inclusive and equitable society.
