COVID fallout leaves many NHPI adults without adequate care

By Pooja Mamnoor

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    4/18/25 (LAPost.com) — Despite experiencing negative mental health and economic impacts during the COVID-19 pandemic, a majority of eligible Native Hawaiians and Pacific Islanders in California did not receive available care and financial assistance, according to a new report released this month.

The California Pacific Islander Well-being and COVID-19 Economic Survey – known as CAPIWAVES – surveyed more than 900 NHPI adults in California between January and May 2024. Researchers from the University of California, Los Angeles Center for Health Policy Research’s NHPI Data Policy Lab, UC Irvine, and UC Riverside collaborated on the study.

The report revealed about one in three NHPI adults, or 33.9%, reported needing mental health care in the prior year for help with stress, depression, or emotions. Yet only 26.8% of NHPI adults said they had sought mental health care at any point in their lives.

“Our report helps address a data gap that Native Hawaiian and Pacific Islander community leaders have expressed,” Brittany Morey, the report’s lead author and associate professor of health, society, and behavior at UC Irvine, said. “We knew from stories that NHPI communities were deeply impacted, and continue to be impacted, by the pandemic. But now we have the data to show the extent of the impact and provide some insight into what we can do about it.”

The survey found 17% of NHPIs reported avoiding or delaying needed mental health care in the previous 12 months. Respondents cited several barriers to seeking care, including cost concerns, lack of insurance, not knowing how to find a mental health provider, concern about friends or family finding out, inability to take time off work, and lack of insurance coverage for mental health services.

The report highlighted substantial differences in mental health care-seeking behaviors among specific NHPI groups. Native Hawaiians were most likely to have sought mental health care at 40.7%, followed by CHamorus at 37.2%, Samoans at 20.5%, and Tongans at 19.7%.

During the pandemic, 35.5% of NHPI adults reported moderate distress, and 9.2% reported high levels of distress. Major sources of stress included health-related concerns at 43.9%, financial concerns at 38.8%, and the pandemic’s impact on family members at 37.6%.

When managing stress, NHPI adults most commonly reported communicating with friends and family at 53.2%, engaging in meditation, mindfulness, or prayer at 43.5%, and participating in more family activities at 34.8%.

The report also documented significant economic hardships. More than one in three NHPI adults reported a decrease in household income since the beginning of the pandemic. This impact varied among specific groups, with 46.3% of Fijian, 42.9% of Marshallese, 41.4% of Tongan, and 35.6% of Native Hawaiian respondents reporting reduced income.

Job loss was also substantial, with nearly one in seven NHPI respondents losing their regular employment during the pandemic. More than 25% of respondents reported difficulty meeting basic financial needs, including paying bills, affording tuition, buying groceries, or covering rent or mortgage payments.

Despite these economic challenges, the data revealed low utilization of available assistance programs. Among those eligible based on reported household income, less than one-third received government health benefits such as Medi-Cal or Medicare. Similarly, only 31.5% of eligible respondents received CalFresh, California’s implementation of the federally funded Supplemental Nutrition Assistance Program.

The CAPIWAVES report addresses a longstanding issue of data representation for NHPI communities. In the past, NHPIs have often been categorized with Asian Americans in population surveys, which researchers say has obscured their distinct experiences and needs.

“This report illustrates the powerful insights we gain from data disaggregation,” Ninez Ponce, director of the UCLA Center for Health Policy Research and principal investigator of the NHPI Data Policy Lab, said. “Without knowing how different populations are affected by social conditions and how much they use available resources, it is impossible to develop effective policies and programs.”

Researchers emphasized that collaboration with NHPI community members throughout the study was crucial to its success.

“Throughout my life, I have seen how our NHPI communities are rarely considered when public health resources are allocated,” Calvin Chang, director of the NHPI Data Policy Lab, said. “This data helps our communities pursue our fair share of resources by giving weight to our stories and lived experiences.”

Audrey Kawaiopua Alo of the Southern California Pacific Islander Community Response Team, who helped encourage participation in the study, noted the report’s value for future planning efforts. The report originated from concerns about COVID-19’s disproportionate effect on NHPI communities, which had higher case and death rates than other racial and ethnic groups in 13 of the 19 states that reported such data.

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