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  • By Robert A. Underwood

Micronesians are dying from Covid in high rates. Or are they?

There is nothing more revealing about the conditions of our existence than our income and our health. We expend great effort in acquiring statistics on both income and health. Sometimes, the results are confounding but mostly confusing. There is a difference.

Many would argue that health statistics reveal the real strength of a community.

“If you don’t have your health, you don’t have anything,” is a common refrain attributed to football coach Chuck Pagano. What good is it to have money, family or freedom if you are not going to be around to enjoy it. Obesity, diabetes and getting a vaccine can tell us much more than income levels about the quality of life and the challenges people face.

In these times of the pandemic, getting a vaccine shouldn’t be a political statement, but it can be. Some argue that they are risking their health and it is their free choice, like riding a motorcycle without a helmet while smoking.

About 97 percent of new Covid cases are associated with the unvaccinated in Hawaii. In the United States, almost 100 percent of all cases involving the Delta variant are among the unvaccinated.

But being unvaccinated is a label proudly worn by some as an expression of freedom. It allows them a new sticker on their car or helmet if they had one. That can be confounding to us. Some of the unvaccinated are confused by various sources of information regarding DNA alteration and zombie attacks.

They aren’t deliberate confounders, just confused by information.

Pacific Islanders, especially Micronesians, have a series of different experiences with vaccines and the rates of contact with Covid.

According to Worldmeter, a reference website that provides real-time statistics, the experience in the Federated States of Micronesia, the Marshalls and Palau amid the pandemic has been remarkably good. Palau and the FSM have reported only one case of Covid in each. Marshall Islands has reported four since the beginning of the pandemic. Of course, they have the capacity to shut down entry into their islands and they have done so in a strict, but prudent manner. Nobody has died from Covid 19 in any of the freely associated states.

The rates in Guam, Hawaii and the U.S. mainland paint a confounding and confusing picture. In Guam, the Department of Public Health and Social Services stated that while 43 percent of CHamorus, 71 percent of the Filipinos are vaccinated, only 30 percent of the Chuukese and 34 percent of the Marshallese have experienced the needle. Palauans are at 48 percent and the apparently obedient Yapese are at 64 percent.

In Hawaii and elsewhere, this data is counted as Native Hawaiian and Other Pacific Islander (NHPI). Of course, the Hawaiians are dominant in this census classification in Hawaii and pretty much all the other states. CHamorus, Samoans and Tongans are also in the NHPI.

The most information I could get on vaccine rates was the Native Hawaiians account for 76 percent of the vaccinated NHPI’s while they are 86 percent of the group. The rest (16 percent) account for 24 percent of the vaccinated which means that they have a higher rate of participation. You need a little math to figure out how much higher. I received this information from We Are Oceania, a wonderful Micronesian community advocacy group.

Hawaii authorities reported that 49 percent of Native Hawaiians were vaccinated, but did not report the rest. They did report that although other Pacific Islanders account for 4 percent of the total population, they account for 19 percent of Covid cases and 21 percent of deaths. It is a tragic and startling statistic.

Oregon had the most surprising data. NHPIs had the highest vaccinated population rate. Yes, more than Caucasians, Asians, Native Americans and the others. They are at almost 78 percent fully vaccinated. Of course, they are a much smaller community than the rest. Community contacts and family networks were credited with making possible this high rate. Don’t the same factors exist here in Guam and in Hawaii?

Trying to figure out the impediments to getting vaccinated is a daunting challenge. It seems simple enough. Do outreach. Use the languages of the community when needed. In fact, use them even when they are not needed. It helps promote a feeling of attention, participation and care. I have heard some messages in Chuukese, CHamoru and Tagalog in Guam. There need to be more.

But like most social issues, we quickly diverge into two camps. One camp blames the community or the islanders themselves. They are ignorant, lack judgment or are unsophisticated. They are easily misled by social media.

Apparently, they aren’t the only ones.

The other camp quickly blames the social institutions and conditions that the islander communities live in. They don’t have regular access to health care or transportation. They are, too, busy working. They can also be victims of prejudice and stereotyping which can be transmitted unwittingly by public officials or servants.

Like most serious issues, analysis requires a hard look at accountability as well as fault-finding. But it begins with information and real data. This clearly is not the case now. We must deal with a new label called NHPI. It feels like it puts non-Hawaiian Pacific Islanders out of focus. We might as well develop a new category for Native Americans. We could call them Cherokees, Navajos and other Native Americans or Alaska Natives.


The information provided by Hawaii and Guam call for new protocols as well. In the case of Hawaii, Honolulu City Councilwoman Esther Kiaaina introduced a resolution calling for further disaggregation. She said, “In jurisdictions where there are large percentages of Asian and Pacific Islander populations, it is important that government officials do what they can beyond the minimum federal data collection standards and further disaggregate data”

She further argued that by specifying Pacific Islander groups, “community advocates can hold both private and government officials accountable on how they better address underlying disparities.”

Esther is a Guam-born Native Hawaiian and has grappled with these demographic issues for over 25 years.

Through her efforts to hold agencies accountable for meaningful data, we can in turn hold agencies accountable for policies to reduce disparities. Once we have agreed upon data, we can better deal with data manipulation and misinformation which is rampant. We can better understand why Micronesians who stay at home are Covid-free while those in Guam and Hawaii are suffering disproportionately.

The pandemic has revealed many of our weaknesses as island societies. We are not immune to destructive social media. We are not immune to faulty logic and insufficient data. There is no vaccine for either one. If we had such vaccines, the unvaccinated would proudly proclaim their lack of knowledge and insidious claims as badges of freedom. Unfortunately, they will still be with us.

Dr. Robert Underwood is the former president of the University of Guam and former member of the U.S. House of Representatives. Send feedback to


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