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Recent data from Hawaii’s Department of Health demonstrates that COVID-19 has disproportionately affected our Filipino community. Filipinos in Hawaii experience the second-worse , following Pacific Islanders.

Throughout the United States, Filipino communities have been negatively impacted by COVID-19 at higher rates than many other ethnicities.

Filipinos are disproportionately working in the COVID-19 frontlines. A large number of Filipinos serve as nurses: of employed RNs and nearly half of employed LPNs in Hawaii are Filipino. Many also serve as doctors, nurse aides, caregivers, or transporters.

In addition, the Filipino community is . Many Filipinos work in other essential services such as retail, grocery and food services. The ubiquitous community-oriented services that we Filipinos contribute increases our risk of contracting COVID-19.

Furthermore, most Filipino families live in a multi-generational household intended to help afford housing and basic needs, yet this economic solution can translate into a health risk facilitating the easy transmission of COVID-19. Exacerbating these concerns of contracting COVID-19 is the heightened prevalence of chronic illnesses such as diabetes and cardiovascular diseases .

Such underlying health conditions magnify the risk of developing severe COVID-19 illness and raise concerns surrounding the physical and mental health of Filipinos both during and after the pandemic.

Aftermath Of COVID-19

Despite Filipinos having the second-largest population in Hawaii, Filipino health is still poorly understood as there is limited research on this topic. Filipinos are often aggregated under Asians or Pacific Islanders which can obscure how Filipinos are impacted by health disparities.

This pandemic only highlights these issues.

Prior to the pandemic, Filipinos reported of access to health care across racial/ethnic groups in the state, according to a recent letter to state leadership by the Pilipino Underrepresented Scholars Organization.

Consequently, limited access to routine health care during this pandemic may have an effect on Filipinos’ physical health. Social distancing requirements limit the capacity and quality with which patients can see their primary care provider.

For many Filipino immigrants, an added barrier to seeking health care is reflected in their limited English proficiency and health care literacy along with the system’s lack of translational services in Ilokano and Tagalog, especially in tele-health services. This can cause difficulties, especially for older Filipino immigrants and Filipinos with chronic conditions, as they try to navigate a foreign health system to meet their health needs.

Filipino culture is collectivistic and sometimes self-sacrificing in nature. “Bahala na,” which can be loosely translated to “whatever will be, will be,” is a cultural value often used in times of hardship where Filipinos will resign themselves to the situation. This resilient mindset can be concerning because Filipinos will continue to work on the frontlines to fight this pandemic despite increased risks.

This can come at a great cost to our Filipino community’s mental health and result in chronic stress and trauma. Likewise, mental health issues that impact Filipinos may be amplified as Filipino cultural values and stigma can hinder help-seeking behavior for mental health services.

There is still a lot of ambiguity about how COVID-19 will continue to affect our communities and what future policies will be adopted as we move ahead, particularly as we open back up to tourism. This is another economic sector where Filipinos are heavily represented and must be protected.

Focusing our perspectives on positive aspects of the Filipino community and using strategic planning to address these problems will help resolve the health burden.

What’s Our Next Steps?

As public health graduate students from Filipino communities in Hawaii, we advocate for health equity. Concerns of the quality of physical and mental health in Filipinos are rising due to the coronavirus pandemic and becoming more visible.

In light of this, it is imperative that further research and resources should be devoted to understanding and improving the health of our communities and achieving health equity for Filipinos and other ethnic communities that are disproportionately impacted.

Current COVID-19 rates highlight “how important it is to separate the Filipinos from the Asian category, especially during the COVID-19 pandemic,” states Dr. May Rose Dela Cruz, assistant researcher at the University of Hawaii Manoa Office of Public Health Studies and co-founder of PUSO. Dela Cruz explains that as we research how COVID-19 affects the state of Hawaii, separating Filipinos from the Asian category will allow us to examine how COVID-19 has affected Filipino health, food security, economy, and more.

“It is important we address this so that our people can gain access to the appropriate help and services,” she says.

The foundation for both eradicating the health disparities and improving health outcomes should draw upon the cultural strengths of our Filipino community. Given that a large proportion of our Filipino population are immigrants, we need to understand the difference in cultural core values and provide health care services that are culturally appropriate for Filipino needs.

Filipino culture is collectivistic and sometimes self-sacrificing in nature.

We can build upon our community values to address health needs. For example, as an important part of our culture, Filipino food can be incorporated into health programs by providing healthy alternative styles of cooking that help individuals manage their chronic conditions. Culturally sensitive and comprehensive approaches can also be implemented in mental health services, including the establishment of family and social support groups, church socials, and recipe sharing that can be conducted with hybrid or virtual methods of communication.

Furthermore, developing bilingual support services for Filipino immigrants will enable them to establish trustworthy relationships between the patient and provider, even in tele-health situations, thus strengthening the quality of care received.

Together strategies such as these can contribute in dismantling the health disparities for our communities. Our community needs must be clearly recognized to build clear solutions to address those needs, and the strengths of our Filipino communities can help resolve the health challenges in the time of COVID-19 and beyond.