Alaska Natives and Pacific Islanders are harder hit by COVID-19 in Alaska. The reasons are complex.

A green house with a blue sign on the wall as seen through a chain link fence
The Anchorage Samoan Assembly of God, the site of a COVID-19 outbreak in July. State health data shows that the Alaska Pacific Island population is almost eight times more likely to contract the virus than the general population, which some attribute to the cultural importance of large group gatherings. (Lex Treinen/Alaska Public Media)

Pacific Islanders and Alaska Natives in Alaska are more likely to get the coronavirus and if they do, are more likely to be hospitalized, according to state health data. 

While some of the populations have higher risks of having underlying conditions like diabetes, smoking, and cardiovascular disease, community leaders say culture and economics also contribute to the disparity. For the Pacific Island community, being physically close is customary. 

“We’re a culture that we love to hugs and we love to kiss. It’s the way we show our love and affection,” said Lucy Hansen, president of the Polynesian Association of Alaska.

Pacific Islanders in Alaska have been contracting COVID-19 at about eight times the rate of the rest of the population. They’re also over four times as likely to be hospitalized, according to state data. 

Hansen says community get-togethers have been a conduit for transmission, so she’s been getting community and church leaders to get out the message that meeting in person is dangerous. Hansen says she’s been working with city and state health officials who alerted her to the disparity to get the word out. 

She’s also been translating health resources into Samoan and Tongan, since some community members don’t speak English as a first language. She says there’s some information that was incorrectly translated using internet tools, which don’t carry the nuance of Samoan, where the translation of one word can change the meaning of the whole sentence. 

“So we just have to remind each other that it’s very real. It’s not something that you joke around with,” she said. 

Economic factors also play a role in certain groups’ transmission, hospitalization and death rates. Pacific Islanders and Alaska Natives and American Indians, who also have been more susceptible to the virus, are also more likely to live in crowded, multi-generational housing where the virus more easily spreads. 

Alaska Natives are over one and a half times more likely to contract the coronavirus, and almost twice as likely to be hospitalized if they do.

Many houses in rural Alaska also lack adequate sanitation, another risk factor, says Dr. Bob Onders, medical director of the Alaska Native Tribal Health Consortium. Onders says that it’s a result of social and economic factors, not just health conditions.  

“Even in the urban setting, there may be other factors that create populations, including Alaska Natives, that may have a higher risk. And the same thing is the multi-generational housing: potentially challenges with housing that may exist even in the urban setting as a rural setting,” he said.  

Onders says many of these problems were identified during the H1N1 pandemic in 2009. He says, unfortunately, not much has changed in the intervening years.

“We know that these social determinants of health have a much larger impact and so we have to have the commitment to make those changes if we truly want to improve the health of these communities that may not have running water, may not have adequate housing. And so that takes a significant investment of time,” he said. 

Onders says he hopes this time around, understanding the inequity can push policymakers to address these problems.