A Community Assessment of Psychological Distress in Pacific Islanders Across San Francisco Bay Area Churches During the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic has exacerbated health and social disparities among US Pacific Islanders (PI). Historically, PIs have experienced a high burden of mental illness yet have underutilized mental health services. These already large treatment gaps in mental health care among PIs may worsen during the COVID-19 pandemic. In the face of pre-existing challenges, little is known about the impacts of the COVID-19 pandemic on mental health outcomes among PIs. METHODS: A community-based, cross-sectional survey was administered to members of 13 PI churches across the San Francisco Bay Area. We assessed the burden of psychological distress among PIs and its associations with demographic, sociocultural, and health factors. KEY RESULTS: Among 439 PI respondents, nearly half reported moderate or severe psychological distress. Only about one-tenth took prescription medication for mental health and less than half utilized a mental health provider in the past year. Most trusted PI churches to provide health and social services. Respondents reporting moderate or severe psychological distress were less likely to utilize a mental health provider in the past year and more likely to feel marginalized, excluded, isolated, or alienated from society "most of the time" or "always." Psychological distress was also associated with "fair" or "poor" health status, female gender, older adults, low trust in PI churches to provide health and social services, and concern over household finances. CONCLUSION: Partnerships with faith-based and community-based organizations are essential to address unmet mental health needs and promote support-seeking behaviors among PIs during this ongoing pandemic and beyond.

Transnational Caregiving for Older Adults and Caregivers’ Wellness in Japanese Americans during the Pandemic

Global migration has greatly affected intergenerational family support beyond national borders, in particular adult children’s transnational family caregiving for elderly parents. Specifically, the COVID-19 pandemic has largely influenced transnational caregiving due to the travel restrictions. Transnational caregiving for older adults includes adult children’s periodical returning to their home country and/or adult children’s caregiving for their parents in their settled country. The goal of this study was to identify trajectories between adult children’s transnational caregiving for their parents and caregivers’ wellness in Japanese Americans before and during the pandemic. We conducted semi-structured interviews with Japanese Americans 40 to 59 years of age (N=20) in California before the lockdown and during the increasing number of patients infected with the Delta variant. The qualitative data analysis showed some Japanese Americans periodically returned to Japan to provide caregiving for their parents before the pandemic, while others didn’t. However, the former group currently relied on their families in their home country more than before. The limitations led to not only distress over uncertainty but also release from a strong sense of reciprocity and filial responsibility, by changing from physical support to emotional and financial support via online. They also enhanced cultural identity as Japanese Americans, by thriving from discrimination against Asian Americans. Thus, our findings demonstrate important factors that impacted on transnational caregiving and caregivers' wellness, including cultural identity, family norms, beliefs and practices of intergenerational support, social and historical contexts, financial remittance, ICT use, and healthcare policies among the underrepresented populations across the Pacific.

Pacific Islanders in the Era of COVID-19: an Overlooked Community in Need.

BACKGROUND: Pacific Islanders (PIs), an indigenous, diverse population in the USA, have endured generational burdens of Western colonization and institutional racism that placed this population at socioeconomic and health disadvantages, such as in poverty, chronic disease, and now COVID-19. However, little is known about the impact of COVID-19 on this historically disadvantaged population. This study assessed the extent US PIs have been adversely affected by COVID-19 across the 50 states. METHODS: Using state-level national data as of September 9th, 2020, we conducted a secondary-data analysis of COVID-19 cases and deaths in PIs relative to their population representation and other racial groups, case odds ratios, and age-adjusted standard mortality ratios. KEY RESULTS: Only 46% of states reported PI cases and 36% of states reported PI deaths. Of 23 states with available data on PIs, PIs were overrepresented in COVID-19 cases and deaths relative to their population representation in 21 and 14 states, respectively. The proportion of COVID-19 cases and deaths to the PI population was highest among all racial groups in 15 and 9 states, respectively. PIs had higher odds of exposure to COVID-19 than Whites in 21 of 23 states, and higher number of observed deaths than expected in 6 of 7 states with available PI data. CONCLUSIONS: Engaging PI community-based and faith-based organizations in medical and public health outreach efforts, health workforce employment and training programs, along with granular data collection and reporting, are vital to mitigate the disproportionate effects of COVID-19 on this population.