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Kwan, C. Y., Rachapudi, M., Calumpit, M., Chan, C. H., Sediqi, S., Uy, L. A., Jamal, A., Rajeshuni, N., Kim, G. and Huang, R. (2025) Leading causes of death among Native Hawaiians and Pacific Islanders in the United States, 2011-2022. In: 18th European Public Health Conference 2025, 12-14 November 2025, Helsinki, Finland.
Background:
Native Hawaiian and Pacific Islander (NHPI) populations in the U.S. face substantial but underrecognized health disparities. A history of systemic inequities has led to high rates of chronic disease and premature mortality. Most national health data aggregates NHPIs with other racial groups, obscuring subgroup-specific disparities. This study aims to provide disaggregated mortality parameters for NHPI subgroups to better inform public health policy.
Methods:
We conducted a mortality analysis using data from the National Vital Statistics System from 2011 to 2022. Age-standardized mortality rates (ASMRs) per 100,000 were calculated and stratified by sex and NHPI subgroups (Native Hawaiian, Samoan, Chamorro/Guamanian) and compared with Asian American (AA) and non-Hispanic White (NHW) populations. We assessed proportional mortality and temporal trends using logistic regression.
Results:
NHPI males (ASMR: 1157.85) and females (832.29) had higher mortality than AAs (617.86; 428.53) and NHWs (596.06; 429.37) males and females, respectively. The median age at death among NHPIs was 65, a decade younger than AAs (76) and NHWs (78). Among NHPI subgroups, Samoans had the highest ASMRs, especially heart disease (313.08; 226.81), cancer (217.28; 200.21), and diabetes mellitus (109.23; 91.13). Guamanians had high mortality from accidents (47.79; 21.10), while Native Hawaiians had lower mortality across all diseases, but greater proportional mortality from dementia compared to the other race groups. Males had higher mortality across most conditions. Groups with lower education levels had higher mortality on average.
Conclusions:
These findings highlight persistent and profound disparities between NHPIs and AAs and NHWs, as well as within NHPI communities. Disaggregated data is essential to illuminate subgroup-specific burdens. As the west navigates changing public health demands, this study underscores the importance of precise, equity-driven approaches to minority health.
Key messages:
• NHPIs (median age at death 66) die over a decade earlier than AAs (77) and NHWs (78).
• Samoans and Guamanians face the highest NHPI mortality - heart disease (up to 313), diabetes (109), and injury (48) deaths per 100,000.
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