Native Hawaiians and Other Pacific Islanders in the US Physician Workforce

Significant efforts have been made to investigate the physician workforce in the context of race, as discussed extensively throughout this textbook. However, much of the attention of the existing body of literature for diversity, equity, and inclusion focuses on the largest underrepresented in medicine (URM) groups: namely Black and Hispanic populations with less emphasis on Indigenous populations. The Native Hawaiian and Other Pacific Islander (NHPI) racial category has had significantly less attention and is often underacknowledged in the United States. This translates to fewer resources allocated to study NHPIs compared to other URM racial groups. Despite being one of the five official federally recognized United States racial groups experiencing significant healthcare disparities, NHPIs are acutely underrepresented in medical schools, residency programs, and academic institutions across the United States. There is limited appreciation for the cultural and historical context of this population. In this chapter, we will delineate NHPI definitions, provide cultural and historical perspectives in medicine, and highlight the grim NHPI health disparities. We will review the challenges NHPIs experience in medical research and outline potential solutions to overcome these barriers. Throughout the text, we will be referring to Representative Quotients (RQs), which show the proportion of NHPI in medicine relative to the United States population. Overall, we advocate that ensuring equal representation of NHPIs proportional to that of the United States population may promote health equity among NHPI communities.