Pacific Islanders living in the United States are being diagnosed and hospitalised with COVID-19 at significantly higher rates than people from other ethnic groups.
The US has been significantly impacted by the coronavirus pandemic with over 4.2 million cases and 146,000 deaths so far and thousands of new cases reported every day.
But in some states, ethnic groups including Pacific Islanders and Native Hawaiians are massively overrepresented in COVID-19 statistics.
In Washington State, the rate of confirmed cases for Native Hawaiian or Pacific Islander people is nine times higher than the rate of white people, The Guardian reported.
Their hospitalisation rate is also 10 times that of white people.
In Los Angeles, Pacific Islanders have the highest case and death rates according to local news outlet Spectrum News 1.
Islanders in Oregon are three times more likely than any other racial group to be infected by the novel coronavirus, The Guardian reported.
In some areas, the percentage of case numbers for Pacific Islanders living in the United States is also much higher than their population.
In Washington's Spokane county, people from the Marshall Islands make up 30 percent of confirmed coronavirus cases despite only representing less than 1 percent of the county's population.
In Arkansas, Pacific Islanders make up 0.3 percent of the population but account for 8 percent of COVID-19 infections.
In Hawaii, Pacific Islanders are 4 percent of the state's population, but 25 percent of COVID-19 cases.
Health authorities have argued cultural and social differences have impacted the rates of infections.
Experts told The Guardian Pacific Islanders tend to live in large family groups and close-knit communities which has led to higher COVID-19 infection rates than other ethnic groups.
Dr Nia Aitaoto, from the Pacific Islands Center of Primary Care Excellence, said cultural practices also contributed to the high infection rates of Pacific Islanders.
"We live in large families, if one family gets infected they can pass to another. And we celebrate and gather, that's just our nature and that does not help," she said.
"When you are positive, you need to be in isolation, this is hard to do for Pacific islanders. It's hard to isolate anyone in that environment, in most cases with two bedrooms and eight to 10 people per household."
Pacific Islanders also have higher rates of chronic diseases which can complicate COVID-19.
"Diabetes, for one and high blood pressure," Reverend Pausa Thompson, from Los Angeles County, told Spectrum News 1.
"We know through research those are the conditions that make us most vulnerable."
The Centres for Disease Control and Prevention (CDC) has also said racial and ethnic minorities in the United States can be at increased risk to COVID-19 due to discrimination in social systems including healthcare, housing and education.
"People from some racial and ethnic minority groups are more likely to be uninsured than non-Hispanic whites," the CDC website says.
"Healthcare access can also be limited for these groups by many other factors, such as lack of transportation, child care, or ability to take time off of work; communication and language barriers; cultural differences between patients and providers; and historical and current discrimination in healthcare systems."
