Native Hawaiian / Pacific Islander Health

U.S. map showing the top 10 states with the largest percentage of Native Hawaiians and Pacific Islanders.

Map of the United States showing the top 10 states with the largest percentage of Native Hawaiians and Pacific Islanders according to the Census Bureau.

This profile offers an overview of the social, economic, and environmental factors that shape the health of the Native Hawaiian and Pacific Islander population in the United States. Considering the unique environments, cultures, histories, and circumstances of Native Hawaiians and Pacific Islander populations is fundamental to understanding and improving their health outcomes and reducing longstanding disparities and inequities. These factors, known as social determinants of health (SDOH), affect various health, functioning, and quality-of-life outcomes and risks. Non-medical factors like poverty, limited access to healthcare, and lack of education are all examples of individual SDOH factors that contribute to health disparities and inequities.

Visit Healthy People 2030 to learn more about SDOH.

Data Collection and Reporting for Asian American, Native Hawaiian, and Pacific Islander Populations
Specific health data for Native Hawaiians and Pacific Islanders is often limited. Federal data collection and reporting practices often fail to measure, reflect, and disaggregate the diversity of Asian American, Native Hawaiian, and Pacific Islander experiences. These practices mask the unique needs within these communities, which include dozens of distinct ethnic groups that speak over 100 different languages and dialects. Practices that support granular data collection across various characteristics should also help us understand health in a way that considers intersecting identities of Asian American, Native Hawaiian, and Pacific Islander populations based on sex, race, ethnicity, sexual orientation, gender identity, disability, and socioeconomic status.

Read the White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders National Strategy to Advance Equity, Justice, and Opportunity for Asian American, Native Hawaiian, and Pacific Islander Communities to learn about federal strategies to improve data disaggregation practices for these populations.

Native Hawaiian/Pacific Islander Population Information

The U.S. Census Bureau defines “Native Hawaiian/Pacific Islander” as persons having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. It includes other designations such as “Native Hawaiian,” “Chamorro,” “Samoan,” and “Other Pacific Islander,” as well as other detailed Pacific Islander responses such as Palauan, Tahitian, Chuukese, Pohnpeian, Saipanese, Yapese, etc.

According to the U.S. Census Bureau's American Community Survey (ACS) population estimates, in 2022 there were approximately 665,807 Native Hawaiians/Pacific Islanders alone residing within the United States, representing about 0.3% of the U.S. population. In 2023, the ten states with the largest percentage of Native Hawaiians/Pacific Islanders were Hawaii (10.3%), Alaska (1.7%), Utah (1.2%), Washington (0.9%), Nevada (0.9%), California (0.5%), Oregon (0.5%), Arkansas (0.5%), Oklahoma (0.3%), and Arizona (0.3%).

According to ACS estimates, Native Hawaiians/Pacific Islanders were most represented in the United States by the following sub-categories and their respective estimated populations:

  • Polynesian: 375,599
  • Micronesian: 205,444
  • Native Hawaiian: 185,466
  • Samoan: 123,150
  • Guamanian or Chamorro: 84,847

According to 2022 ACS estimates, 40.3% of non-Hispanic Native Hawaiians/Pacific Islanders alone age 5 years and older in the United States speak a language other than English at home. 11.8% report speaking English less than “very well”.

Of the 308,834,688 people in the United States who speak a language other than English, 485,925 spoke a Pacific Island language, such as Ilocano, Samoan, Hawaiian, or other Austronesian language. This does not include Tagalog, the main language of the Philippines, which is also considered a Pacific language and is spoken by 1,763,585 people in the United States.

According to 2022 ACS estimates, 89.1% of non-Hispanic Native Hawaiians/Pacific Islanders alone age 25 years or older had high school diplomas or higher levels of education compared to 94.2% of non-Hispanic whites. 19.6% of non-Hispanic Native Hawaiians/Pacific Islanders had a bachelor's degree or higher compared to 39.5% of non-Hispanic whites. 6.0% of non-Hispanic Native Hawaiians/Pacific Islanders obtained graduate or professional degrees compared to 15.5 % of non-Hispanic whites.

According to 2022 ACS estimates, the median non-Hispanic Native Hawaiian/Pacific Islander alone 12-month household income was $74,058, compared to $80,404 for non-Hispanic white households. In 2022, 13.5% of non-Hispanic Native Hawaiian/Pacific Islander families experienced poverty, compared to 5.9% of non-Hispanic white families.

2022 estimates from the U.S. Department of Labor show the unemployment rate for Native Hawaiians/Pacific Islanders was 4.0%, compared to 3.2% for non-Hispanic whites.

According to 2022 ACS estimates, 59.8% of non-Hispanic Native Hawaiians/Pacific Islanders alone age 16 or older in the labor force were employed compared to 59.1% of non-Hispanic whites.

According to 2022 ACS estimates, 60.3% of non-Hispanic Native Hawaiians/Pacific Islanders alone had private health insurance, compared to 74.1% of non-Hispanic whites. 38.4% of non-Hispanic Native Hawaiians/Pacific Islanders had Medicaid or public health insurance, compared to 36.1% of non-Hispanic whites. 11.5% of non-Hispanic Native Hawaiians/Pacific Islanders had no health insurance coverage, compared to 5.3% of non-Hispanic whites.

According to the Centers for Disease Control and Prevention, 2022 life expectancy estimates for the Native Hawaiian/Pacific Islander population were not produced due to limited race and ethnicity data. In 2021, the leading causes of death among non-Hispanic Native Hawaiians/Pacific Islanders were COVID-19, heart disease, cancer, unintentional injuries, and diabetes.