NCHS Data Brief ■ No. 277 ■ March 2017

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Selected Health Conditions Among

Native Hawaiian and Pacific Islander Adults:

United States, 2014

Adena M. Galinsky, Ph.D., Carla E. Zelaya, Ph.D., Patricia M. Barnes, M.A., and Catherine Simile, Ph.D.

Key findings 

Data from the Native 

Hawaiian and Pacific 

Islander National Health 

Interview Survey (NHPI 

NHIS) and the National 

Health Interview Survey 

(NHIS)

● The age-sex-adjusted

percentages of NHPI adults

with fair or poor health

(15.5%), serious psychological

distress (4.1% in past 30

days), cancer (5.7%), coronary

heart disease (6.0%), diabetes

(15.6%), lower back pain

(28.5% in past 3 months),

arthritis (19.7%), migraines

(14.1% in past 3 months),

and asthma (9.9%) were

greater than the corresponding

percentages for single-race

Asian adults.

● NHPI adults were more

likely than all U.S. adults to be

in fair or poor health, to have

diabetes, and to have ever had

asthma, but they were less

likely to have cancer.

Although the Asian or Pacific Islander federal race category was split into two 

in 1997 (1), few reliable health statistics are available for the Native Hawaiian 

and Pacific Islander (NHPI) population. In 2014, the National Center for 

Health Statistics (NCHS) fielded a first-of-its-kind federal survey focused 

exclusively on NHPI population health. This report uses data from that survey, 

in combination with 2014 data from the annual National Health Interview 

Survey (NHIS), to highlight differences in the prevalence of selected health 

conditions between the NHPI population and the Asian population with whom 

they have historically been combined.

Keywords: Fair or poor health • Native Hawaiian and Pacific Islander 

National Health Interview Survey

NHPI adults were more likely to be in fair or poor health and 

to have experienced serious psychological distress in the 

past 30 days compared with single-race Asian adults.

 
NCHS Data Brief ■ No. 277 ■ March 2017

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● The percentage of NHPI adults who were in fair or poor health was 15.5%, which was 

higher than the percentage among single-race Asian adults (9.2%) and all U.S. adults 

(12.0%) (Figure 1).

● The percentage of all NHPI adults (4.1%) who had experienced serious psychological 

distress in the past 30 days was higher than the percentage among single-race Asian adults 

(1.6%) and higher than, but not significantly different from, the percentage of all U.S. adults 

(3.1%).

Compared with single-race Asian adults, NHPI adults were more likely to 

have each of the three leading causes of death analyzed. 

● A higher percentage of all NHPI adults (5.7%) had cancer compared with single-race Asian 

adults (3.2%), while the percentage for NHPI adults was lower than that for all U.S. adults 

(7.8%) (Figure 2). 

● A higher percentage of all NHPI adults (6.0%) had coronary heart disease compared with 

single-race Asian adults (3.2%); the percentage of all NHPI adults was higher than, but not 

significantly different from, the percentage of all U.S. adults (5.4%).

● A higher percentage of all NHPI adults (15.6%) had diabetes compared with single-race 

Asian adults (8.0%) and all U.S. adults (8.7%). 

 
NCHS Data Brief ■ No. 277 ■ March 2017

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NHPI adults were more likely than single-race Asian adults to have lower 

back pain, arthritis, and severe headaches.

● A higher percentage of all NHPI adults (28.5%) had lower back pain in the past 3 months 

compared with single-race Asian adults (17.2%) (Figure 3).

● A higher percentage of all NHPI adults (19.7%) had arthritis compared with single-race 

Asian adults (11.4%); the percentage of all NHPI adults was lower than, but not significantly 

different from, the percentage of all U.S. adults (21.1%).

● A higher percentage of all NHPI adults (14.1%) had migraines or severe headaches in the 

past 3 months compared with single-race Asian adults (9.9%); the percentage of all NHPI 

adults was lower than, but not significantly different from, the percentage of all U.S. adults 

(15.1%).

 
NCHS Data Brief ■ No. 277 ■ March 2017

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NHPI adults were more likely than single-race Asian adults to have ever 

been diagnosed with and still have asthma.

● A higher percentage of all NHPI adults (19.2%) had ever been diagnosed with asthma 

compared with both single-race Asian adults (9.2%) and all U.S. adults (12.8%) (Figure 4).

● A higher percentage of all NHPI adults (9.9%) still had asthma compared with both singlerace Asian adults (4.8%) and all U.S. adults (7.4%).

 
NCHS Data Brief ■ No. 277 ■ March 2017

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Summary

In 2014, NHPI adults reported a consistent pattern of poorer health compared with single-race 

Asian adults for all ten measures in this report. 

NHPI adults were also more likely than all U.S. adults to be in fair or poor health, to have 

diabetes, and to have ever had asthma, but they were less likely to have cancer. NHPI adults did 

not differ significantly from all U.S. adults in their likelihood of having each of the three painrelated conditions analyzed (lower back pain, arthritis, and migraines), serious psychological 

distress, and coronary heart disease.

Historically, few reliable health statistics have been available for the NHPI population because 

they constitute only about 0.4% of the total U.S. population (2). Thus, this type of analysis has 

generally not been possible, either because NHPI and Asian data were aggregated to produce 

Asian or Pacific Islander statistics, or relatedly, because survey sample sizes for NHPI were 

too small to calculate reliable estimates. Using the relatively large NHPI sample from the 2014 

NHPI NHIS, it is possible to calculate reliable NHPI estimates with smaller variance and thereby 

discern differences between the NHPI population and other racial groups. These results highlight 

some of the important differences between the NHPI and Asian populations that are obscured 

when the two groups are combined. 

Definitions

Arthritis: Respondents were asked if they had ever been told by a doctor or other health 

professional that they had some form of arthritis, rheumatoid arthritis, gout, lupus, or 

fibromyalgia. Those who answered “yes” were classified as having arthritis. 

Cancer: Respondents were asked if they had ever been told by a doctor or other health 

professional that they had a cancer or malignancy of any kind. 

Coronary heart disease: In separate questions, respondents were asked if they had ever been told 

by a doctor or other health professional that they had coronary heart disease, angina (or angina 

pectoris), or heart attack (or myocardial infarction). Prevalence of coronary heart disease includes 

coronary heart disease, angina, and heart attack. 

Diabetes: Respondents were asked if they had ever been told by a doctor or other health 

professional that they had diabetes (or sugar diabetes; female respondents were instructed to 

exclude pregnancy-related diabetes). Responses from persons who said they had borderline 

diabetes were treated as unknown with respect to diabetes. 

Ever and current asthma: Respondents were asked, “Has a doctor or other health professional ever 

told you that you had asthma?” and “Do you still have asthma?” 

General health status: Respondents were asked to assess their own health and that of family 

members living in the same household as excellent, very good, good, fair, or poor.
NCHS Data Brief ■ No. 277 ■ March 2017

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Lower back pain and migraines or severe headaches: In separate questions, respondents were 

asked, “During the past 3 months, did you have low back pain?” and “During the past 3 months, 

did you have a severe headache or migraine?” For both questions, respondents were instructed to 

report pain that had lasted 1 whole day or more, and conversely, not to report fleeting or minor 

aches or pains. 

Serious psychological distress: Based on responses from six survey questions about how often a 

respondent felt sad, nervous, restless, hopeless, everything was an effort, and worthless during 

the past 30 days. The response codes (0–4) for each of the six items are summed to yield a scale 

with a 0–24 range. A value of 13 or more for this scale was used to define serious psychological 

distress (3).

Data sources and methods

Data from the 2014 NHPI NHIS and the 2014 NHIS were used for this analysis. All estimates for 

the NHPI population were calculated using 2014 NHPI NHIS data. All estimates for the total U.S. 

population and single-race Asian population were calculated using 2014 NHIS data. 

NHIS data are collected continuously throughout the year for NCHS by interviewers from the 

U.S. Census Bureau. NHIS collects information about the health and health care of the civilian 

noninstitutionalized U.S. population. NHPI NHIS data were collected between February and 

November of 2014 by experienced NHIS interviewers. For both surveys, interviews were 

conducted in respondents’ homes, with telephone follow-up to complete interviews when needed 

(4,5). Following questions about the household and family, one adult aged 18 or over was 

randomly selected from each family for a detailed interview. All sample adults in NHPI NHIS are 

single- or multiple-race NHPI. Analyses in this report are based on data from 2,590 NHPI sample 

adults from NHPI NHIS and 36,697 sample adults from 2014 NHIS.

Both surveys were designed to yield a nationally representative sample, and this analysis used the 

appropriate weights to produce national estimates. Point estimates and estimates of corresponding 

variance accounted for the complex sampling designs of NHIS and NHPI NHIS. Compared with 

single-race Asian adults, NHPI adults were more likely to be younger and male. To control for 

differences in age and sex distributions within race groups and the effect of age and sex on the 

health characteristics studied, estimates were age-sex-adjusted using the projected 2000 U.S. 

population from the U.S. Census Bureau as the standard population and using age groups 18–24, 

25–34, 35–44, 45–64, and 65 and over. Differences between percentages were evaluated using 

two-sided significance tests at the 0.05 level. The estimated standard error of the difference 

between all NHPI and total U.S. estimates did not account for nonindependence. 
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About the authors

Adena M. Galinsky, Carla E. Zelaya, and Catherine Simile are with the National Center for 

Health Statistics (NCHS), Division of Health Interview Statistics. Patricia M. Barnes is with 

NCHS, Division of Research Methodology.

References

1. Office of Management and Budget. Revisions to the standards for the classification of federal 

data on race and ethnicity. Fed Regist 62(210):58782–90. 1997. Available from: https://www.gpo.

gov/fdsys/pkg/FR-1997-10-30/pdf/97-28653.pdf.

2. Hixson L, Hepler BB, Kim MO. The Native Hawaiian and Other Pacific Islander population: 

2010. 2010 Census briefs. 2012. Available from: http://www.census.gov/prod/cen2010/briefs/

c2010br-12.pdf. 

3. Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, et al. Screening for 

serious mental illness in the general population. Arch Gen Psychiatry 60(2):184–9. 2003. 

4. National Center for Health Statistics. Survey description, Native Hawaiian and Pacific 

Islander National Health Interview Survey, 2014. 2017.

5. National Center for Health Statistics. Survey description, National Health Interview Survey, 

2014. 2015.
NCHS Data Brief ■ No. 277 ■ March 2017

Suggested citation

Galinsky AM, Zelaya CE, Barnes PM, 

Simile C. Selected health conditions among 

Native Hawaiian and Pacific Islander adults: 

United States, 2014. NCHS data brief, no 

277. Hyattsville, MD: National Center for 

Health Statistics. 2017.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Interview Statistics

Marcie L. Cynamon, Director

Stephen J. Blumberg, Ph.D., Associate 

Director for Science

Division of Research and Methodology

Nathaniel Schenker, Ph.D., Director

Donald Malec, Ph.D., Associate

Director for Science

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