A new national study reveals that Pacific Islander adults in the U.S. face significantly higher mortality rates than Asian American adults—especially in counties with higher income, education, and population density. The findings challenge assumptions that living in wealthier areas guarantees better health outcomes for all.
Researchers analyzed death certificate data from 2018 to 2020 and found that Pacific Islander adults had consistently higher rates of death from all causes, cancer, and heart disease compared to Asian Americans. The disparities were most pronounced among adults under 65, particularly in counties with the lowest unemployment and highest education and income levels.
In counties with the highest educational attainment, Pacific Islander women aged 20 to 54 had heart disease mortality rates nearly 14 times higher than Asian American women. Among men in the same age group, the rate was over six times higher.
“These findings suggest that Pacific Islander adults living in higher socioeconomic and more populated areas experience the greatest mortality disparities,” the authors wrote. They pointed to factors like limited access to care, low insurance coverage, cultural disconnection, and systemic barriers as possible contributors.
Historically, Pacific Islanders have been grouped with Asian Americans in health data, masking these disparities. The study’s authors argue that disaggregating data is essential to uncovering and addressing the unique challenges Pacific Islander communities face.
See: “Equity, Diversity, and Inclusion County-Level Factors and Mortality Among Pacific Islander Compared With Asian American Adults” (June 6, 2025)
