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COVID-19 revealed and intensified many existing health inequities and revealed the many gaps in our health and social systems. This resulted in disproportionate impacts to certain communities primarily Native Hawaiians, Pacific Islanders, and Filipinos. In Hawai‘i, these groups experienced the highest rates of COVID-19 cases and deaths. We soon learned that other key populations were experiencing the brunt of COVID-19 infection and severe health outcomes: people with pre-existing conditions, people who were immunocompromised, people with disabilities, and older adults (kūpuna). These groups are more likely to experience severe illness,  require hospitalization, develop long COVID, experience social hardships, and die from COVID-19.

Emergencies and disasters disproportionately affect those who are historically underserved and those most vulnerable. This underscores the need for a targeted approach to effectively address the unique challenges and needs of high-risk populations. HIPHI is committed to centering the experiences of our most vulnerable populations in Hawai‘i and continue to find opportunities for equitable responses to COVID-19 and other emergencies.


COVID-19 has affected all of our lives, but perhaps none more than older adults (kūpuna) whose health and well-being have been severely impacted by the pandemic including carrying the highest risk of severe illness due to the virus, threats of social isolation, disruptions in caregiving, and limitations in access to food/meals, vaccines, and medical care. The current pandemic has revealed and exacerbated many gaps in the health and social systems that serve kūpuna, further emphasizing both the unique needs of this population as well as the resilience and leadership of kūpuna, demonstrated through their perseverance through the uncertainties of this pandemic and their contributions to COVID-19 response.

Kupuna Vaccination

When the COVID-19 vaccine first became available in Hawaiʻi, kūpuna aged 75 and older were one of the first groups eligible for vaccination as part of the state’s plan to minimize risk of severe COVID-19 infection and save as many lives as possible. Today, kūpuna take the lead in vaccination rates in every county across the state. This is a testament to the unwavering commitment of Hawaii’s vaccine providers and community partners who worked tirelessly over the last several months to empower kūpuna with the support and resources needed to access the COVID-19 vaccine. The Kūpuna Vaccination Outreach Group, a collective of over 60 community-based stakeholders, came together under the leadership of the City & County of Honolulu Elderly Affairs Division, Executive Office on Aging, and AARP Hawaiʻi (and the facilitation of Hawaiʻi Public Health Institute) to ensure equitable access to vaccination for all kūpuna regardless of geographic location, language proficiency, ethnic background, physical or cognitive abilities, and economic status.

Persons with Disabilities and other High-Risk Individuals

Persons with disabilities  and other individuals such as those with pre-existing conditions and who are immunocompromised are at high-risk for the most severe outcomes and co-morbidities of COVID-19. Some persons with disabilities may be more at-risk of exposure to the virus due to circumstances such as congregate living settings, or systemic health and social inequities. People with serious underlying chronic medical conditions such as lung disease, heart conditions, or weakened immune systems are more likely to get severely ill from COVID-19 and require hospitalization.

In addition to being more vulnerable to the virus itself, persons with disabilities may also have difficulties accessing resources related to COVID-19 and even receiving necessary health care. 

Many disability advocates also support that persons with Long COVID or chronic post-COVID conditions should be classified as having a disability in order to provide resources and support.

Find more information on Long COVID as a disability at US Department of Health and Human Services released guidance on Long COVID as a disability: 

Guidance on “Long COVID” as a Disability Under the ADA, Section 504, and Section 1557

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