Date of Award

Spring 2022

Degree Type

Open Access Dissertation

Degree Name

Public Health, DPH


School of Community and Global Health

Advisor/Supervisor/Committee Chair

Paula H. Palmer

Dissertation or Thesis Committee Member

C. Anderson Johnson

Dissertation or Thesis Committee Member

Jay Orr, Esq.

Terms of Use & License Information

Terms of Use for work posted in Scholarship@Claremont.

Rights Information

© 2022 Jake Ryann C Sumibcay


Maori, Native Hawaiian, New Zealand, Pacific Islanders, Structural Racism, United States

Subject Categories

Public Health


Native Hawaiians and Pacific Islanders (NHPI) in the United States are known to experience profound and persistent disparities across most indicators of socioeconomic status and health when compared to the majority population. Similarly, the Indigenous Māori and Pacific peoples in Aotearoa New Zealand parallel the same experiences. Reducing disparities and improving health equity among racial/ethnic minority populations have been regarded as a national priority in both the United States and New Zealand. Improved population health data have provided insights into the social determinants of health (SDoH), which has unveiled multiple factors that contribute to health disparities, including income, education, residential segregation, stress, social and physical environment, employment, and many others. Health disparities also represent a lack of efficiency within the health system. There is an increasing recognition to “dig deeper” and understand the root causes of inequities and examine the structural factors. More explicitly, how structural racism underlies the persistence of health disparities and inequities. Structural racism is defined as the macrolevel systems, social forces, institutions, ideologies, and processes that interact with one another to generate and reinforce inequities among racial and ethnic groups. Prior research and literature suggest that structural racism exists through the evidence of racial disparities. However, verification and understanding the scope of structural racism can only be done by asking those affected about their lived experiences. The focus of the study was to examine the extent to which structural racism is a fundamental cause of the health inequities and disparities among Pacific Islanders in the United States and New Zealand. Using a mixed-methods comparative design, a document analysis of publicly available resources (N=28) and key informant interviews (N=27) were conducted to assess the patterns of health inequities and disparities among Pacific Islanders and to understand the possible explanations through multiple contexts. The results of the analysis used in this study conceptualized the ways structural racism is operationalized. The study illustrates the experiences and forces that impact Pacific Islanders and offers insights into the wider historical and socio-political context of how structural racism affects Indigenous health. It also provides analyses of current public health practices in the United States and New Zealand.



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