Washington State University wants to find ways to better identify and reduce COVID‑19 infection in vulnerable minority and rural groups.

Marshallese Pacific Islanders living in the United States are one such community that has been hit hard by COVID. Like other high‑risk groups, Marshallese often serve as frontline workers and suffer from widespread disparities in health care contributing to an increased prevalence in conditions such as type 2 diabetes that escalate COVID‑19 risk.

An effort to combat this threat to the Marshallese is being led by Ka’imi Sinclair, associate director of WSU’s Institute for Research and Education to Advance Community Health (IREACH). Sinclair, who holds a PhD in health behavior and health education, wants to identify culturally tailored, participatory surveillance methods to reduce the spread of COVID‑19 in high‑risk communities. Funded with a $2.3 million grant from the National Institutes of Health’s new Rapid Acceleration of Diagnostics Radical (RADx‑rad) initiative to support non-traditional means to battle the pandemic, Sinclair’s project – Marshallese: Alternate Surveillance for COVID‑19 in a Unique Population (MASC UP) – focuses on early detection and engages community members to identify local practices that may increase disease risk.

COVID‑19 infection rates are 4-25% higher for the Marshallese than for many other Americans. Although Marshallese represent only 1% of the population in Spokane County, they accounted for nearly 30% of COVID cases in the spring of 2020. During the same period, Marshallese deaths accounted for 38% of COVID‑19 mortality in Northwest Arkansas, where they make up 3% of the population. Marshallese communities experience significant health and health care disparities and have a fraught relationship with the U.S. government due to past nuclear weapons testing in the Marshall Islands. Almost half of the Marshallese living in the U.S. are uninsured, and many live in multi-generational households that value close contact and hold big social gatherings. In Northwest Arkansas, 30% of Marshallese adults are employed by Tyson Foods, the large poultry distributor that notoriously failed to protect its workers from COVID‑19 infection.

To reduce COVID‑19 disparities in this high‑risk population that has been profoundly underserved by public health policies, MASC UP is developing and testing culturally tailored, participatory approaches to disease surveillance and prevention. The intention is to extend the improved methods that are generated to other high‑risk groups and have these mechanisms at the ready to combat future viral threats.

“To solve a problem as complicated as COVID‑19, we need ideas, tools, and technologies that challenge the way we think about pandemic control,” said NIH Director Francis S. Collins, M.D., Ph.D. “These awards from the RADx‑rad program provide superb examples of outside-the-box concepts that will help us overcome this pandemic and give us a cadre of devices and tactics to confront future outbreaks.”