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In the state of Hawaii, it has been shown that certain ethnic minority groups, such as Filipinos and Pacific Islanders, suffer disproportionally high rates of cardiovascular disease, evidence that local health-care systems and governing bodies fail to equally extend the human right to health to all. This study aims to examine whether these ethnic health disparities in cardiovascular disease persist even within an already globally disadvantaged group, the houseless population of Hawaii.

A retrospective chart review of records from Hawaii Houseless Outreach and Medical Education Project clinic sites from 2016 to 2020 was performed to gather patient demographics and reported histories of type II diabetes, obesity, hyperlipidemia, hypertension and other cardiovascular disease diagnoses. Reported disease prevalence rates were compared between larger ethnic categories as well as ethnic subgroups.

Unexpectedly, the data revealed lower reported prevalence rates of most cardiometabolic diseases among the houseless compared to the general population. However, multiple ethnic health disparities were identified, including higher rates of diabetes and obesity among Native Hawaiians and other Pacific Islanders and higher rates of hypertension among Filipinos and Asians overall. The findings suggest that even within a generally disadvantaged houseless population, disparities in health outcomes persist between ethnic groups and that ethnocultural considerations are just as important in caring for this vulnerable population.

To the best of the authors’ knowledge, this is the first comprehensive study focusing on ethnic health disparities in cardiovascular disease and the structural processes that contribute to them, among a houseless population in the ethnically diverse state of Hawaii.

The current COVID-19 pandemic is influencing our life in every aspect, including working and living environments. Millions of people were forced to isolate themselves in their homes, which has posed significant pressure on buildings and shown us that our dwellings are not designed for such purposes. This is partly due to the fact that homes are designed and built for occasional use rather than isolated and long-term occupation. The legislative system of a country plays an important role in defining and shaping the conditions of people living there. Hence, the aim of the study is to evaluate the readiness of Kazakhstani and the EU construction-related legislation for pandemics.

Previously developed pandemic-resilient indicators were used for the evaluation of construction legislation. Both legislative systems were reviewed, and the quality of responses was evaluated by assigning response scores.

The results based on response scores indicate that the environmental resource consumption sub-category was better covered by EU legislation. At the same time, the buildings’ health, safety and comfort are better taken into account in Kazakhstani legislation. Seven pandemic-resilient indicators were not responded to by any legislative system indicating a gap between current legislation and requirements for new living conditions.

No study has analyzed how COVID-19 can transform construction legislation. The study reveals the limitation of current construction legislation in Kazakhstan (KZ) and the EU, indicating the need for transformation to meet the requirements of the pandemic era.