Four committees of the Hawai`i State Legislature recognized the importance of a new assessment of health in Hawai`i by jointly sponsoring a public briefing to receive the data on September 24 at the State Capitol Building.
The University of Hawai`i John A. Burns School of Medicine (JABSOM) and its community partners presented the “Assessment & Priorities for Health and Well-Being of Native Hawaiians and other Pacific Peoples.” The study is the result of two years of work, and the most comprehensive collection of data focusing on what is working and what challenges remain in the health status of Native Hawaiians, Filipinos, Samoans, Tongans, Guamanian/Chamorro, Micronesians (Federated States of Micronesia, Palau, Marshall Islands and the Commonwealth of the Northern Mariana Islands) and Fijians, who collectively represent a significant portion of Hawai`i’s population.
The challenges for this population are enormous: most of them have shorter life spans than other Hawai`i citizens. Thirty organizations across the state and in California identified the major health concerns, which include diabetes, heart disease and obesity.
The positive news is that over time, there has been improvement as a result of focused efforts. For example, Filipinos in Hawai`i now can be expected to live, on average, to nearly age 81—that’s slightly better than the overall Hawai`i life expectancy of 80.5 years. Native Hawaiians, however, typically die six years earlier than other populations. (That does show a steady if slow improvement from 1970, when the life expectancy of Native Hawaiians was 13 years less than that of other populations.)
In short, what is working in these communities still generally beset by fewer providers of health care, less education, lower wages and higher rates of disease?
•Health improvement programs in the community run by people the community knows and trusts.
•Culture and science can blend for successful outcomes. A cardiac health improvement study incorporated hula, and saw as much as a 20-point drop in blood pressure among participants. (Hula Empowering Lifestyle Adaptation (HELA), sponsored by the UH medical school, The Queen’s Medical Center, Papkolea’s Kula no Na Po`e, Kōkua Kalihi Valley and hula experts from Halau Mohala `Ilima; funded by the National Institutes of Health.)
•Focus on improving educational opportunities shows results. UH Community Colleges Pathways program has shined: almost doubled enrollment of Native Hawaiians from 1992-2007.
“Collaborations are difficult but they work,” said Mele Look, Director of Community Engagement for the JABSOM Department of Native Hawaiian Health. “If we focus on what the community wants, what they will participate in, and what works, we can make progress.”
The medical school and its partners emphasize that overall inequity in the health of Native Hawaiian and Pacific Islanders persists and are “considerable and disturbing.” The University of Hawai`i, including the medical school, endeavors to provide better education which researchers have determined is linked to better income and improved health.