An analysis of nearly two decades of data revealed Native Hawaiian study participants had more than twice the risk of developing gout as older adults, relative to White participants. Black and Japanese participants had the second and third highest risk, respectively.
New public health research shows that emergency department (ED) visits by Native Hawaiian children with asthma account for the largest proportion of the total statewide costs for potentially preventable visits for children’s asthma. Native Hawaiian children have higher rates of asthma, which usually requires daily medications and regular follow-up care.
The COVID-19 pandemic has worsened many of the problems faced by Native Hawaiian communities, but in a new paper, public health researchers detail the numerous efforts of Native Hawaiian-led groups that show these communities’ strength and resilience.
Since the start of the pandemic, Native Hawaiians and other Pacific Islanders have faced a higher risk of contracting COVID-19 than other groups in Hawaiʻi. They also endured high levels of unemployment and economic insecurity.
“This paper highlights the power of Native Hawaiian communities during these trying times,” said Jane Chung-Do, senior author and associate professor with University of Hawaiʻi at Mānoa’s Office of Public Health Studies within the Thompson School of Social Work & Public Health. The paper is published in the Journal of Indigenous Social Development.
Nonprofit efforts
The nonprofit group Ke Kula Nui O Waimānalo (KKNOW), whose aim is to promote health and support the self-sustainability of the Waimānalo community, has partnered with other nonprofits, businesses and governmental agencies to provide food for Waimānalo families. Since mid-March, the group has distributed 24,000 prepared meals and 3,550 boxes of fresh produce. KKNOW also delivered seeds and seedlings of traditional Hawaiian crops such as kalo (taro) and ʻuala (sweet potato) to families and community members who are vulnerable to food insecurity, economic instability and other social challenges.
“The goal of KKNOW is to build community resilience by helping fellow Native Hawaiians grow their own food before further disruptions strike,” said Kirk Dietschman, president of Ke Kula Nui O Waimānalo and a co-author of the paper.
Other nonprofits have also pitched in. The meals were prepared by chefs and students in a culinary training program, coordinated by the nonprofit KUPU Hawaiʻi. Meal delivery was led by Aloha Harvest, and the Department of Hawaiian Home Lands and the Waimānalo Market Co-Op, which provided the sites for the daily food distribution.
“These efforts succeeded because these Native Hawaiian-led groups anticipated the needs of the community and leveraged existing resources and relationships to meet those needs,” said Ilima Ho-Lastimosa, the lead author of the paper and a community coordinator at the Waimānalo Learning Center of the UH Mānoa College of Tropical Agriculture and Human Resources (CTAHR). “It is key that these organizations all have history with the community and have earned the trust of the members.”
Producing long-lasting results
Historically, efforts to address health disparities have used western-centric methods and have often failed to produce long-lasting results among Indigenous peoples, the researchers wrote in their paper. They concluded that place-based, culturally-grounded interventions show promising results with Indigenous peoples and will be needed to restore the health of Native Hawaiians.
The co-authors on the paper also include LeShay Keliʻiholokai, Kaua Kassebeer, Hae Kassebeer, Joseph Awa Kamai, Ikaika Rogerson, Kenneth Ho Jr., Manahā Ho, Kamalei Ho, and Denise Kaʻaʻa, of Ke Kula Nui O Waimānalo; Alexxus Ho, of the HawaiʻiPacific University College of Health and Society, and Theodore Radovich of CTAHR.
This research is an example of UH Mānoa’s goal of Excellence in Research: Advancing the Research and Creative Work Enterprise (PDF), one of four goals identified in the 2015–25 Strategic Plan (PDF), updated in December 2020.
Story originally posted at UH News
Native Hawaiians who have higher levels of resilience may also have better health, according to new public health research from the University of Hawaiʻi at Mānoa.
Researchers led by Mapuana C.K. Antonio, an assistant professor in Native Hawaiian and indigenous health at the Office of Public Health Studies in the Myron B. Thompson School of Social Work, developed a new scale to measure resilience in Native Hawaiians. The scale was included in a survey of 124 Native Hawaiian adults living on Hawaiian Homestead Lands. The researchers compared the participants’ resilience scores with their self-reported health.
The findings are published online in the journal Behavioral Medicine.
“Resilience is complicated to measure,” Antonio said. For the new study, she and her co-authors incorporated scales that expanded on traditional measures of resilience, which look at a person’s ability to overcome adversity and persevere in times of difficulty. Traditional measures have generally looked only at internal traits, such self-reliance.
The researchers developed a new measure that takes into account the indigenous perspective of resilience, which places high value on relationships. “It is important to consider that for Native Hawaiians, health and resilience involves cultural identity and a sense of lōkahi, or harmony between the physical, spiritual, social and emotional self, and extends to include the outside world or environment,” said Antonio.
The researchers tested out their new scale and found it had good validity. They also found that the participants in their survey who scored higher on the resilience scale also reported higher levels of general health, mental health and physical functioning.
Native Hawaiians face much adversity that stems from colonization and historical trauma, including discrimination, health disparities and lower socioeconomic status compared with other racial and ethnic groups. “Our findings suggest that resilience may slightly mediate the effect that adversity has on health,” Antonio said.
The new scales can be used in future research on Native Hawaiian health that uses a strength-based approach, meaning research that focuses on the positive aspects of the community, rather than targeting deficits.
“A multi-faceted measure of resilience is needed to promote better health outcomes for Native Hawaiians,” added Antonio.
Antonio’s co-authors on the study included Earl S. Hishinuma, Claire Townsend Ing, Fumiaki Hamagami and Joseph Keaweʻaimoku Kaholokula of the John A. Burns School of Medicine; Adrienne Dillard, B. Puni Kekauoha and Cappy Solatorio of Kula no na Poʻe Hawaiʻi; Kevin Cassel of the University of HawaiʻiCancer Center; and Kathryn L. Braun, also of the Office of Public Health Studies.
Native Hawaiians who use a DVD-based weight loss program can shed pounds and keep pounds off just as well as those who take in-person classes, a new study finds.
In the study called PILI@Work, researchers at the University of Hawai‘i at Mānoa recruited more than 200 employees in Native Hawaiian-serving organizations who wanted to lose weight. Most of the study participants were Native Hawaiian or other Pacific Islander.
“Obesity leads to diabetes and premature death. This program aimed to improve long-term health by teaching ways to lose pounds and keep them off,” said Professor Kathryn L. Braun, DrPH, who worked on the study and is the director of the Office of Public Health Studies at the university.
The PILI@Work progam is a year long. In the first three months, participants met in groups to learn new skills and develop action plans. A significant portion lost at least 3 percent of their original body weight.
During the next nine months, half the participants continued to attend classes, while the other half watched lessons on DVDs at work or home. About 60 percent of all participants maintained their weight loss one year later. Results were the same, whether the participants had watched the DVD or had participated in face-to-face classes.
“PILI@Work works because it builds on a curriculum developed by Hawaiians for Hawaiians,” said Professor J. Keawe‘aimoku Kaholokula, principal investigator of study and chair of the Department of Native Hawaiian Health at the John A. Burns School of Medicine.
“The classes and DVDs were tailored to Hawaiian culture and communities. The program included language and foods specific to Native Hawaiians and focused on helping participants garner family support and identify community resources that support their healthy lifestyle choices. The program also incorporated tips on eating healthy on a budget and good communication with your doctor,” added Claire Townsend Ing, DrPH, who coordinated the study and is a researcher with the John A. Burns School of Medicine.
The researchers noted that the people who had maintained the greatest weight loss after a year were the ones who participated the most intensely during the first three months of the program.
"It seems that a key to weight loss is to jump in with both feet when you're starting a program,” said Braun.
DVDs may be appealing because they are less expensive than classes. DVDs also give people more flexibility in scheduling.
