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Kaiser Permanente Hawaii plans to spend the next three years studying the prevalence of diabetes among 10 of the state’s ethnic groups.
In addition, the study will include looking at the factors within those groups that contribute to diabetes-related diseases affecting the heart and kidney.
The $1.5 million study, funded by the National Institute of Diabetes and Digestive and Kidney Disorders, is the first of its kind designed to take a deeper look at the specific impacts diabetes has on people living in Hawaii who identify as Japanese, Chinese, Filipino, Hawaiian, Samoan, mixed Asian-Caucasian, mixed Asian-Hawaiian, mixed Hawaiian-Caucasian and mixed Asian-Hawaiian-Caucasian. A Caucasian-only group will also be included for comparison purposes.
"It’s problematic that Asians and Pacific Islanders have such high rates of diabetes, yet they have been studied far less than other minorities in the U.S.," said Dr. Beth Waitzfelder, a sociologist with Kaiser’s nonprofit Center for Health Research Hawaii who will lead the study, which was launched July 15.
"What’s really unique about the study is that we’re looking at well-defined mixed-race groups, which as far as I can tell has not been done before in this way," she said.
Native Hawaiians in Hawaii have more than twice the rate of diabetes and are 5.7 times as likely to die from diabetes than white residents, according to the U.S. Department of Health and Human Services’ Office of Minority Health. Residents who identify as being Filipino have more than three times the death rate as white residents.
Diabetes, a disease in which the body has trouble processing sugar, is the nation’s seventh-leading cause of death. It can cause poor circulation, heart and kidney problems, nerve damage, blindness and eye problems, and nontraumatic lower limb amputations.
Waitzfelder said the goal of the study is to identify what factors play into how the population groups are affected by those outcomes, so as to develop better treatment and prevention methods.
"We first have to figure out what the problem is — what are the underlying factors that are contributing to poor outcomes — and then we hope to develop interventions to address those," Waitzfelder said.
According to the Centers for Disease Control and Prevention, 8.3 percent of the U.S. population had diabetes as of 2010.
A 2010 state Department of Health diabetes report found that about 7.7 percent of Hawaii residents reported having been diagnosed with the disease. The report also states that 13.4 percent of residents who earn less than $15,000 a year have diabetes; 15.2 percent of Nanakuli/Waianae residents reported having the disease; 9.9 percent of Filipinos have the disease; and the prevalence of the disease varies little by county.
Waitzfelder, who has been researching diabetes for about 15 years, said the study seeks to evaluate how patient characteristics such as culture, education and income, as well as treatment factors and environment, contribute to differences in diabetes-related outcomes among the 10 study populations.
According to the 2010 U.S. Census, the number of Asians and Pacific Islanders increased in the United States by 43 percent and 35 percent respectively since 2000, making them the fastest-growing populations in the country.
Waitzfelder noted that previous diabetes studies done on Asians and Pacific Islanders often lumped these populations into one heterogeneous category, potentially blurring important differences among these groups.
To complete the study, Kaiser Permanente Hawaii will pull information from its electronic medical record system and conduct a large-scale patient survey among people within the identified groups. Patients will not be identified in study results, and personal information will be kept confidential.
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