Life spans, diseases still worse than other residents’, study finds

Despite a significant increase in life expectancy in recent decades, Native Hawaiians still have shorter life spans than other Hawaii residents, and a higher proportion suffer from diabetes, heart disease and obesity.

A two-year study released Tuesday by the University of Hawaii John A. Burns School of Medicine found that Native Hawaiians’ average life span is 74.3 years, about six years less than the average of 80.5 years for all residents.

While this is an improvement from 1960 when the life expectancy of Native Hawaiians was 7.8 years less than that of all residents, the gap is still significant and a cause for concern.

"Similar to blacks across the nation, Hawaiians are dying at younger ages, with dramatic differences starting in the midlife age range," the study’s authors wrote.

"Although we have a wonderful climate and lots of sunshine, there are still differences in our population," said Jerris Hedges, dean of the medical school, at a public briefing before lawmakers at the state Capitol.

Disparities in health status are tied to lack of education, poverty and environmental influences that affect emotional and spiritual well-being and lead to unhealthful behaviors such as heavy drinking, smoking, lack of physical activity and poor eating habits, the study said.

"(The differences are) not just (tied) to one’s intrinsic genetic makeup, but also how you react to the environment and some of the stressors that different groups experience," Hedges added.

Native Hawaiians are plagued with disproportionately higher rates of chronic diseases — obesity, diabetes and high blood pressure — and death from heart disease and cancer as compared with the overall state population.

"Unjust differences in health occur in disadvantaged peoples," said Marjorie Mau, director of the UH Center for Native and Pacific Health Disparities Research. "It goes beyond race."

The lack of sidewalks in Wai­anae and high prevalence of smoking and heavy drinking in many of the rural communities where large numbers of Native Hawaiians and Pacific Islanders live are examples of what contributes to their higher mortality rates.

"It’s by design that some of our communities are in the position they’re in, and it’s really unfortunately around ethnic groups here in Hawaii. Socioeconomic conditions of people go hand in hand with their health and well-being," said J. Keawe Kaho­lo­kula, chairman of the UH Department of Native Hawaiian Health, adding that the state needs to invest in community resources to promote healthy behaviors.

"We all want to be healthy. The sickest of people want to be healthy. In Hawaii, where you have to work two jobs to make ends meet, it’s difficult for people to avoid McDonald’s when they have (little) time to get to the next job. By design we’re forced into a lifestyle that promotes obesity," Kaho­lo­kula said.

The study found nearly 70 percent of Native Hawaiians were obese compared with 37.6 percent of Chinese, with the lowest percentage of overweight adults.

Filipinos in Hawaii have seen improvement in their health and now can be expected to live, on average, to nearly age 81 — slightly better than the overall Hawaii life expectancy.

As the federal Patient Protection and Affordable Care Act, or Obama­care, rolls out next year, greater emphasis is being placed on prevention of illness.

"For us to be successful and best use our resources here in Hawaii, we’re going to need to address where we have the biggest gap," Hedges said. "If we can prevent the development of diabetes, heart disease and hypertension in the most at-risk groups, then the overall cost of health care in Hawaii will be kept low."

Thirty community groups across the state and in California participated in the study, which focuses on programs that have improved health status and the challenges that remain for the state’s disadvantaged populations including Native Hawaiians, Filipinos, Samoans, Tongans, Guamanian/Chamorro, Micronesians and Fijians.

Health officials presented the report to state lawmakers in hopes of gaining political momentum to fund prevention programs and improvements in disadvantaged communities, including more organized physical activity in public schools and support for neighborhood parks and gardens where people can grow their own food. Their main recommendation was the creation of a Native Hawaiian health improvement plan.

"We can prescribe all the medicines we want, but if people don’t value that or forget to take it because they’re working two jobs, it’s not going to happen," Kaho­lo­kula said. "We have the worst health, and that shouldn’t be in a state where there is no one ethnic majority. People can only thrive where living conditions are good. We have to improve living conditions in Hawaii so that many people can thrive."

The UH John A. Burns School of Medicine’s Department of Native Hawaiian Health and the Center for Native and Pacific Health Disparities Research published the study, "Assessment & Priorities for Health and Well-being of Native Hawaiians and Other Pacific Peoples."

UH Health Report by craiggima