May 30, 2010

2010 He Huliau: Department of Native Hawaiian Health

S. Kalani Brady, MD, MPH, FACP

Hawai’i Medical Journal

Since its creation by the Board of Regents of the University of Hawai‘i in October 2003, the Department of Native Hawaiian Health of the John A. Burns School of Medicine has been a leader in research addressing the health of Hawai‘i’s host population. It has established a Center for Native and Pacific Health Disparities Research at the University of Hawai‘i. The Department has found that difference in health and health care can influence and are influenced by health disparities research. The elimination of health disparities has become a widespread public health imperative. In 2000, the U.S. Congress passed the Minority Health and Health Disparities Research and Education Act, which established the National Center on Minority Health and Health Disparities (NCMHD). The National Institutes of Health were mandated to fund and coordinate research, research training, and community outreach and dissemination activities to eliminate health disparities in America. Concurrently, the Institute of Medicine released its report on “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” which informed public health officials and policymakers to take action to reduce and eliminate health disparities. Healthy People 2010, the agency which establishes our nation’s health priorities, also established Health Disparities as one of only two public health goals for 2010 and established several targets for improvement and evaluation. The goal of health disparities research is to make scientific discoveries that will eliminate unjust differences in health and health care and promote better health for all people.

The Department of Native Hawaiian Health has hosted an annual two-day Scientific Session to provide the opportunity for presentation of research by a broad spectrum of investigators both within Hawai‘i and beyond, with attendance encouraged not only by “academics” but by our community partners and healthcare workers as well. The following articles were presented at its fifth He Huliau Conference (“A Turning Point”), which occurred in southern California in 2009.

McEligot et. al. address psychosocial factors related to diet and exercise in Southern California Native Hawaiians, contrasting these variables in patients with cardiometabolic disease and those without. They noted that the psychosocial data showed significantly lower social support, social interaction, self-monitoring, and cognitivebehavioral strategies in the patients with cardiometabolic disease. Moy et. al. report about their pilot on measures of physical activity using actual monitors and culturally appropriate questionnaires in a Native Hawaiian and Pacific Islander population. Ryan and Shaw discuss the epidemic of cardiovascular disease in Filipinos in Northern California. Cook et. al. present results of several indices of excellence in care of Native Hawaiians admitted to The Queen’s Medical Center for cardiovascular disease and addressed by the Integrative Care Program of the Queen’s Heart Native Hawaiian Health Initiative. Kaholokula et. al. report their study of the effect of perceived racism and acculturation on the prevalence of hypertension in Native Hawaiians.

Two papers address diabetes. Lee et. al. study numerous indices of good diabetes care in an outpatient clinic, finding that while provider-initiated management met national benchmarks, Native Hawaiians and Pacific Islanders were more likely to have poor glucose control. Chang et. al. studied all delivery records of Micronesian patients in the State of Hawai‘i for a decade, and report that given the high prevalence of obesity and type 2 diabetes mellitus in the Micronesian population as a whole, the prevalence of gestational diabetes was lower than would be expected.

The Department’s mission is to be a center of excellence in education, research, and quality health care practices committed to the optimal health and wellness of Hawai‘i Maoli (Native Hawaiian people), their families and communities that embraces traditional Hawaiian values and practices. It is our hope that this supplement will share our findings with an even broader audience committed to the elimination of health disparities!

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