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At least 19 recordsLinked to original sources
PubMed2003

Utilization of dental care services by Asians and native Hawaiian or other Pacific Islanders: United States, 1997-2000.

OBJECTIVE: This report describes national estimates of dental care service utilization and unmet dental care needs due to cost for six Asian ethnic subgroups and the native Hawaiian or other Pacific Islander (NHOPI) population. METHODS: Combined data from the 1997-2000 National Health Interview Surveys (NHISs), conducted by the Centers for Disease Control's National Center for Health Statistics, were analyzed to produce estimates for Asians and NHOPIs aged 2 years and over. Information on dental care service utilization and unmet dental care needs due to cost was self-reported by persons aged 18 years and over. For children aged 2-17 years, the information was collected from an adult who was knowledgeable about the child's health. RESULTS: Approximately 64% of Asian and 56% NHOPI persons had visited a dentist at least once in the past year. Utilization of dental care services, however, varies significantly by ethnic subgroup. Asian Indians were most likely to have never had a dental visit and the NHOPIs were most likely to experience unmet dental care needs in the past year. Among adults, Japanese Americans (68.2%) were most likely and NHOPIs (49.3%) were least likely to have had a dental visit in the past year. Underutilization of dental care services was most prevalent among Asian adults with poor or near poor poverty status, without health insurance coverage, and who had resided in the United States for less than 5 years. Among children, NHOPIs (82.0%) were most likely and Asian Indians (60.1%) were least likely to have had a dental visit in the past year. Underutilization was most prevalent among Asian children who were not living with their parents or living with a single parent, who had no insurance coverage, who had poor or near poor poverty status, and whose parents had less than 12 years of education. CONCLUSIONS: Utilization of dental care services and unmet dental care needs due to cost vary among the Asian ethnic subgroups and the NHOPI population.

Adolescent↗
PubMed2000

Cancer research studies in Native Hawaiians and Pacific Islanders.

PURPOSE: To review and assess published findings from relevant cancer research studies in Native Hawaiians and other Pacific Islanders and to develop strategies for designing and implementing successful cancer research studies in the future. METHODS: Data were collected primarily from MEDLINE and BIOSIS Preview searches of the English literature during a 30-year period for published reports of cancer surveillance studies and epidemiological and clinical cancer studies in the Native Hawaiian and Pacific Islander populations. The cancer burden was critically assessed in the retrieved citations for each of the indigenous groups from Hawai'i, American Samoa, Guam, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Republic of Palau, and the Republic of the Marshall Islands. RESULTS: A review of the published literature revealed a lack of systematic data collection on cancer incidence and mortality in Pacific Islanders. Wide variations were found regarding the status of cancer research among ethnic groups. It is estimated that Native Hawaiians represent 0.1% of subjects accrued to cancer prevention trials, and that Pacific Islanders represent 0.5% of subjects in a large cancer screening trial. CONCLUSION: The paucity of cancer data and clinical cancer research supports the need for increased attention to these indigenous populations to improve the quality of cancer care in Native Hawaiian and Pacific Island communities.

Ethnicity↗
PubMed1997

The insulin resistance syndrome in native Hawaiians. Native Hawaiian Health Research (NHHR) Project.

OBJECTIVE: To investigate whether fasting hyperinsulinemia is associated with a clustering of cardiovascular disease (CVD) risk factors, manifesting as the insulin resistance syndrome (IRS), in a population of native Hawaiians. RESEARCH DESIGN AND METHODS: A total of 574 native Hawaiians > or = 30 years of age were examined for blood pressure, waist-to-hip ratio (WHR), BMI, oral glucose tolerance, and fasting lipid, insulin, and C-peptide concentrations. All statistical analyses (n = 384) excluded 190 individuals who had NIDDM or who were taking hypertension medication. Using logistic regression analysis, fasting insulin and C-peptide levels were compared with CVD risk factors (glucose intolerance, hypertension, central adiposity, elevated triglyceride levels, and low HDL cholesterol levels) after adjusting for age and obesity. RESULTS: Sixty-six percent of native Hawaiians were overweight or obese, and 70% were found to have central adiposity. Fasting insulin concentrations were correlated with BMI, WHR, blood pressure, and triglyceride, HDL cholesterol, and glucose concentrations. Fasting insulin was also significantly associated with an increasing number of CVD risk factors in each participant (P < 0.001). Fasting insulin and C-peptide concentrations were independently associated with glucose intolerance, high triglyceride levels, and low HDL cholesterol levels. However, only fasting C-peptide concentrations were independently associated with hypertension and central adiposity. Apparent differences in the correlates of fasting insulin and C-peptide may be related to multiple factors and warrant further evaluation. CONCLUSIONS: This study provides cross-sectional data confirming the existence of the IRS in native Hawaiians. However, further longitudinal studies are needed to examine the relationship of insulin resistance and/or surrogate markers to increased rates of NIDDM and CVD mortality in native Hawaiians.

Adult↗
PubMed2026

Cancer statistics for Asian American, Native Hawaiian, and Pacific Islander people, 2026.

BACKGROUND: Cancer statistics for Asian American and Native Hawaiian and Pacific Islander (NHPI) people are usually aggregated, masking substantial variation within this heterogeneous population. Herein, the American Cancer Society reports cancer incidence and survival for 8 Asian American and 3 NHPI ethnic groups. METHODS: The authors used population-based cancer registry data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program, for Asian American and NHPI ethnic groups from 2000 through 2022. RESULTS: During 2018-2022, overall cancer incidence ranged from 218.3 per 100,000 Kampuchean people to 474.5 per 100,000 Native Hawaiian people, which was 1.5 times higher than the rate for the aggregated Asian American and NHPI population (307.3 per 100,000). High incidence among Native Hawaiian people is largely driven by the highest rates of female breast, colorectal, and prostate cancers, whereas infection-related cancers were highest among Asian American ethnic groups. For example, liver and stomach cancer incidence is highest among Vietnamese (22.2 per 100,000) and Korean people (17.8 per 100,000), respectively, both of which were nearly twice that in Native Hawaiian people (12.9 and 9.6 per 100,000, respectively). Native Hawaiian and Samoan women are twice and 3 times as likely, respectively, to be diagnosed with uterine corpus cancer as aggregated Asian American and NHPI women or White women. Five-year relative survival ranges from 42% in Laotians to 74% in Asian Indians/Pakistanis, with largest differences for colorectal (43% in Laotians to 72% in Asian Indians/Pakistanis) and prostate (63% in Kampucheans to 97% in Japanese) cancers. CONCLUSIONS: Wide variation in cancer risk within the Asian American and NHPI population highlights the critical need for disaggregated data to effectively target cancer prevention and control interventions.

Adolescent↗
PubMed2004

Physical activity among Asians and native Hawaiian or other Pacific islanders--50 States and the District of Columbia, 2001-2003.

Data on physical activity participation rates among Asians and Native Hawaiian or Other Pacific Islanders (NHOPIs) in the United States are limited. For example, few studies have measured physical activity prevalence among the diverse Asian population, which was estimated to be 11.9 million in 2000 according to the U.S. Census and is projected to increase to 33.4 million by 2050. One of the broadly defined goals of the 2010 national health objectives is to reduce disparities in health among population groups. To determine the prevalence of recommended levels of lifestyle (i.e., nonoccupational) physical activity (e.g., combined leisure-time, household-related, and transport-related), the prevalence of physical inactivity, and the prevalence of leisure-time physical inactivity among Asians and NHOPIs in the United States, CDC analyzed physical activity data from the Behavioral Risk Factor Surveillance System (BRFSS) surveys from 2001, 2002, and 2003 for the Asian and NHOPI populations from all 50 states and the District of Columbia (DC). This report summarizes the results of that analysis, which indicated that 38.6% of Asians and NHOPIs met recommended levels of lifestyle physical activity, compared with 45.8% of the total U.S. population, and approximately 24% were inactive during their leisure time. To increase physical activity in the Asian and NHOPI populations, state and local health departments and other organizations should adopt evidence-based strategies at the community and individual level to promote and encourage physical activity.

Adult↗
PubMed1995

High mortality rates in Native Hawaiians.

Native Hawaiians continue to have higher mortality rates than do other ethnic groups in Hawaii. This discrepancy becomes even more pronounced when rates are calculated separately for full-Hawaiians versus part-Hawaiians versus all races. In an exploratory discussion of these data, a group of Native Hawaiian physicians recommend greater attention be given to Native Hawaiian values and participation in health care delivery, increasing access to services, and further research.

Attitude to Health↗
PubMed1998

Prevalence of glucose intolerance among Native Hawaiians in two rural communities. Native Hawaiian Health Research (NHHR) Project.

OBJECTIVE: To estimate prevalence of type 2 diabetes and impaired glucose tolerance (IGT) among a population of native Hawaiians in two rural communities. RESEARCH DESIGN AND METHODS: Prevalence of glucose intolerance was assessed in two rural communities by history (confirmed by record review) or with a 75-g oral glucose tolerance test according to World Health Organization criteria. Anthropometric and demographic data were also obtained. A short survey was used to estimate the prevalence of known diabetes among nonparticipants. Prevalence rates were adjusted using the standard world population of Segi. RESULTS: A total of 574 native Hawaiians age > or = 30 years participated. The crude prevalence of IGT and type 2 diabetes were 15.5 and 20.4%, respectively. Only IGT prevalence was significantly higher (P = 0.03) among women (18.7%) than among men (10.9%). Prevalence of glucose intolerance was significantly associated with BMI, waist circumference, and waist-to-hip ratio (WHR). After adjusting for age and BMI, waist circumference and WHR were significantly and independently associated with type 2 diabetes prevalence only among women. Prevalence of type 2 diabetes was not significantly associated with the percentage of Hawaiian ancestry after adjusting for age. CONCLUSIONS: This study observed a high prevalence of glucose intolerance associated with being overweight among native Hawaiians. Age-adjusted type 2 diabetes prevalence was four times higher than among the U.S. National Health and Nutrition Examination Survey (NHANES) II population. Prevalence was high despite high rates of admixture with other ethnic groups of Hawaii, suggesting that these other Asian and Pacific Island populations share similar susceptibility to type 2 diabetes risk.

Adipose Tissue↗
PubMed2004

Addressing the cancer control needs of Pacific Islanders: experience of the Pacific Islander Cancer Control Network.

PURPOSE: This paper describes the accomplishments of the Pacific Islander Cancer Control Network (PICCN). PICCN's objectives fall under two broad categories: increasing cancer awareness and enhancing cancer control research among Samoans, Tongans, and Chamorros. METHODS: PICCN established an infrastructure for addressing the goals that include the University of California, Irvine; the UCI Chao Family Comprehensive Cancer Center; and community-based organizations (CBOs) in areas where large numbers of Pacific Islanders live. Activities that increase cancer awareness include assessing existing cancer education materials, developing new culturally-sensitive materials, and distributing the materials in a culturally-sensitive manner. Activities that enhance cancer control research include training Pacific Islander investigators and providing them with mentors to help with the development of research projects. RESULTS: During the four project years, PICCN has conducted more than 180 cancer awareness activities in its six study sites: Carson, CA; San Mateo, CA; San Diego, CA; Salt Lake City, UT; American Samoa; and Guam. PICCN members have also participated in conferences and lead discussions about the importance of clinical trials for Pacific Islanders. In addition, the Network has trained nine Pacific Islander investigators (three individuals from each ethnic group) in its cancer control academy. Finally, PICCN investigators are conducting pilot research projects that will answer important questions regarding the cancer control needs of these Pacific Islanders and set the stage for interventions aimed at addressing the needs. CONCLUSION: PICCN is advancing the national goal of eliminating cancer-related health disparities through its cancer awareness and research activities for Pacific Islanders.

American Samoa↗
PubMed1996

Age-Specific Native Hawaiian Mortality: A Comparison of Full, Part, and Non-Hawaiians.

PURPOSE OF THE PAPER: The purpose of this paper is to test if the previously identified disparity in mortality rates among full Hawaiians, part Hawaiians, and non&shy;Hawaiians in the state of Hawaii has continued into the 1990s. SUMMARY OF METHODS UTILIZED: Based on Hawaii vital records and population data, standardized age&shy;specific mortality rates by cause and 95% confidence intervals were estimated. PRINCIPAL FINDINGS: The most striking finding was the significant differences in mortality rates in four age strata &shy;&shy; 45&shy;54, 55&shy;64, 65&shy;74, and 75&shy;84 &shy;&shy; with mortality rates highest for full Hawaiians, lowest for non&shy;Hawaiians, and intermediate for part Hawaiians. CONCLUSIONS: Findings suggest that Native Hawaiians continue to be at greater risk of death compared with non&shy;Hawaiians, with full Hawaiians at greatest risk. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS: Asian and Pacific Islander Americans have been called the model minority. These data provide evidence that Native Hawaiians, especially full Hawaiians, have dramatically higher mortality rates than non&shy;Hawaiians and merit special attention.

Journal Article↗
PubMed2005

Differential mortality and transplantation rates among Asians and Pacific Islanders with ESRD.

Few studies in patients with ESRD have examined outcomes in Asian or Pacific Islander subgroups compared with white individuals. The objective of this study was to assess ethnic disparities in mortality and kidney transplantation among a multiethnic cohort of incident dialysis patients. A total of 24,963 patients who initiated dialysis within the TransPacific Renal Network (Network 17) between April 1, 1995, and September 30, 2001, were studied to ascertain death and kidney transplantation through September 30, 2002. Overall, 12,902 deaths and 2258 kidney transplantations were observed during 59,075 person-years of follow-up. Mortality on dialysis among Asians and Pacific Islanders (except Chamorros) was lower than that of white individuals after controlling for differences in sociodemographic characteristics, comorbid conditions, and other risk factors for death (adjusted hazard ratio [95% confidence interval] versus white individuals: Japanese 0.64 [0.57 to 0.72], Chinese 0.64 [0.52 to 0.78], Filipino 0.64 [0.57 to 0.72], Native Hawaiian 0.84 [0.72 to 0.96], Samoan 0.62 [0.48 to 0.82], and Chamorro 0.96 [0.84 to 1.20]). In contrast, Asians and Pacific Islanders were much less likely to undergo kidney transplantation (adjusted rate ratio [95% confidence interval] versus white individuals: Japanese 0.34 [0.24 to 0.46], Chinese 0.54 [0.30 to 0.88], Filipino 0.32 [0.26 to 0.47], Native Hawaiian 0.17 [0.10 to 0.30], Samoan 0.17 [0.07 to 0.38], and Chamorro 0.04 [0.01 to 0.14]). Despite wide variations in primary cause of ESRD, clinical characteristics, and body size at dialysis initiation, Asians and Pacific Islanders experience better survival but substantially lower transplantation rates compared with white individuals. Strategies that are aimed at improving access to transplantation in Asian and Pacific Islander communities may further enhance survival among Asians and Pacific Islanders with ESRD.

Age Distribution↗
PubMed2004

Factors associated with health-seeking behaviors of Native Hawaiian men.

Native Hawaiian men have higher mortality rates and lower life expectancies than Caucasian men in the United States and in Hawai'i. As an initial step in developing targeted cancer awareness interventions for Native Hawaiian men, the Native Hawaiian Cancer Committee (NHCC) of the American Cancer Society Hawai'i Pacific, Inc. conducted focus groups of Native Hawaiian men living in four geographical areas in Hawai'i in 2002-2003. The purpose was to explore attitudes and practices related to health-seeking behaviors among Native Hawaiian men. In all, 54 urban- and rural-dwelling men participated. Many common issues related to access to care, perceptions, attitudes, as well as cultural values were identified. These findings provide opportunities to motivate Hawaiian men to navigate the current healthcare system and facilitate access to healthcare. Integrating cultural strengths and preferences into health-seeking approaches can readily affect behaviors, and with time, improve the health status of Native Hawaiian men.

Adult↗
PubMed2004

Na Liko Noelo: a program to develop Native Hawaiian researchers.

Native Hawaiians are underrepresented in health research. They also have expressed dissatisfaction with the way in which many non-native researchers have formulated research questions, conducted research, and disseminated findings about Native Hawaiians. 'Imi Hale - Native Hawaiian Cancer Network was funded by the National Cancer Institute to increase research training and mentorship opportunities for Native Hawaiians. To this end, 'Imi Hale has followed principles of community-based participatory research to engage community members in identifying research priorities and assuring that research is beneficial, and not harmful, to Native Hawaiians. Developing indigenous researchers is a cornerstone of the program and, in its first 4 years 'Imi Hale enrolled 78 Native Hawaiian "budding researchers (called Na Liko Noelo in Hawaiian), of which 40 (68%) have participated in at least one training and 28 (36%) have served as investigators, 40 (51%) as research assistants, and 10 (13%) as mentors on cancer prevention and control studies. The major challenge for Nă Liko Noelo is finding the time needed to devote to research and writing scientific papers, as most have competing professional and personal obligations. Program evaluation efforts suggest, however, that 'Imi Hale and its Na Liko Noelo program are well accepted and are helping develop a cadre of community-sensitive indigenous Hawaiian researchers.

Biomedical Research↗
PubMed1998

The Development of the Ethnocultural Identity Behavioral Index: Psychometric Properties and Validation with Asian Americans and Pacific Islanders.

PURPOSE. The goal of this article is to present a measurement tool with potential utility for health care workers and mental health professionals who require a means of systematically assessing ethnocultural behaviors in the course of their professional clinical activities and decision making. METHODOLOGY. As part of a larger effort to develop a multi&shy;dimensional, ethnocultural identification scale for clinical and research use, a cultural general 19 item self&shy;report behavior index entitled the Ethnocultural Identity Behavior Index (EIBI) was designed. The psychometrics of the EIBI were examined on a sample of 352 college students self&shy;identifying with an Asian American or Native Hawaiian ethnocultural group. PRINCIPAL FINDINGS. The data suggest that the EIBI has high internal consistency. Construct and concurrent convergent validity were also established for the EIBI through a comparison of the EIBI schores of immigrants and non&shy;immigrants, through correlations with self&shy;reported strength of identification with one's chosen ethnocultural group (r=0.48), and through correlations with the self&shy;reports of pride toward one's group (r=0.31). A factor analysis of the EIBI yielded three factors (i.e. Cultural Activities, Social Interactions, Language Opportunities) that accounted for 60% of the total variance. CONCLUSIONS. The EIBI appears to be a valid and reliable index of one's involvement with an ethnocultural group, making it useful as a quick index of ethnocultural identity. RELEVANCE TO ASIAN AMERICAN AND PACIFIC ISLANDER POPULATIONS. This article is particularly relevant to persons identifying with Asian American and Native Hawaiian ethnocultural groups. KEY WORDS. Ethnocultural identity, measurement, Asian American and Native Hawaiian adults

Journal Article↗
PubMed1996

Does acculturation influence psychosocial adaptation and well-being in Native Hawaiians?

Native Hawaiians have suffered higher disease rates and achieved lower educational and economic levels than other ethnic groups living in Hawaii. This study tests the hypothesis that cultural affiliation protects against psychosocial pathology in Hawaiians. Subjects included 172 Hawaiians of varying blood quantum and 92 non-Hawaiians. The Na Mea Hawai'i, a rationally derived, empirically validated measure of Hawaiian acculturation was administered to all subjects in addition to psychological tests which included 19 visual analogue scales that measure both state and trait variables. The Na Mea Hawai'i proved excellent at differentiating Hawaiians from non-Hawaiians (p = .0001), and it correlated well with blood quantum (r = 0.31, p = .0001). Low acculturation scores among Hawaiians did not correlate with any measure of discontent or psychosocial pathology irrespective of blood quantum. We conclude that Na Mea Hawai'i is a valid measure of Hawaiian acculturation, and that adaptation of the Hawaiians in our sample has been unaffected by level of acculturation.

Acculturation↗
PubMed2002

Relationship between plasma glucose concentrations and Native Hawaiian Ancestry: The Native Hawaiian Health Research Project.

OBJECTIVE: To investigate the relationship between fasting glucose and 2 h glucose with percentage of Hawaiian ancestry and ethnic admixture. DESIGN: Cross-sectional epidemiological study of type 2 diabetes and heart disease risk factor prevalence among Native Hawaiians. SUBJECTS: A total of 578 Native Hawaiians residing in two rural communities were examined between 1993 and 1996. Sample sizes in statistical analyses varied due to missing data and selection criteria based on ethnic ancestry. MEASUREMENTS: Percentage of Hawaiian ancestry and non-Hawaiian ethnic admixture, assessed by self-report. Fasting and 2 h post glucose challenge plasma glucose levels. Anthropometric measures (height, weight, waist and hip circumferences). Self-report of diet and physical activity. Medical history. RESULTS: Increased Hawaiian blood quantum was significantly associated with increased fasting glucose (P=0.0047), increased body mass index (BMI; P<0.0001), waist-to-hip ratio (WHR; P=0.0103), and age (P<0.0001), but not with leisure time physical activity and total dietary caloric intake. This association was attenuated after adjusting for BMI and WHR, but not by age-adjustment alone. However, when the effects of descent from other ethnic groups was examined in a subset of participants, full-Hawaiians had significantly higher fasting glucose concentrations (7.28 mmol/l) than part-Hawaiians after adjustments for age, gender, BMI and WHR. In contrast, part-Hawaiians of predominantly Asian ancestry had the highest 2 h glucose concentrations (7.62 mmol/l). CONCLUSION: These results suggest that ethnic admixture may be an important, but extremely complex, factor concerning the high prevalence of type 2 diabetes observed among this population. The complexity of this relationship may have obscured the relationship between ancestry and glucose tolerance in earlier observations of this population.

Adult↗
PubMed2005

1999-2001 Cancer mortality rates for Asian and Pacific Islander ethnic groups with comparisons to their 1988-1992 rates.

We report upper and lower boundary estimates of the 1999-2001 site-specific cancer mortality rates for Asian Indians, Chinese, Filipinos, Koreans, Vietnamese, Native Hawaiians, and Samoans. These rates are for the seven states (California, Hawaii, Illinois, New Jersey, New York, Texas, and Washington) that officially record mortality data for these ethnicities. The rates are based on the 2000 Census, which reports two population counts as follows: persons who identify themselves as belonging to a single ethnic group (which forms the basis for an upper boundary estimate of the rates) and persons who identify themselves as belonging to a single ethnic group or to multiple groups that include the single ethnic group (which forms the basis for a lower boundary estimate for the rates). The top five cancers for each Asian and Pacific Islander ethnic group by gender are reported. In addition, the 1988-1992 cancer mortality rates based on the 1990 Census for Chinese, Filipino, Japanese, and Native Hawaiians are determined. Their 1999-2001 and 1988-1992 rates are compared.

Asian↗
PubMed2001

Ethnic disparities in care following acute coronary syndromes among Asian Americans and Pacific Islanders during the initial hospitalization.

Despite the fact that Asian Americans and Pacific Islanders are the fastest growing minority population in the United States, little is known about their treatment patterns and outcomes, particularly for Asian American and Pacific Islander sub-groups. Multivariable logistic regression was used to compare differences in revascularization and mortality rates following acute coronary syndromes among Asian American and Pacific Islander sub-groups [Japanese (n = 1342), Chinese (n = 249), Filipino (n = 314), Native Hawaiian (n = 361)) and Caucasians (n = 569)] during the initial hospitalization using administrative (claims) data from 1997 to 1999. Analyses were stratified by gender and controlled for age, diabetes mellitus, congestive heart failure, acute myocardial infarction, ACG morbidity level and system of care. We found that the type of procedures received during the initial hospitalization differed according to patient ethnicity for male patients but not for female ones. Compared to Caucasians, male Asian Amercian and Pacific Islanders patients were less likely to undergo percutaneous coronary interventions and more likely to undergo coronary artery bypass graft surgery. In the future, a more comprehensive outcomes study is needed, to examine the impact of any interethnic differences in revascularization rates on intermediate and long-term mortality, patient satisfaction, and self-reported functioning and well-being. The trend toward higher mortality following acute coronary syndromes among Asian Americans and Pacific Islander males emphasizes the importance of such a study.

Asian↗