Traditionally, illness was thought to be the result of an imbalance in the three anchors of the lokahi triangle (physical, mental/emotional and spiritual). Healing traditions addressed all three and healing occurred in a very holistic way. Many Pacific cultures share these or similar beliefs. For example, in Palau, illness could occur from “ancestral-wrongness to the spirit” (Wong et al., 2004).
Effect of Historical Experiences on Health Care/Status
Many health disparities suffered by Native Hawaiians today are thought to have their origins in what is referred to as “cultural historical trauma” (Blaisdell, 1996). Cultural historical trauma is the psychological, physical, social and cultural aftermath of the colonialism many indigenous people have experienced. This includes the loss of social structures, lands and ways of life, as well as the effects of racism and discrimination. The term also refers to the cumulative emotional and psychological wounding that seems to be carried forth into successive generations and affects all aspects of health. This “cultural wounding” can result in communal feelings of disruption and a sense of collective helplessness, which can in turn impact one’s “sense of self” and health seeking behaviors.
Specifically, Native Hawaiians have the highest incidence of morbidity and mortality and the highest age-adjusted mortality of any ethnic group in Hawai’i (Anderson et al., 2006). As an example of how westernization has affected the lifestyle of many Native Hawaiians, consider how the traditional diet, which was low in fat and high in complex carbohydrates, has changed to a typically western diet, high in fat and low in complex carbohydrates (Blaisdell, 1993, 1996). Currently, the prevalence of obesity in Native Hawaiians is 69.3% (Anderson et al., 2006). Studies in Hawaii and other islands have suggested that a return to traditional diets, focused on staples such as taro, breadfruit, and sweet potato, could help lower serum cholesterol, blood sugar levels and other obesity related conditions.
Micronesia offers another insight into the effects of dietary change. Instead of fishing and agriculture, many Micronesians have come to rely on the canned meat, shortening, and salty, canned fish that is readily available as a result of Micronesia’s past “trust” relationship with the US. Consequently, rates of cardiovascular disease, obesity and diabetes are all increasing (National Institutes of Health & National Heart Lung and Blood Institute (NHLBI), 2000).