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Geriatrics

Geriatrics

Ethnogeriatrics

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    • Ethnogeriatrics Overview
      • Introduction
      • Patterns of Health Risk
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Historical Background: Westernization of Hawaiian Islands

In 1778, Captain James Cook was the first documented European to land on the shores of the Hawaiian Islands. With the arrival of Christianity came the overthrow of the kapu system, the laws that had governed interactions involving people, nature and the gods for hundreds of years. The result was an overwhelming change in social structure and lifestyle. These changes, coupled with changes in diet and a significant loss of population due to the introduction of foreign diseases, had a long lasting and often devastating effect on the Native Hawaiian population (Bushnell, 1993; Kanahele, 1996).

Important economic and social changes took place over the following decades. Subsistence agriculture based on communal lands was replaced with a western style land tenure/ownership and capitalist economies based on sugar, lumbar (sandalwood), ranching and whaling. Foreign economic and political control increased with the rise of those industries (Mitchell, 1992).

The culmination of foreign influence eventually resulted in the overthrow of the Hawaiian monarchy by a group of influential Caucasian businessmen, many of them American or of American descent, who then offered the Hawaiian Islands to the US government. Although the US did not initially accept this offer, the strategic location of the islands in the middle of the Pacific and the onset of the Spanish American war settled Hawai’i’s fate. Despite strong objections by Native Hawaiians, the island nation became a US territory in 1900. By this time, the Native Hawaiian population had been permanently affected by a series of events (i.e. foreign infectious diseases, out-migration, etc.) that together had decreased the Native Hawaiian population by 87.5% since 1778 (Blaisdell, 1993).

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Native Hawaiian and Pacific Islander

  • Description
  • Learning Objectives
  • Introduction and Overview
    • Demographics
    • Background
  • Patterns of Health Risk
    • Life Expectancy and Mortality
    • Morbidity
      • General Health Status
      • Cardiovascular and cerebrovascular disease
      • Dyslipidemia
      • Hypertension
      • Diabetes Mellitus
      • Chronic Kidney Disease and End Stage Renal Disease
      • Arthritis, Gout & Hyperuricemia
      • Cancer
      • Mental Health
      • Substance Abuse
      • Infectious Diseases
      • Asthma

Culturally Appropriate Care

  • Fund of Knowledge
    • Historical Background
      • Westernization of Hawaiian Islands
      • Colonization of Pacific Islands
    • Traditional Health Beliefs
      • Native Hawaiian Values
      • Values of Other Pacific Islanders
      • Theories of Illness
    • Traditional Health Practicies
  • Assessment
    • Population Diversity
    • Important Cultural Issues
    • Eliciting the Patient’s Perspective
  • Delivery of Care
    • Preventive Care
    • Compliance/Healthcare Utilization
    • Use of Traditional Healers
    • Community Based Health Initiatives
    • End of Life Preferences
    • Caregiver Stress
  • Cancer Care

Learning Resources

  • Instructional Strategies
    • Case Study 1
    • Case Study 2
    • Case Study 3
    • Case Study 4
  • Student Evaluation
  • List of References
  • Searchable Reference Database
  • Glossary
  • Interview Strategies
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