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Geriatrics

Geriatrics

Ethnogeriatrics

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Introduction and Overview

More Information

  • For further information, see the census web site www.census.gov

Demographics

Data on Native Hawaiians and Pacific Islanders is extremely limited and is often confounded by the tendency to aggregate races with different patterns of health risk under headings such as Asians and Pacific Islanders (AAPIs). Such headings are problematic as they do not recognize the diversity that exists within this population group (Louie, 2001). For example, the average life expectancy for AAPIs is 80.3 years—higher than the life expectancy for the total U.S. general population (75.2 years). However, AAPIs include both the Japanese, who have one of the longest life expectancies at 82.1 years, and Native Hawaiians who have one of the lowest at 68.3 years. Data on specific races by age group is even less available, highlighting the need for continued research in this area.

Accordingly, the Office of Management and Budget (OMB) introduced a new racial category in 2000 that identified Native Hawaiians and other Pacific Islanders as a separate category disaggregated from Asian Americans (Executive Office of the President, Office of Management and Budget (OMB), & Office of Information and Regulatory Affairs, Accessed August 29, 2007). This curriculum will use OMB’s definition of race and ethnicity.

Native Hawaiians & Other Pacific Islanders US PopulationWithin this new racial category, Native Hawaiians comprise the largest proportion of individuals followed by Samoan and Guamanian/Chamorro (Figure 1) (US Census Bureau, Accessed August 29, 2007). However, other Pacific Islander groups exist in the US but are limited by the relatively small size of their total population.

For the purposes of this curriculum, the scope was limited to the following racial/ethnic groups based on available literature:

  • Native Hawaiian (the indigenous population of the State of Hawai’i),
  • Samoan (the indigenous population of Samoa or Western Samoa),
  • Tongan (the indigenous population of the island nation of Tonga),
  • Guamanian/Chamorro (the indigenous population of the island nation of Guam),
  • Micronesian (the indigenous population of the cluster of islands of the Federated States of Micronesia, Palau, Marshall Islands, and the Commonwealth of the Northern Mariana) and
  • Fijian (the indigenous population of the island nation of Fiji).

Ethnologically, the Pacific rim area can be described by three regions:

1. Micronesia (i.e. Federated States of Micronesia, Palau, Commonwealth of the Northern Marianas islands, Guam),

2. Melanesia (i.e. Tonga, Fiji), and

3. Polynesia (i.e. Samoa, Hawai’i).

These groupings are can be helpful in that they cluster people by common heritage and in some cases by linguistics, cultural practices and values (Chappell 1997).

Native Hawaiians & Other Pacific Islanders US PopulationApproximately 32% of all Native Hawaiians and other Pacific Islanders live in the state of Hawaii, followed by California with 25% (Grieco, Accessed August 29, 2007). The distribution of Native Hawaiians and Pacific Islanders as a percentage of the total US population is shown in the map to the right. According to the 2000 Census, 5% of the total Native Hawaiian/Pacific Islander population is aged 65 and older (US Census Bureau, Accessed August 29, 2007).

In general, Native Hawaiians and Pacific Islanders are known to bear a disproportionately higher prevalence of many common conditions such as obesity, diabetes, and cardiovascular disease,. In addition, key health indicators such as life expectancy continue to document disparities that exist between Pacific Islanders and the general U.S. population (Park 2009).

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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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