Patterns of Health Risk

Life Expectancy

At 71.5 years for men and 77.2 years for women, life expectancy for Native Hawaiians is lower than for the state of Hawaii (75.9 years for men and 82.1 years for women) and the U.S overall (Anderson et al., 2006). Similarly, residents of the Federated States of Micronesia and the Republic of the Marshall Islands have lower life expectancies than the total United States population (60 years versus 75 years for men; 63 years versus 80 years for women) (Anderson et al., 2006).


For the state of Hawaii, the age-adjusted death rates for Native Hawaiians due to heart disease, cancers, stroke, accidents and diabetes are higher than those for the state of Hawaii as a whole. (Johnson, Oyama, LeMarchand, & Wilkens, 2004)

The reported death rates for Asian or Pacific Islander elders are lower than rates for whites, blacks, or American Indians (Minino, Heron, Murphy, & Kochankek, 2007). However, this is likely due to the aggregation of data from Asians, who tend to have longer life expectancies, with Native Hawaiians and other Pacific Islander racial groups, who tend to have lower life expectancies (Braun, Yang, Onaka, & Horiuchi, 1997). Unfortunately, mortality rates for Native Hawaiians and other Pacific Islander races by age group are not currently available for the overall U.S. population. However, for the state of Hawaii, Johnson et al. (Johnson, Oyama, LeMarchand, & Wilkens, 2004) found that the age-adjusted death rates for Native Hawaiians due to heart disease, cancers, stroke, accidents and diabetes were higher than those for the state of Hawaii as a whole. The authors also concluded that fewer Native Hawaiians are dying in the older age groups than expected in part because fewer Native Hawaiians reach older age categories compared to other racial groups in Hawaii.

Year 2000 Age-Adjusted Death Rates per 100,000 (State of Hawaii)

Selected Causes of Death Total State Native Hawaiian
Heart Disease 221.9 221.9
Cancers 155.8 208.6
Stroke 60.0 72.0
Accidents 27.5 32.0
Diabetes 16.3 38.0
Source: Johnson et al. 2004, reprinted with permission

In 2000, Native Hawaiians comprised approximately 20% of the state of Hawaii’s population. In the 65-75 year age group, 20% of all deaths were attributed to Native Hawaiians. However, among the 75-84 and > 85 years and older age groups, Native Hawaiians accounted for only 13% and 7% of all deaths, respectively.


Cardiovascular disease deaths was the number one cause for death, and occurred more frequently in urban than rural areas. In a 1996 study, Melanesian Fijians were reported to have an overall mortality rate at 15.9 and 9.2/1000 person years in men and women, respectively (Collins, Dowse, Cabealawa, Ram, & Zimmet, 1996).

By comparison, the leading causes of death in the United States in 2004, included diseases of the heart (27%), cancer (23%), and stroke (6%) (National Center for Health Statistics, Accessed August 24, 2007). In American Samoa, Guam, and the Federated States of Micronesia, similar causes for mortality were observed (Ichiho, Gladu, Keybond, & Ruben, 2004; Ichiho, Wong, Hedson, & David, 2004; Ruidas, Adaoag, Williams, & Sesepasara, 2004; Shehata, Kroon, Skilling, & Taulung, 2004; Taoka, Hancock, Ngaden, Yow, & Durand, 2004; Tseng, Omphroy, Cruz, Naval, & Haddock, 2004). By contrast, the Republic of Palau reported cardiac arrest and respiratory arrest as the 2 leading causes of death (Wong, Taoka, Kuartei, Demei, & Soaladaob, 2004), while the leading cause of death in the Marshall Islands was sepsis (Kroon et al., 2004).