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Geriatrics

Geriatrics

Ethnogeriatrics

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Arthritis, Gout & Hyperuricemia

According to the Hawai‘i State Department of Health Behavioral Risk Factor Surveillance Survey (BRFSS), 41.4% of Native Hawaiian elders (age 65 years and older) said that they had been told by a doctor or other health professional that they have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia. This percentage is comparable to the rates of self-reported arthritis among Caucasian elders (47.5%) (Salvail FR et al, 2003). Not surprisingly, among very elderly Palauans (86 years of age and older), arthritis was reported to be the most common chronic illness (Jensen & Polloi, 1984, 1988).

Data on the prevalence of gout and hyperuricemia among elderly Native Hawaiians and Pacific Islanders is not available. In the general US population, the prevalence of gout is 2.7% (Centers for Disease Control and Prevention, Accessed August 24, 2007a). By comparison, on the Pacific island of Nauru, clinical gout in men was reported to be 6.9%, while less than 1% of women were affected (Zimmet, Whitehouse, Jackson, & Thoma, 1978). The same study found that 64% of men and 60% of women aged 20 years or older had hyperuricemia. The prevalence of asymptomatic hyperuricemia was also relatively high among Polynesian women with a prevalence of 44%, possibly due to a genetic defect in renal urate handling and/or a high prevalence of the insulin resistance syndrome in Native Hawaiian and Pacific Islander populations (Simmonds et al., 1994; Zimmet et al., 1978).


Summary

  • Native Hawaiian elders have similar rates of self-reported arthritis (degenerative and inflammatory) compared to elderly Caucasians.
  • Native Hawaiians and Pacific Islanders are reported to have higher rates of gout and hyperuricemia, some of which may be attributable to genetic variations and/or the insulin resistance syndrome.
  • Little is known about the prevalence of these conditions specifically among the elderly.
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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
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