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Geriatrics

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Ethnogeriatrics

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Mental Health

Asians and Pacific Islanders are known to under use mental health services (Browne, Fong, & Mokuau, 1994). Consistent with low utilization of mental health services, Native Hawaiian elders have a relatively low suicide rate of 35 per 100,000, approximately half the overall rate of the entire state of Hawai’i (64 per 100,000) (Kanaiaupuni, Malond, & Ishibashi, Accessed August 22, 2007). Similarly, among Palauans 90 years of age and older, the occurrence of mental illness was reported to be infrequent (Jensen & Polloi, 1988). By contrast, another study found that elderly Asian Pacific Islanders have poorer mental health compared to Caucasian elders. In this study, the authors also found within-group differences and concluded that recent immigrant groups and colonized populations were at highest risk for mental health problems (Browne et al., 1994).

Among persons aged 65 and older, the estimated U.S. prevalence of dementia ranges from 6-9% (Galasko et al., 2007). However, among Guamanian/Chamorros, the point prevalence of all-cause dementia was 12.2% (Galasko et al., 2007). In Guam, a distinct syndrome termed the “parkinsonism-dementia complex” (PDC) has been described as a neurodegenerative disorder identified only in Chamorros (Galasko et al., 2007). The prevalence of the PDC syndrome, which is clinical equivalent to Alzheimer’s disease but presents with Parkinsonism in addition to dementia, was 8.8% (Galasko et al., 2007; Winton et al., 2006). Palauans 90 years of age and older were found to have a 25% prevalence of mild dementia and a prevalence of 42% for moderate or severe dementia (Jensen & Polloi, 1988).


Summary

 

  • Utilization of mental health services by Native Hawaiians and other Pacific Islanders is low compared to Caucasians.
  • Suicide rates in Native Hawaiians and Pacific Islander elders are lower than Caucasian elders.
  • Individuals at highest risk for developing mental health problems are reported to be those individuals who are immigrants or who are from colonized populations (i.e. Native Hawaiians, Marshallese, etc.).
  • Dementia disproportionately affects some Pacific Islanders and is reportedly 2-fold higher compared to Caucasians.
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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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