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Health Promotion Among Diverse Populations

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Health Promotion Among Diverse Populations
“Native Hawaiians/Pacific Islanders have higher rates of smoking, alcohol consumption, and obesity than other minority populations.” (CDC, 2013). This is just one of many examples of how minority groups differ, and how health and health promotion/prevention vary from Native Hawaiian/Pacific Islanders (NHPI) to the major population. Race, ethnicity, socioeconomic status, and education have a major impact on the NHPI group.
The most current data available, paints a picture of poor health choices and many health disparities. With the NHPI group having higher death rates related to cancer in comparison to non-Hispanic whites (CDC, 2013). As previously stated, the NHPI group has poor health promotion, as they are the minority group with the highest smoking, alcohol consumption, and obesity rates (CDC, 2013). The full-blooded Hawaiian people known as Kanaka Maoli, are estimated to be completely gone by year 2043 as a result of having “the worst health and socioeconomic indicators in Hawaii” (Louie, 2001). One health indicator is the prevalence of cancer in comparison to all US racial and ethnic groups. There are estimated 111 per 100,000 women with breast cancer in the Kanaka Maoli as compared to 86 per 100,000 for white women (Louie, 2001).
Prior to the 1700’s, the Hawaiian natives believed in “ka mauli o k’aina a he mauli kanasa.” Which is a Hawaiian saying that pertains to protecting and maintaining the land directly effects the health of the people. They seemed to have survived well with this believe system until the 1700’s when the Europeans began settling and introduced new diseases to the island. Diseases like small pox had a significant effect on the population, as many died. The population went from 800,000 in 1700’s to a mere 180,000 in the beginning of the 1800’s (Hilgenkamp & Pescaia, 2003). With the settlement of the Europeans, as well as the Asians, many of the traditional Hawaiian treatments and beliefs were frowned upon. Western medicine became the primary tool for health care. There have been many integrations of traditional Hawaiian medicine in conjunction with Western medicine (Hilgenkamp & Pescaia, 2003).
Other factors to take into consideration is that the NHPI socioeconomic and educational status directly affect the health outcomes. According to the CDC the NHPI group are more likely to live in poverty as 21.5% do. This directly effects their access to health care as fear of cost, and lack of resources are available. NHPI are less likely to be college graduates (14.5%) and less likely to be placed in art, business, science, and management positions. This lack of education effects their ability to increase their incomes by holding higher-level positions (CDC, 2013). These factors are huge contributors to the NHPI’s ability to afford or access health care within the United States health care system.
This minority group faces many health disparities on a daily basis. Three health disparities for the NHPI people are: higher cancer death rates (as discussed in previous paragraph), increased hepatitis B incidence, and higher rates of smoking, alcohol consumption, and obesity (CDC, 2013). The NHPI five year survival rate for cancer is 47% in comparison to 57% for whites, and 55% for all races combined (CDC, 2013). The hepatitis B initiative has been implemented to promote education, prevention, vaccinations, and awareness within this population in order to decrease the number of infected patients (CDC, 2013). The fact that this group has shown higher smoking rates, alcohol consumption, and obesity reflect the lack of health education. This is also part of a national health concern, not just a NHPI issue.
The future of the NHPI people would greatly benefit from the primary approach to health promotion. They need to be educated on prevention such as vaccinating against hepatitis b and learning how to prevent the spread, and proper food handling and hand-washing. Although the people would benefit from the primary approach, they would also benefit from the secondary approach. They would benefit by being able to identify early warning signs of breast cancer, doing monthly self-checks, and having early detection through annual check-ups. The prevalence of smoking, alcohol consumption, and obesity would benefit from both approaches as well. If the people were more educated in health, the importance of a well-balanced diet and regular exercise, and the effects of smoking and alcohol, there could be prevention of these issues. If there were regular detection of poor eating habits, such as annual cholesterol monitoring, the risk for heart disease would decrease. Both primary and secondary approaches to health promotion would serve as valuable tools for this minority group.
There are many factors that play a role in the health status, and health future for the NHPI people. The key to fixing these issues is to find a way to allow the natives to practice their traditional medicine, and integrate modern medicine. The people benefit from maintaining their cultural beliefs, but they do require education on how to properly maintain and improve their health. The health disparities that this culture faces can be improved through education, understanding, and them having the freedom to be themselves.

References
Center for Disease Control and Prevention. Native Hawaiian & Other Pacific Islander
Populations. 2013. Retrieved on August 16, 2015 from: http://www.cdc.gov/minorityhealth/populations/REMP/nhopi.html#Gov
Hilgenkamp, K. & Pescaia, C. Traditional Hawaiian Healing and Western Influence. California
Journal of Health Promotion 2003 Vol. 1. Retrieved on August 16, 2015 from: http://www.cjhp.org/volume1_2003/issuehi-textonly/34-39-hilgenkamp.pdf
Louie, K. White Paper on the Health Status of Asian Americans and Pacific Islanders and
Recommendations for Research. 2001; 173-78.

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