Linking Hawaiian Concepts of Health with Epigenetic Research: Implications in Developing Indigenous Scientists

2017 ◽  
Author(s):  
Dana-Lynn T. Ko‘omoa ◽  
Alika K. Maunakea
Keyword(s):  
Health Disparities ◽  
Environmental Factors ◽  
Health Outcomes ◽  
Native Hawaiian ◽  
Health Sciences ◽  
Native Hawaiians ◽  
Epigenetic Mechanisms ◽  
Concept Of Health ◽  
Concepts Of Health ◽  
Epigenetic Research

Inherent in the traditional native Hawaiian concept of health is the understanding that environmental factors, including nutrition and social behaviors, trans-generationally impact health outcomes in individuals and communities. Epigenetic mechanisms may now explain molecular links between these environmental factors and health outcomes. This article explores the epigenetic concepts present in ancient Hawaiian wisdom of health and highlights this link as a basis for forging a pathway to modern careers in the health sciences to address diseases of health disparities among native Hawaiians and Pacific peoples.

scholarly journals Lack of Native Hawaiian Neurologists and Disparities in Care for Native Hawaiians in Hawaiʻi

2021 ◽  
Vol 21 (7) ◽  
pp. 415-420
Author(s):  
Maiya Smith ◽  
Christina Tse ◽  
Nicholas Fancher ◽  
Ryoko Hiroi ◽  
William Harris ◽  
...  
Keyword(s):  
Health Disparities ◽  
Native Hawaiian ◽  
Neurological Diseases ◽  
Quality Care ◽  
Native Hawaiians ◽  
Current Status ◽  
Ethnic Representation ◽  
Racial Concordance ◽  
Patient Relationships ◽  
Physician Patient

Introduction: In Hawaiʻi, there are 367,000 Native Hawaiian and Pacific Islanders. Native Hawaiians experience health disparities in a variety of conditions, including stroke, diabetes, and cancer.  Ethnic minorities are underrepresented among physicians; this lack of physician-patient racial concordance may contribute to the disparities, as recent studies suggest that racial discordance resulted in poorer healthcare quality. This study aims to assess the current status of neurological health disparities in the Native Hawaiian population in Hawaiʻi, with a focus on identifying neurologist ethnic representation, neurological diseases, and healthcare-related challenges disproportionately affecting Native Hawaiians. Methods: An anonymous survey on physician’s attitudes and practice was emailed to all neurologists in the Hawaiʻi Neurological Society from February 2019 to June 2019. Findings: Twenty-three full responses and one partial response was received. No participants self-identified as Native Hawaiian nor did they know of any Native Hawaiian neurologists in Hawaiʻi, yet all who completed the survey reported treating Native Hawaiians in their practice (n = 23), which identifies a gap in Native Hawaiian representation in the field of neurology in Hawaiʻi. In addition, majority of participants perceived that Native Hawaiians are disproportionately affected by neurological diseases and have difficulty accessing neurology services and obtaining quality care. Conclusions: Future focus on creating opportunities to improve racially discordant physician-patient relationships and to increase Native Hawaiian representation in neurology may help narrow the gap in health disparities experienced by Native Hawaiians. 

Community and Research Together

2017 ◽  
Author(s):  
Claire Townsend Ing ◽  
Rebecca Delafield ◽  
Shelley Soong
Keyword(s):  
Health Status ◽  
Health Outcomes ◽  
Participatory Research ◽  
Native Hawaiian ◽  
Academic Research ◽  
Community Based Participatory Research ◽  
Native Hawaiians ◽  
Community Based ◽  
The Social ◽  
Academic Researchers

Hawaiians have faced historical and cultural traumas leading to modern day inequities in the social, economic and political realms. These inequities contribute to poor health status that many Native Hawaiians experience. Two groups have attempted to improve these health outcomes, Academic researchers and the Native Hawaiian community. However, often times the approaches and goals of these two groups are at odds. Community-Based Participatory Research (CBPR) is an approach that seeks to combine community goals, action, and priorities with those of academic research. This chapter illustrates the evolution of CBPR in Hawai‘i, and its meaningful principles that have been effective for both the Native Hawaiian and research communities in their promotion of health.

Fatalism and Locus of Control as a Consideration When Designing Health and Risk Messages

2017 ◽  
Author(s):  
Lijiang Shen
Keyword(s):  
Health Disparities ◽  
Locus Of Control ◽  
Environmental Factors ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Life Events ◽  
Economic Factors ◽  
External Locus ◽  
External Locus Of Control ◽  
Socio Economic Factors

Fatalism is a set of beliefs that encompasses such dimensions as predestination, pessimism, and attribution of one’s health (life events) to luck. Locus of control refers to the extent to which individuals believe they are in control of events that affect them. Individuals with an external locus of control perceive their life is controlled by environmental factors they can’t change, or by chance or fate. Fatalism and external locus of control are both negatively associated with health behaviors and health outcomes; and contribute to health disparities due to the link between culture and socio-economic factors.

Alcohol Use Disorder

2018 ◽  
Author(s):  
Igor Ponomarev
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Critical Discussion ◽  
Epigenetic Mechanisms ◽  
Future Directions ◽  
Clinically Significant ◽  
Early Life Exposures ◽  
The Brain ◽  
Epigenetic Research

Alcohol use disorder (AUD) is characterized by clinically significant impairments in health and social function. Epigenetic mechanisms of gene regulation may provide an attractive explanation for how early life exposures to alcohol contribute to the development of AUD and exert lifelong effects on the brain. This chapter provides a critical discussion of the role of epigenetic mechanisms in AUD etiology and the potential of epigenetic research to improve diagnosis, evaluate risks for alcohol-induced pathologies, and promote development of novel therapies for the prevention and treatment of AUD. Challenges of the current epigenetic approaches and future directions are also discussed.

Increasing the Capacity of Health Sciences to Address Health Disparities

2009 ◽  
Vol 101 (9) ◽  
pp. 881-885 ◽  
Author(s):  
Sandra P. Daley ◽  
Shelia L. Broyles ◽  
Lourdes M. Rivera ◽  
Vivian M. Reznik
Keyword(s):  
Health Disparities ◽  
Health Sciences

scholarly journals Health Disparities among adults cared for at an urban cystic fibrosis program

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Emily DiMango ◽  
Kaitlyn Simpson ◽  
Elizabeth Menten ◽  
Claire Keating ◽  
Weijia Fan ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
New York ◽  
New York City ◽  
Health Disparities ◽  
Pulmonary Function ◽  
Health Outcomes ◽  
York City ◽  
Median Income ◽  
Cross Sectional ◽  
Caucasian Patients

Abstract Background Evidence is conflicting regarding differential health outcomes in racial and ethnic minorities with cystic fibrosis (CF), a rare genetic disease affecting approximately 28,000 Americans. We performed a cross-sectional analysis of health outcomes in Black/Latinx patients compared with non-Hispanic Caucasian patients cared for in a CF center in New York City. Adult patients enrolled in the CF Foundation Patient Registry at the Columbia University Adult CF Program and seen at least once during 2019 were included. Health metrics were compared between Black/Latinx and non-Hispanic Caucasian patients. Results 262 patients were eligible. 39 patients (15%) identified as Black/Latinx or non-Hispanic Caucasian. Descriptive statistics are reported with mean (standard deviation). Current age was 35.9 (13.3) years for non-Hispanic Caucasian and 32.0 (9.3) years for Black/Latinx patients (p = 0.087). Age of diagnosis did not differ between groups; 9.56 (15.96) years versus 11.59 (15.8) years for non-Hispanic Caucasian versus Black/Latinx respectively (p = 0.464). Pulmonary function, measured as mean forced expiratory volume in one second (FEV1) was 70.6 (22.5) percent predicted in non-Hispanic Caucasian versus 59.50 (27.9) percent predicted in Black/Latinx patients (p = 0.010). Number of visits to the CF clinic were similar between groups. When controlled for age, gender, co-morbidities, median income, and insurance status, there was a continued association between minority status and lower FEV1. Conclusions Minorities with CF have significantly lower pulmonary function, the major marker of survival, than non-Hispanic Caucasians, even when controlled for a variety of demographic and socioeconomic factors that are known to affect health status in CF. Significant health disparities based on race and ethnicity exist at a single CF center in New York City, despite apparent similarities in access to guideline based care at an accredited CF Center. This data confirms the importance of design of culturally appropriate preventative and management strategies to better understand how to direct interventions to this vulnerable population with a rare disease.

scholarly journals The concept of health in older age: views of older people and health professionals

2007 ◽  
Vol 31 (4) ◽  
pp. 642 ◽  
Author(s):  
Melita J Giummarra ◽  
Betty Haralambous ◽  
Kirsten Moore ◽  
Joan Nankervis
Keyword(s):  
Older People ◽  
Focus Groups ◽  
Health Professionals ◽  
Social Connectedness ◽  
Older Age ◽  
Concept Of Health ◽  
Concepts Of Health ◽  
Health Promoting ◽  
Barriers And Motivators ◽  
Holistic Manner

This study aimed to explore how older people and health professionals conceptualise health in older age. Thirty-six older people and 41 health professionals participated in 10 focus groups (five with older people and five with health professionals) and discussed concepts of health, the modifiable aspects of health, and barriers and motivators to undertaking health-promoting behaviour change. Both older people and health professionals were found to conceptualise health in a holistic manner. While health professionals tended to place the source of poor health on failures of social connectedness and poor service delivery, older people stressed the importance of taking ownership of one?s own health and actively seeking out health promoting activities and services.

Medical and Social Determinants of Brain Health and Dementia in a Multicultural Community Cohort of Older Adults

2021 ◽  
pp. 1-14
Author(s):  
James E. Galvin ◽  
Stephanie Chrisphonte ◽  
Lun-Ching Chang
Keyword(s):  
Older Adults ◽  
Health Disparities ◽  
African Americans ◽  
Health Outcomes ◽  
Sex Education ◽  
Screening Program ◽  
Healthcare Services ◽  
Social Dimension ◽  
Medical Comorbidities ◽  
Race Ethnicity

Background: Socioeconomic status (SES), race, ethnicity, and medical comorbidities may contribute to Alzheimer’s disease and related disorders (ADRD) health disparities. Objective: Analyze effects of social and medical determinants on cognition in 374 multicultural older adults participating in a community-based dementia screening program. Methods: We used the Montreal Cognitive Assessment (MoCA) and AD8 as measures of cognition, and a 3-way race/ethnicity variable (White, African American, Hispanic) and SES (Hollingshead index) as predictors. Potential contributors to health disparities included: age, sex, education, total medical comorbidities, health self-ratings, and depression. We applied K-means cluster analyses to study medical and social dimension effects on cognitive outcomes. Results: African Americans and Hispanics had lower SES status and cognitive performance compared with similarly aged Whites. We defined three clusters based on age and SES. Cluster #1 and #3 differed by SES but not age, while cluster #2 was younger with midlevel. Cluster #1 experienced the worse health outcomes while cluster #3 had the best health outcomes. Within each cluster, White participants had higher SES and better health outcomes, African Americans had the worst physical performance, and Hispanics had the most depressive symptoms. In cross-cluster comparisons, higher SES led to better health outcomes for all participants. Conclusion: SES may contribute to disparities in access to healthcare services, while race and ethnicity may contribute to disparities in the quality and extent of services received. Our study highlights the need to critically address potential interactions between race, ethnicity, and SES which may better explain disparities in ADRD health outcomes.

Prostate Cancer Disparities in Risk Group at Presentation and Access to Treatment for Asian Americans, Native Hawaiians, and Pacific Islanders: A Study With Disaggregated Ethnic Groups

2021 ◽  
Author(s):  
Bhav Jain ◽  
Kenrick Ng ◽  
Patricia Mae G. Santos ◽  
Kekoa Taparra ◽  
Vinayak Muralidhar ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Asian Indian ◽  
Asian American ◽  
Native Hawaiian ◽  
Risk Group ◽  
Pacific Islander ◽  
Pacific Islanders ◽  
Native Hawaiians ◽  
High Risk Disease

PURPOSE We identified (1) differences in localized prostate cancer (PCa) risk group at presentation and (2) disparities in access to initial treatment for Asian American, Native Hawaiian, and Pacific Islander (AANHPI) men with PCa after controlling for sociodemographic factors. METHODS We assessed all patients in the National Cancer Database with localized PCa with low-, intermediate-, and high-risk disease who identified as Thai, White, Asian Indian, Chinese, Vietnamese, Korean, Japanese, Filipino, Hawaiian, Pacific Islander, Laotian, Pakistani, Kampuchean, and Hmong. Multivariable logistic regression defined adjusted odds ratios (AORs) with 95% CI of (1) presenting at progressively higher risk group and (2) receiving treatment or active surveillance with intermediate- or high-risk disease, adjusting for sociodemographic and clinical factors. RESULTS Among 980,889 men (median age 66 years), all AANHPI subgroups with the exception of Thai (AOR = 0.84 [95% CI, 0.58 to 1.21], P > .05), Asian Indian (AOR = 1.12 [95% CI, 1.00 to 1.25], P > .05), and Pakistani (AOR = 1.34 [95% CI, 0.98 to 1.83], P > .05) men had greater odds of presenting at a progressively higher PCa risk group compared with White patients (Chinese AOR = 1.18 [95% CI, 1.11 to 1.25], P < .001; Japanese AOR = 1.36 [95% CI, 1.26 to 1.47], P < .001; Filipino AOR = 1.37 [95% CI, 1.29 to 1.46], P < .001; Korean AOR = 1.32 [95% CI, 1.18 to 1.48], P < .001; Vietnamese AOR = 1.20 [95% CI, 1.07 to 1.35], P = .002; Laotian AOR = 1.60 [95% CI, 1.08 to 2.36], P = .018; Hmong AOR = 4.07 [95% CI, 1.54 to 10.81], P = .005; Kampuchean AOR = 1.55 [95% CI, 1.03 to 2.34], P = .036; Asian Indian or Pakistani AOR = 1.15 [95% CI, 1.07 to 1.24], P < .001; Native Hawaiians AOR = 1.58 [95% CI, 1.38 to 1.80], P < .001; and Pacific Islanders AOR = 1.58 [95% CI, 1.37 to 1.82], P < .001). Additionally, Japanese Americans (AOR = 1.46 [95% CI, 1.09 to 1.97], P = .013) were more likely to receive treatment compared with White patients. CONCLUSION Our findings suggest that there are differences in PCa risk group at presentation by race or ethnicity among Asian American, Native Hawaiian, and Pacific Islander subgroups and that there exist disparities in treatment patterns. Although AANHPI are often studied as a homogenous group, heterogeneity upon subgroup disaggregation underscores the importance of further study to assess and address barriers to PCa care.

scholarly journals Why Are Native Hawaiians Underrepresented in Hawai‘i's Older Adult Population? Exploring Social and Behavioral Factors of Longevity

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Lana Sue Ka‘opua ◽  
Kathryn L. Braun ◽  
Colette V. Browne ◽  
Noreen Mokuau ◽  
Chai-Bin Park
Keyword(s):  
Older Adult ◽  
Native Hawaiian ◽  
Adult Population ◽  
Historical Trauma ◽  
Health Indicators ◽  
Native Hawaiians ◽  
Future Research ◽  
Behavioral Factors ◽  
Poverty Level ◽  
Older Adult Population

Native Hawaiians comprise 24.3% of Hawai‘i's population, but only 12.6% of the state's older adults. Few published studies have compared health indicators across ethnicities for the state's older adult population or focused on disparities of Native Hawaiian elders. The current study examines data from two state surveillance programs, with attention to cause of death and social-behavioral factors relevant to elders. Findings reveal that Native Hawaiians have the largest years of productive life lost and the lowest life expectancy, when compared to the state's other major ethnic groups. Heart disease and cancer are leading causes of premature mortality. Native Hawaiian elders are more likely to report behavioral health risks such as smoking and obesity, live within/below 100–199% of the poverty level, and find cost a barrier to seeking care. Indicated is the need for affordable care across the lifespan and health services continuum. Future research might explain behavioral factors as influenced by social determinants, including historical trauma on Native Hawaiian longevity.

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