Ka Wai Ola - Office of Hawaiian Affairs, 1 January 1983 — HE MAU NINAU OLA [ARTICLE+ILLUSTRATION]

HE MAU NINAU OLA

by Kekuni Blaisdell. M.D.

This l h ī rd eolumn of He Mau Ninau Ola, like the second. answers ninau ola from our readers. whom we mahalo lor your interest and contributions. I. Q: What are the major illnesses affecting us Hawaiians and how do we compare with nonHawaiians? \ "Major illnesses" ntay he considered in at least two wa\s as the most eommon "causes of dealh" and as the most eommon serious chronic diseases. I he most frequent causes of deathamong"full-Hawai-ians" \s. "part-Hawaiians" compared to "a 1 1 races." as most reccntly reported for 1980. ranked as follows:

I he rounded ligures listed are standardi/ed mortalit\ rates. adjusted lor age. as calculated fora February 1982 State ol Hawai'i Department ot Heahh publication. It is e\ident that the rates among po'e Hawai'i piha (full-Hawaiians) are 2 to 3 times greater than for po'e Hawai'i hapa (part-Hawaiians). The rates for po'e Hawai'i hapa are interniediate or approach those for all races. We need to bear this point in niind whenever wesee statistics on "Ha\vaiians" collectively. We should imniediate!y seek breakdown ol \alues ol piha vs. hapa po'e Hawai'i to understand their lull significance. The five most eommon serious chronic diseases for po'e Hawai'i piha vs. hapa vs. po'e apau (all races). as recently compiled by Alu Like for 1975. were as shown:

T he ligures represent prevalences of these conditions in the three ethnic groups. as deri\ed from Department of Heahh Surveillance data lrom about 14.000 interviewed island residents. We see that in 4 out o! the 5 major chronic disease categories. more po'e Hawai'i piha said the\ were affected than po'e hapa and po'e apau. As with the mortality rates. po'e hapa values were similar to po'e apau figures. except for hano (asthma). whieh was most prevalent among po'e hapa. Details on high blood pressure rates will be given in the answer to Question 3 helow. and the other eommon diseases will be topics for future columns. We are fortunate to have the statistics given above to answer your ninau. for such data are not regularly and routinely available lroni any agency. In this particular case, these data resulted from the special efforts ol par-

ticular persons at particular times. Mele L.ook. a former Universit\ fo Hawai'i student. prepared the mortality rates ol po'e Hawai'i as a sunimer 1981 project under the super\ ision of Dr. fhomas Burch of the Department of Heahh. The chronicdiseasesdata for 1975 were generated by the Department ol Heahh at the specific request of Bella Bel I of Alu L.ike. At present. there is no mechanism for systematic. on-going colIection. analvsis and dissemination of such needed heahh data on us po'e Hawai'i. lmportant documents. like the current draft of the Nati\e Hawaiians Stud\ Commission Report. also allude to the paueity ol critical heahh data on us po'e Hawai'i. Yet. some po'e Hawai'i eomplain about being "studied to death" and demand "action, no more studies." I hope the examples cited in this eolumn will temper these understandable emotions and stimulateOH A to establish a permanent mechanism for continuing. adequate heahh data eolleeiion and analysis on us po'e Hawai'i. so that the\ may be effectively used to meet our heahh needs. We shall continue to discuss aspects of heahh data in future columns. 2.Q: What is OHA doing about Hawaiian heahh problems? A: In my second eolumn. 1 referred to three heahh problems that have been considered by theOHA Heahh and Human Resources Committee. chaired by OHA trustee Thomas Kaulukukui. Sr.: (1)A chemopre\ention cancer control trial (2)An alcoholism pilot project (3)Teenage pregnancies. I he five-year chemoprevention trial. proposed by the Cancer Center of Hawai'i and endorsed by the OHA Heahh and Human Resources Committee, was described in my pre\ ious eolumn. This trial. ifapproved with funds from the \ational Cancer lnstitute. will begin in 1983. lt will reach about 20.000 \ olunteers on O'ahu, ages 45 to 74. di\ ided into four main groups. Eaeh adult in a group will take a pill onee a day containing a ehemieal believed to protect against lung. gut and breast cancers. These chemicals are vitamin A. \itamin C. \itamin E. and the trace mineral selenium. A plaeeho (inert ehemieal) will also be taken as a control by a subgroup. After five years. the rates of \arious cancers occurring in these O'ahu adults will be analy/ed to see if any of the four chemicals. compared to the plaeeho. have had any effect on cancer outcome. Since the highest rates ol cancer o! the lung. stomach. breast. uterus. and pancreas occur among us po'e Hawai'i. our ethnic group is of special

i rleasurement. and mechanism of systolic and diastolic blood pressure

Most Common Death Per 100,000 Population Causes of l ull/ Part/ All Death Hawaiian Hawaiian Races (1) All heart 297 104 83 diseases (2) All cancers 181 75 69 (3) All strokes 171 39 38 (4) All accidents 100 36 34

Most Common Prevalence Rates Chronic Full- Part- All Diseases Hawaiians Hawaiians Races ( 1 ) High 22.6Q I0.8Q I2.2Q blood pressure (2) Diabetes 14.4 5.2 5.3 (3) Asthma 8.7 17.2 8.5 (4) Arthritis 8.3 4.3 5.6 (5) Heart trouble 4.2 2.3 2.8