Ka Wai Ola - Office of Hawaiian Affairs, Volume 4, Number 2, 1 February 1987 — He Mau Ninau Ola [ARTICLE+ILLUSTRATION]

He Mau Ninau Ola

Some Health Questions by Kekuni Blaisdell, M.D.

Ninau: E kauka, since pure Hawaiians have more sickness than us part Hawaiians, doesn't that mean that Hawaiians have bad genes and it is better for us to marry non-Hawaiians? Pane: Your ninau is 'ano nui (important) as many po'e Hawai'i, as well as non-Hawaiians, seem

to support, if not explicitly in word, at least implicitly in action, the basic reasoning implied in your ninau. That is, po'e Hawai'i outmarry more than other racial groups in Hawai'i. Is this better for us po'e Hawai'i? One's pane depends, of course, on how one ho'ono'on'o (thinks) about this issue. It may be helpful to analyze your ninau in three parts: (1) the premise that po'e Hawai'i piha (pure Hawaiians) have more ma'i (sickness) than po'e Hawai'i hapa (part Hawaiians), and the related assumption that we po'e Hawai'i fare worse healthwise than non-Hawaiians; (2) the inference that po'e Hawai'i are genetically inferior to non-Hawaiians; and(3) the prediction that kamali'i (ehildren) born of makua (parents) with less Hawaiian ancestry will be healthier than those with more koko Hawai'i (Hawaiian blood). Historically, available fragments of evidence favor the view that our pre-haole kupuna (ancestors) were, in general, remarkably more robust than their haole counterparts who first arrived in the late 18th century. This is believed to be mainly because they did not have the deadly contagious infections that were the scourge of the continents. Also, the simple, high-starch, highfibre, low-saturated fat, low-cholesterol diet of the maka'ainana probably protected them from certain "diseases of western civilization" so prevalent today, such as coronary heart disease. Physical fitness and personal cleanliness were also characteristic of their lifestyle, while tobacco, aleohol and narcotic .abuse were unknown to them. The temperament of the native people was generally 'olu'olu (amiable), like their island cosmos, whieh they revered as lokahi 'ia (united) with themselves as living, conscious and communicating. The only overt evidence of "bad" genes were a few birth defects, like clubfoot, whieh reflected close intermarriages of a people all descended from perhaps 50 first settlers who migrated by wa'a (eanoe) from over 2,000 miles of the vast Moananui (Pacific) Thus, po'e Hawai'i kahiko, who were, of course, po'e Hawai'i pono, appear to have had considerable gene strength, not weakness, presumably because they had adopted lifestyles meaningfully in harmony with their lit-tle-changing salubrious environment over more than 15 centuries of near isolation from the rest of the planet. Why the big change from kahiko to now?" The fatal impact of foreign contact, beginning in 1778, resulted in almost complete — 90 percent eradication of these our kupuna over the subsequent 130 or so years. This holocaust was due mainly to introduced infections, laek of acquired resistance, cultural conflict and despair and adoption of some harmful haole ways. Thus, drastic changes in their environment and lifestyle dominated over genetic factors in this tragedy. Many of our kupuna, beginning in those early years, perceived the devastation about them as a result of depletion of native mana compared to the greater mana of white people. To these native victims, the way to survival was not only to embrace haole ways, but to embrace haole bodies directly in mating. Thus, emerged a gradually growing class of part Hawaiians with new gene patterns, as well as new lifestyles in a rapidly altering environment. It was not until circa 1905, however, that health statistics began to be collected on two separate categories of po'e Hawai'i: (1) Those who were identified as Hawaiians and no other race, and (2) part Hawaiians, who were recorded as being Hawaiian and also non-Hawai-ian. The former eame to be called "pure Hawaiians," although this group included some part Hawaiians; and the latter, part Hawaiians who ranged widely in degree of Hawaiian ancestry, from minimal to almost pure. Nevertheless, health data, such as death rates as early as 1910 and continuing through 1980, were generally worst for "pure Hawaiians," intermediate for part Hawaiians and better for non-Hawaiians. This trend is confirmed for 1980-1985 compared to figures for U.S. all races, as recently reported by Dr. Lawrence Mike, now in the U.S. Congress Office ofTechnology Assessment,

but originally from Moanalua, O'ahu:

Thus, the premise in your ninau about "pure Hawaiians" being more affected than part Hawaiians is reenforced, but with some additional points to keep in mind: (1) Piha Hawaiians number only about 8,000 today, they are older and they eonhnue to decline in number; while (2) hapa Hawaiians are on the increase, with a higher birth rate and younger average age. Since the health profile for these younger part Hawaiians is

approximating the more favorable one for all U.S. races, it would seem that the prediction inyour ninau — kamali'i with less Hawaiian ancestry will be less sick — is being fulfilled. While it is tempting to consider the above cited health data differences as due to "bad Hawaiian genes, there are no reliable data on lifestyle and environmental difference, except that pure Hawaiians tend to have lower ineome and less formal western education. Further, there is also need for more refined methods for measuring genetic influences. These aspects will be considered in future columns. The foreging comments might be interpreted as supporting your proposition that "it is better" for us po'e Hawai'i to marry non-Hawaiians. Aka (however), next month He Mau Ninau will consider the opposite case, and some related alternatives, not only for our survival as Ka lahui o Hawai'i, but for a reflourishing of koko Hawai'i, our culture and our livelihood.

Average Deaths per 100,000 per year, 1980-1985 Leading Cause "Pure Part U.S. of Death Hawn" Hawn All Races 1. Heart disease 525 230 190 2. Cancer 299 163 133 3. Stroke 86 38 35 4. Accidents 77 30 36 5. Diabetes 67 27 10 All Causes 1,358 645 552