Ka Wai Ola - Office of Hawaiian Affairs, Volume 34, Number 2, 1 February 2017 — TASK FORCE TAKES AIM AT HEALĪH DISPARITIES [ARTICLE+ILLUSTRATION]

TASK FORCE TAKES AIM AT HEALĪH DISPARITIES

ByTreenaShapiro The United Heahh Foundation has named Hawai'i the heahhiest state in America for five years running, but a recent report by the Native Hawaiian Heahh Task Force tells a different story. While the state's population in general enjoys good heahh, the same can't be said for all its residents. At an infor-

manonai onenng at tne state Capitol on the eve of the 2017 legislative session, members of the task force made the point that there are still significant heahh disparities between Native Hawaiians and the rest of the population. "As we all know,

Native Hawaiians, the indigenous people of Hawai'i, who make up a quarter of our state's population, are more likely to be undereducated, to live in environments that compromise their heahh and safety, to live in multigenerational homes because of the high cost of living, and to be incarcerated," said task force co-chair Keawe'aimoku Koholokula, Ph.D., chairman of the Department of Native Hawaiian Heahh at the John A. Burns School of Medicine. In addition to those social inequities, Kaholokula continued, Hawaiians are underrepresented in politics, business, education and other skilled professions, while overrepresented when h comes to developing chronic diseases or being at risk because of factors like obesity and smoking. "We develop chronic diseases 10 years sooner than other groups and we die 10 years earlier than other groups," he told

lawmakers. "The disproportionate burden of chronic disease suffered by Native Hawaiians is a puhlie heahh crisis that desperately needs our attention." The task force was established two years ago to report back to the state Legislature on recommendations to improve the heahh of Native Hawaiians, taking into account the social and cultural determinants that impact their wellbeing. The report delivered on Jan. 17 offered 16 recommendations, such as increasing the minimum wage to $15 an hour by 2020 to opening heahh centers based in puhlie schools. Lawmakers, particularly Sen. J. Kalani English and Sen. Kai Kahele, whose late father Sen. Gil Kahele called for the task force's report, seemed receptive to moving forward on some of the recommendations, even offering up their staff to help craft bills based on the task force's proposals. "We're ready to move," English said, adding that the legislature doesn't need to see more studies or data. "We need actionable items, such as legislation of what to do." Office of Hawaiian Affairs Ka Pouhana / CEO Kamana'opono Crabbe, Ph.D., also a task force co-chair, noted that this crisis isn't a recent development and was documented by Hawaiian organizations in the 1960s. In 1985, Alu Like published "E Ola Mau: The Native Hawaiian Heahh Needs Assessment," and task force members traveled to Washington, D.C., to advocate for recommendations that led to the Native Hawaiian Heahh Care Act of 1988 and the establishment of community-based Native Hawaiian Heahh Care Systems. "We know nationally Hawai'i has been the No. 1, No. 2 healthiest state in the United States," Crabbe said. "However, the data shows for the past 30 years, Native Hawaiians have been at the bottom." ■

The report's executive summary offers highlights and recommendations that promote interagency collaboration and focus on some of the social, political, eeonomie and cultural determinants that impact an individual's health: • Establish an online database across state agencies • Advocate and plan for median strips, sidewalks and other infrastructure to increase safety in Native Hawaiian communities, with community input • Advocate for a livable wage by 2020 • Support paid family leave efforts with a definition of family that is culturally relevant • lnclude pre-kindergarten in public schools • Establish a directory of Native Hawaiian professionals and community leaders with an understanding of Hawaiian culture for Governor-appointed leadership positions to better incorporate culturally relevant perspectives into statewide initiatives • Advocate for a portion of the Transient Accommodations Act • Establish an environmental and cultural preservation fee (9.25 percent) on restaurants and entertainment in hotels • lnclude long-term care options with home-based care in a statewide insurance program • Develop a state plan to incorporate the United Nations Declaration of Rights of lndigenous Peoples • Establish school-based health centers • Develop an undergraduate health sciences academy within the University of Hawai'i system in cooperation with relevant educational institutions to target the recruitment and retention of Native Hawaiian students • lncrease services for Native Hawaiians who eome in contact with the criminal justice system to promote integration back into the community to reduce recidivism rates • Establish a Native Hawaiian Public Policy Advisory Council • Reimburse for culturally appropriate services and traditional practices • Restore adult dental benefits to Medicaid Enrollees. Source: Native Hawaiian Health īask Force Report: Highlights and Recommendations 12017

HEALĪH

Keawe'aimoku Koholokulū, Ph.D.