Diabetes in the Native Hawaiian population

Reclaiming traditions to eradicate disease

By Nina Sayles, Liban Aden, Emmanuel Essien, Kevin Trotman

Food, Lifestyle, and Health Justice Brandeis Semester 2015

July 24th, 2015

What is diabetes? Chronic disease characterized by high

levels of glucose in the blood 23.6 million Americans are affected

(~25% are unaware)Inadequate levels physical activity and

poor diet habits

Forms of Diabetes

http://diabetesmyway.com/wp-content/uploads/2013/03/difference-between-type-1-and-type-2-diabetes2-

e1364620701529.jpg

Symptoms/Risk Factors for Type 2 Diabetes

Symptoms include: Extreme thirst, fatigue, slow wound healing, and extreme hunger

Risk Factors→ Family history and race/ethnicity

Prevalence of Obesity and Diabetes

● Obesity rates (for all Hawaiian residents) increased from 10.7%-21.7% between 2004 and 2007

● Native Hawaiians are 3x more likely to develop diabetes compared to other non-Hispanic whites

Science of DiabetesMetabolic disorderInsulin ResistanceStress

Thrifty Gene● James Neel, Univ. of Michigan 1962● Hunter-Gatherer populations● Insulin Resistance ● “Blessings of Civilization” ● Victim Blaming

Diabetes Detection and Prevention

● Healthy Hawaiian Initiative (Physical Exercise)

● Step It Up Hawaii (Food)● The Hawaii Diabetes Plan

Social Determinants of Health

Factors Leading to Diabetes in the Native Hawaiian CommunityIncomeRising Costs in Health Care Education LevelsSTRESS!Shift in Diets

Employment and Income

Rise in Health Care Costs vs. Rise of Earnings

Lack of Education

Loss of Land and Culture “Culture commodified along with the land, so that it is largely associated with the tourism industry” (Ferreira)

Native Hawaiian Diet● High starch, high

fiber, low saturated fat, low sodium and cholesterol

● From the root to the leaves, Native Hawaiians utilized taro for a variety of food and medicinal purposes

● 10% Fat● 12-15% Protein● 75-78%

Carbohydrate

Loss of Native Food Sourcesvery healthy native diet → immigration and assimilation → blends of multiple oriental dishes becoming modern hawaiian food

Policy, Education, and Action

Organizational Models

Waianae Diet Program

❏ Education❏ Diet

Waltham Fields❏ Youth Crew

Groundwork Lawrence

❏ Community Involvement

❏ Small Scale and Large Scale

ImpactJoslin Initiatives❏ Language and

translationWaianae diet program, Hawaii Medical Journal, Vol. 53, May 1994

Culturally relevant diabetes educationTopics to include:Source of diabetes

prevention

Nutritional facts and information

Cultural clarification:There is no genetic predisposition to diabetes

Victim blaming must be eradicated

Western Medicine is not the only solution

The traditional Hawaiian diet has served

individuals well for centuries

Growing taro, cultivating an active lifestyle

Taro cultivation is hard, active workA year-round youth crew, modeled after Waltham Fields Community Farm’s would benefit participants and the community

Opportunity for replicationWhile taro must be planted in a warm environment,

the moisture level can varyTaro garden initiatives can be replicated in Hawaiian

communities in the lower 48, especially Florida, Texas, and California

(Map of the US with the states that have significant

Native Hawaiian/Pacific Islander populations according to the

Census Bureau)http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=65

Reintegrating taro into the Hawaiian diet

Growing more taro benefits a few, serving more taro benefits all

Taro must be integrated into popular venues such as fast food and cafeterias to make the greatest impact

Leadership and advocacy education for youth crew

efforts to increase consumption of taro will result in various life skills gained by youth volunteers

Spiritual Enlightenment

Often spiritual totality is disregarded as being relevant to health

When somebody is spiritually unwell, they are likely to be stressed

Stress plays a large role in blood pressure, health, and diabetes risk

“[For Hawaiians,] Diet influences spiritual development. That’s just the way it is.”--Ferreira and Lang, 38

THANK YOU