Health disparities among elders in Hawai'i

Life expectancy is Hawai'i is the longest of any US state. However, in this multi-ethnic state (24% Hawaiian, 24% Caucasians, 18% Japanese, 16% Filipinos, 7% Chinese), a 10-year difference is seen between our longest-living (Japanese and Chinese) and shortest-living (Native Hawaiian) groups. This presentation examines reasons for continued differences and outlines work of Ha Kupuna—National Resource Center for Native Hawaiian Elders to address disparities faced by Native Hawaiians, the state's indigenous people. Data from the US Census, death records, BRFSS and the Hawai'i Health Survey were compiled to examine socio-economic variables, years of productive life lost, behavioral risk, and disease prevalence data for the state's major ethnic groups. Disparities in life expectancy and years of productive life lost are mirrored by disparities in the groups' socio-economic status, lifestyle behaviors, and chronic disease prevalence. Native Hawaiian kupuna (elders) have a higher prevalence of chronic disease and disability, and are lowest in socio-economic status. Disparities also may be linked to different experiences throughout the life course for elders of different ethnicities. For example, focus group research suggests that many Native Hawaiians elders have residual effects of discrimination experienced by their families during the colonization of Hawai'i by Western nations and the subsequent loss of land, power, and culture. Taken together, data suggest that the disparate ethnic profiles seen among the elderly in Hawai'i result from very different life courses of these groups. Ha Kupuna is using data to propose strategies to address disparities experienced by Native Hawaiian elders.