247451 Deconstructing the sick Hawaiian: Genes, epigenetics and decolonization

Monday, October 31, 2011: 1:10 PM

David M. K. I. Liu, MD, Phd, JD , Native Hawaiian Center for Excellence, Dept of Native Hawaiian Health, John A Burns School of Medicine, Honolulu, HI
Introduction: Native Hawaiians have some of the poorest health indicators in their own lands. Oftentimes, these data are characterized as the result of poor lifestyle choices, or genetic vulnerabilities. History, the political economy and the genealogy of the sick Hawaiian are erased by locating illness as a fundamental defect (genetic vulnerability) or product of “choice”. Methods: Literature review on PubMed using terms “Hawaii,” “Hawaiian,” “health,” “diabetes,” “cancer,” “heart,” “hypertension,” and “obesity.” Findings: A majority of articles reviewed emphasized the high prevalence or incidence of illness in Native Hawaiians, either compared locally to Hawai'i or to national data. Discussion/Conclusion: The genealogy of the sick Hawaiian is thus inextricably intertwined with the political, social, economic and cultural history of Hawai'i, and retrieving this history problematizes the “sick Hawaiian.” This identity becomes problematized, foregrounding Hawaiian resistance to colonization, contemporaneous with the sick Hawaiian as the colonization of the physical, mental and spiritual body, as the political body was colonized. Epigenetics potentially offers a unique perspective on these processes, by locating morbidity and mortality as the interaction of genes and environment in a heritable manner. History is then written on the genes, and current and future research and interventions provide the opportunity to uncover these genealogies, and reconstruct the healthy Hawaiian, individual, family and nation.

Learning Areas:
Basic medical science applied in public health
Diversity and culture

Learning Objectives:
Describe the historical evolution of the sick Hawaiian identity Evaluate the sick Hawaiian identity in political, economic, social and cultural context Explain how epigenetics may articulate the political, economic, social and cultural determinants of Hawaiian health with individual health outcomes

Keywords: Hawaiian Natives, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: i am boarded in internal medicine and pediatrics, and my research area is in native hawaiian and more broadly indigenous health
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.