Online Program

Disaggregating health outcomes among Native Hawaiians and Pacific Islander subgroups

Wednesday, November 4, 2015

Adrian Bacong, MPH, Pacific Islander Community Health, Institute for Behavior and Community Health (IBACH), San Diego, CA
Christina Holub, PhD, MPH, Pacific Islander Community Health, Institute for Behavior and Community Health (IBACH), San Diego, CA
Brigette Sosa, B.S., Pacific Islander Community Health, Institute for Behavior and Community Health (IBACH), San Diego, CA
Background: Native Hawaiians and Pacific Islanders (NHPI) have traditionally been aggregated with Asian populations or as one NHPI group, which often masks certain health disparity outcomes (e.g., cancer and obesity). Few studies have examined NHPI subgroups independently.    

Objective: To compare diabetes, heart disease (CVD), cancer, and obesity outcomes among Samoans, Native Hawaiians and Chamorros who participated in the PIC Health Study. 

Methods: From 2013-2014, self-administered surveys (n=163) were given to NHPI participants in San Diego, CA; 156 identified as Chamorro, Native Hawaiian, or Samoan. Survey items assessed diabetes, CVD, cancer, and obesity. Anthropomorphic measures included height, weight, and waist circumference.

Results: The analysis included 70 Chamorros, 48 Native Hawaiians, and 38 Samoans. Diabetes prevalence was highest among Native Hawaiians (31.4%), followed by Chamorros (27.7%) and Samoans (8.1%); differences were statistically significant, χ2(2, N = 154) = 7.41, = 0.025. CVD prevalence was over 10% among Native Hawaiians and Chamorros compared to Samoans (2.0%). Cancer prevalence among biological relatives of participants over age 40 was highest among Native Hawaiians (57.7%) and Chamorros (45.2%), compared to Samoans (25.0%). CVD and cancer were not statistically significant between groups. BMI, waist circumference, and waist-to-height ratio (WHtR) all averaged at or above standard obesity cutoffs for all groups; however still with significant differences. Ethnicity was not significantly associated with diabetes after controlling for age, gender, and income; however, ethnicity remained significantly associated with BMI, WHtR, and waist circumference.

Discussion: Prevalence of diabetes and obesity differed between Chamorros, Native Hawaiians, and Samoans. Only obesity remained associated with ethnicity after controlling for age, gender, and income. These results suggest further tailoring of interventions to address obesity issues of different NHPI groups. Future studies should continue disaggregating health outcome data and consider ethnic differences, even among the larger NHPI population, to better understand and address health disparities.

Learning Areas:

Biostatistics, economics
Diversity and culture
Public health or related research

Learning Objectives:
Analyze health outcomes within the Native Hawaiian and Pacific Islander (NHPI) community of San Diego. Discuss ethnic differences in health outcomes between different NHPI subgroups (Samoans, Native Hawaiians, and Chamorros). Identify differences in obesity among Samoans, Native Hawaiians, and Chamorros.

Keyword(s): Asian and Pacific Islanders, Community-Based Research (CBPR)

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working with Pacific Islander Community Health (PIC Health) as a graduate research intern for the past year. PIC Health is the first study of its kind to examine NHPI health outcomes within San Diego. As a community based participatory research project, we hope to contribute to the conversation about health outcomes and health disparities between both NHPIs and NHPI ethnicities. We hope to receive feedback to create interventions catered for NHPIs.
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.