Post on 14-Jan-2017
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