Honolulu Advertiser examines diabetes prevalence among native Hawaiians, Asian-American/Pacific islanders

Native Hawaiians have higher rates of diabetes than other Asian-American/Pacific Islanders and are more likely to die at earlier ages from the disease and its complications than whites, the Honolulu Advertiser reports.

About 12% of Native Hawaiians been diagnosed with diabetes, compared with 9% of Japanese-Americans, 8% of Filipino-Americans and 5% of whites, according to the Hawaii Department of Health's 2007 Behavioral Risk Factors Surveillance System survey.

Native Hawaiians also have the highest diabetes mortality rate of any ethnic group in the state at 47 deaths per 100,000 people, compared with 22 per 100,000 for Filipinos; 19 for Japanese; 32 for "other" groups, including Chinese; and seven for whites. Native Hawaiians on average are diagnosed with the disease at age 43, at least five years younger than other ethnic groups, according to the survey. In addition, Native Hawaiians are more than seven times as likely as whites to die from the disease, according to the state health department.

Mele Look, director of community engagement in the University of Hawaii John A. Burns School of Medicine's Department of Native Hawaiian Health, said the disparity can be attributed to differences in diet, physical activity and behavioral choices. Among new immigrants, "diabetes can be a byproduct of their reach for the American Dream, as they adopt Western habits and struggle to assimilate," the Advertiser reports.

Obesity is another contributor to the higher diabetes numbers, the Advertiser reports. Nearly 75% of Native Hawaiians are overweight or obese, compared with about 50% of whites, Filipino-Americans and Japanese-Americans, according to health department surveys. Further, research has shown that some minority groups, including Asian-American/Pacific Islanders, tend to store most of their fat in their stomachs, which increases the risk for developing diabetes, according to the Advertiser. Jane Pelkey, a certified diabetes educator who sees many low-income Filipino and Micronesian immigrants, said, "For many of them, rice is their main staple and that's dangerous for a diabetic."

Look said, "People with lower income have a tendency to eat cheap fast food that's very high in fat. In many communities, especially in the urban core of Honolulu where there are a lot of immigrants, they don't have as much access to fresh fruit and vegetables, or parks where they feel comfortable walking" (Wilson, Honolulu Advertiser, 9/7).