Topic 4: Cultural Competence and Nutrition in Health Promotion

Select an ethnic minority group that is represented in the United States (American Indian/Alaskan Native, Asian American, Black/African American, Hispanic/Latino, Native Hawaiian, or Pacific Islander). Using health information available from Healthy People, the CDC, and other relevant government websites, analyze the health status for this group.

In a paper of 1,000-1,250 words, compare and contrast the health status of your selected minority group to the national average. Include the following:

1. Describe the ethnic minority group selected. Describe the current health status of this group. How do race and ethnicity influence health for this group?
2. What are the health disparities that exist for this group? What are the nutritional challenges for this group?
3. Discuss the barriers to health for this group resulting from culture, socioeconomics, education, and sociopolitical factors.
4. What health promotion activities are often practiced by this group?
5. Describe at least one approach using the three levels of health promotion prevention (primary, secondary, and tertiary) that is likely to be the most effective in a care plan given the unique needs of the minority group you have selected. Provide an explanation of why it might be the most effective choice.
6. What cultural beliefs or practices must be considered when creating a care plan? What cultural theory or model would be best to support culturally competent health promotion for this population? Why?

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

SOLUTION

Health Promotion among Native Hawaiian Minority

The United States population is made up of different people from all over the world, these individuals make up various minority groups represented. One minority group lives more predominately on the west coast of the United States; this group is the Native Hawaiian minority group. Throughout this paper we will discuss the health status of the native Hawaiian minority. The health disparities and nutritional challenges the native Hawaiian people encounter will be reviewed. Barriers that impact their health will be discussed. The most common health promotion approach will be address. Finally, the cultural beliefs that should be considered by health care professionals when working with the native Hawaiian minority will be reviewed.

Health Status of Native Hawaiian Minority

When addressing the Native Hawaiian minority, it includes anyone with origins from Hawaii, Guam, Samoa, or other Pacific Islands. As of 2015, there were 1.3 million Native Hawaiians who call the United States home, which represents about 0.4% of the entire United States population (minorityhealth.hhs.gov, 2018). Of the native Hawaiian population in 2015, 24% or 370,000 resided in the state of Hawaii. Native Hawaiians are found to have higher rates of smoking, alcohol consumption, and obesity (minorityhealth.hhs.gov, 2018). “Other health conditions that are prevalent in this population are [cmppp_restricted] hepatitis B, HIV/AIDS, and tuberculosis” (minorityhealth,hhs.gov, 2018). “It has been found that the leading causes of death are: cancer, heart disease, accidents, stroke, and diabetes” (minorityhealth.hhs.gov, 2018). The native Hawaiian population is at greater risk for multiple different things, due to their diet and physical exercise beliefs.

Health Disparities and Nutritional Challenges for Native Hawaiian

The Native Hawaiian population encounters many health disparities and nutritional challenges. The native Hawaiian population has the second highest rate of mortality from cancer in the United States, diet and obesity which are cancer links are very high in this population (McEligot, 2012). Mental illness is a growing population among the native Hawaiians, it is now at 13.1%, and it has one of the highest incidents of suicide amongst its population (Lynsen, 2018). Obesity is a large issue for this population, and it is linked to their diet and exercise habits (Bryant, 2017). In this population, the lifestyle behaviors are an increase consumption of high sodium, alcohol, smoking, and a lack of physical activity and consumption of fruits and vegetables (Bryant, 2017). Individual’s diets are more focused on fried food with rice and lacking additions of vegetables and fruit (Bryant, 2017).  The obesity in this population puts them at higher risk for cancer, diabetes, hypertension, and other chronic illnesses (Byrant, 2017). Overall, the diet and lack of physical exercise of the native Hawaiian population leads them to having more risks of developing various chronic illnesses.

Barriers That Effect Native Hawaiian’s Health

This population runs into barriers in education, economics, and access to health care. Only 88.8 percent of native Hawaiians have received a high school diploma or higher and 28 percent speak another language than English in their home (minorityhealth.hhs.gov, 2018). In the 2015 census, it was reported that 17.3 percent of native Hawaiians live under the poverty line, and the median income is $60,133 (minorityhealth.hhs.gov, 2018). When it comes to insurance coverage, roughly 66.4 percent of the population is covered by private insurance and 33.4 percent have public health insurance (minorityhealth.hhs.gov, 2018). These number are higher than the average of non-Hispanics with public health insurance and native Hawaiians have a higher percent of individuals not covered by health insurance than non-Hispanics (mintoryhealth.hhs.gov,2018). The native Hawaiian population is less likely to hold a high school diploma or higher degree, will have a lower salary, and more likely to have public health insurance or no insurance at all than other populations in the United States.

Health Promotion Approach

The most important health promotion for the native Hawaiian population is primary prevention. The native Hawaiian population is less likely to seek health care or be unable to access health care, therefore are less likely to use prevention health care. “This group also has little access to cancer prevention and control programs” (minorityhealth.hhs.gov, 2018). When individuals from this population have participated in various diet and exercise studies, they will see improvement in the first weeks, but will have difficulty maintaining the lifestyle changes (Bryant, 2017). Through primary prevention, patients will be educated on their risk factors, screened for risk factors, and educated on prevention steps (Falkner, 2018). Through primary prevention, the patient will learn their baseline and work with a health care professional to create a personal plan of prevention (Falkner, 2018). With a personal prevention plan in place, a patient should feel more responsible and be held accountable for their actions. Although the native Hawaiian population does not have an encouraging history with prevention programs, primary prevention is the best health promotion for the group in order to identify risk, educate the patient, and create personalized care plans.

Cultural Considerations for Native Hawaiian Minority

The native Hawaiian group has a lot of cultural beliefs that should be considered when working with them in the health care setting. They view health has holistic and in balance or “Lokahi”, which means their physical, mental, and spiritual parts are in balance and harmony (geriatrics.standford.edu, 2014). They believe that the physical healing of the body cannot begin until all issues within mental and spiritual body are healed (geriatrics.standford.edu, 2014). It is important for the patient to take responsibility for healing and mend any disputes that have happened in the past (geriatrics.standford.edu, 2014). The population’s social structure focuses primarily on family and the importance of family being involved (geriatrics.standford.edu, 2014). Patient’s from the native Hawaiian minority believe in love, caring and compassion and use that to guide their feelings in the health care setting. When working with a patient, it is important to them to feel respected and involved in the decision-making of their own care (geriatrics.standford.edu, 2014). The native Hawaiian population is focused on balance and peace, they include family in big decisions and expect to be respected while receiving care.

Conclusion

Throughout this paper we discussed the native Hawaiian minority and the various short-comings and expectations they have in a health care setting. The current health status of the minority population was reviewed. The various disparities and nutritional challenge the minority faces were discussed. Next, we reviewed the barriers that this population faces. Following, we discussed the best health promotion methods for the native Hawaiian population. Finally, the minorities cultural beliefs when it comes to health care were reviewed. Although the population has it short falls and challenges, the group has very good support systems and beliefs to help them through challenging times.

Reference

Falkner, A. (2018). Retrieved from https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/3

Lynsen, A. (2014, September 24). Racial and Ethnic Minority Populations. Retrieved from https://www.samhsa.gov/specific-populations/racial-ethnic-minority

McEligot, A. J. (2012, May). Dietary Intakes, Obesity and Health Behaviors in Native Hawaiians Residing in Southern California. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3360080/

Traditional Health Beliefs: Native Hawaiian Values. (2014, March 18). Retrieved from https://geriatrics.stanford.edu/ethnomed/hawaiian_pacific_islander/fund/health_beliefs.html [/cmppp_restricted]